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Sample records for plantar flexor muscle

  1. Effects of plantar-flexor muscle fatigue on the magnitude and regularity of center-of-pressure fluctuations

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    Roerdink, M.; Hlavackova, P.; Vuillerme, N.

    2011-01-01

    Control of bipedal posture is highly automatized but requires attentional investment, the amount of which varies between participants and with postural constraints, such as plantar-flexor muscle fatigue. Elevated attentional demands for standing with fatigued plantar flexors have been demonstrated

  2. Effects of age and sex on the results of an ankle plantar-flexor manual muscle test.

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    Jan, Mei-Hwa; Chai, Huei-Ming; Lin, Yeong-Fwu; Lin, Janice Chien-Ho; Tsai, Li-Ying; Ou, Yu-Chih; Lin, Da-Hon

    2005-10-01

    The ability to perform 20 or more one-leg heel-rises is considered a "normal" grade for muscle strength (force-generating capacity of muscle) of the ankle plantar flexors, regardless of age and sex. Because muscle strength is closely related to age and sex, the "normal" test criterion was re-evaluated in different groups categorized by age and sex. One hundred eighty sedentary volunteers (21-80 years of age) without lower-limb lesions performed as many repetitions of one-leg heel-rise as possible. Lunsford and Perry criteria were used to determine completion of the test. The age and sex of the participants influenced the maximal repetitions of heel-rise, and the repetitions decreased with age and in female subjects. The muscle strength of the ankle plantar flexors, as measured by manual muscle testing, varied with age and sex. Clinicians should consider the variances of age and sex when they perform manual muscle testing of the ankle plantar flexors.

  3. Effect of eccentric training on the plantar flexor muscle-tendon tissue properties.

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    Mahieu, Nele Nathalie; McNair, Peter; Cools, Ann; D'Haen, Caroline; Vandermeulen, Katrien; Witvrouw, Erik

    2008-01-01

    It has been shown that eccentric training can be effective in the rehabilitation of patients with Achilles tendonopathy. The mechanism behind these results is not clear. However, there is evidence that tendons are able to respond to repeated forces by altering their structure and composition, and, thus, their mechanical properties change. In this regard, the objective of the present study was to investigate whether eccentric training affects the mechanical properties of the plantar flexor's muscle-tendon tissue properties. Seventy-four healthy subjects were randomized into two groups: an eccentric training group and a control group. The eccentric training group performed a 6-wk eccentric training program for the calf muscles. Before and after this period, all subjects were evaluated for dorsiflexion range of motion using universal goniometry, passive resistive torque of the plantar flexors, and stiffness of the Achilles tendon. Passive resistive torque was measured during ankle dorsiflexion on an isokinetic dynamometer. Stiffness of the Achilles tendon was assessed using a dynamometer, in combination with ultrasonography. The results of the study reveal that the dorsiflexion range of motion was significantly increased only in the eccentric training group. The eccentric heel drop program also resulted in a significant decrease of the passive resistive torque of the plantar flexors (from 16.423 +/- 0.827 to 12.651 +/- 0.617 N.m). The stiffness of the Achilles tendon did not change significantly as a result of training. These findings provide evidence that an eccentric training program results in changes to some of the mechanical properties of the plantar flexor muscles. These changes were thought to be associated with modifications to structure rather than to stretch tolerance.

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

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    Takahito Suzuki

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

  5. Maximum toe flexor muscle strength and quantitative analysis of human plantar intrinsic and extrinsic muscles by a magnetic resonance imaging technique.

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    Kurihara, Toshiyuki; Yamauchi, Junichiro; Otsuka, Mitsuo; Tottori, Nobuaki; Hashimoto, Takeshi; Isaka, Tadao

    2014-01-01

    The aims of this study were to investigate the relationships between the maximum isometric toe flexor muscle strength (TFS) and cross-sectional area (CSA) of the plantar intrinsic and extrinsic muscles and to identify the major determinant of maximum TFS among CSA of the plantar intrinsic and extrinsic muscles. Twenty six young healthy participants (14 men, 12 women; age, 20.4 ± 1.6 years) volunteered for the study. TFS was measured by a specific designed dynamometer, and CSA of plantar intrinsic and extrinsic muscles were measured using magnetic resonance imaging (MRI). To measure TFS, seated participants optimally gripped the bar with their toes and exerted maximum force on the dynamometer. For each participant, the highest force produced among three trials was used for further analysis. To measure CSA, serial T1-weighted images were acquired. TFS was significantly correlated with CSA of the plantar intrinsic and extrinsic muscles. Stepwise multiple linear regression analyses identified that the major determinant of TFS was CSA of medial parts of plantar intrinsic muscles (flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, lumbricals and abductor hallucis). There was no significant difference between men and women in TFS/CSA. CSA of the plantar intrinsic and extrinsic muscles is one of important factors for determining the maximum TFS in humans.

  6. Resistance exercise prevents plantar flexor deconditioning during bed rest

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    Bamman, M. M.; Hunter, G. R.; Stevens, B. R.; Guilliams, M. E.; Greenisen, M. C.

    1997-01-01

    Because resistance exercise (REX) and unloading induce opposing neuromuscular adaptations, we tested the efficacy of REX against the effects of 14 d of bed rest unloading (BRU) on the plantar flexor muscle group. Sixteen men were randomly assigned to no exercise (NOE, N = 8) or REX (N = 8). REX performed 5 sets x 6-10 repetitions to failure of constant resistance concentric/eccentric plantar flexion every other day during BRU. One-repetition maximum (1RM) strength was tested on the training device. The angle-specific torque-velocity relationship across 5 velocities (0, 0.52, 1.05, 1.75, and 2.97 rad.s-1) and the full range-of-motion power-velocity relationship were assessed on a dynamometer. Torque-position analyses identified strength changes at shortened, neutral, and stretched muscle lengths. Concentric and eccentric contractile work were measured across ten repetitions at 1.05 rad.s-1. Maximal neural activation was measured by surface electromyography (EMG). 1RM decreased 9% in NOE and improved 11% in REX (P joint positions. Concentric (15%) and eccentric (11%) contractile work fell in NOE (P < 0.05) but not in REX. Maximal plantar flexor EMG did not change in either group. In summary, constant resistance concentric/eccentric REX completely prevented plantar flexor performance deconditioning induced by BRU. The reported benefits of REX should prove useful in prescribing exercise for astronauts in microgravity and for patients susceptible to functional decline during bed- or chair-bound hospital stays.

  7. Muscle Shear Moduli Changes and Frequency of Alternate Muscle Activity of Plantar Flexor Synergists Induced by Prolonged Low-Level Contraction

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    Ryota Akagi

    2017-09-01

    Full Text Available During prolonged low-level contractions, synergist muscles are activated in an alternating pattern of activity and silence called as alternate muscle activity. Resting muscle stiffness is considered to increase due to muscle fatigue. Thus, we investigated whether the difference in the extent of fatigue of each plantar flexor synergist corresponded to the difference in the frequency of alternate muscle activity between the synergists using muscle shear modulus as an index of muscle stiffness. Nineteen young men voluntarily participated in this study. The shear moduli of the resting medial and lateral gastrocnemius muscles (MG and LG and soleus muscle (SOL were measured using shear wave ultrasound elastography before and after a 1-h sustained contraction at 10% peak torque during maximal voluntary contraction of isometric plantar flexion. One subject did not accomplish the task and the alternate muscle activity for MG was not found in 2 subjects; therefore, data for 16 subjects were used for further analyses. The magnitude of muscle activation during the fatiguing task was similar in MG and SOL. The percent change in shear modulus before and after the fatiguing task (MG: 16.7 ± 12.0%, SOL: −4.1 ± 13.9%; mean ± standard deviation and the alternate muscle activity during the fatiguing task (MG: 33 [20–51] times, SOL: 30 [17–36] times; median [25th–75th percentile] were significantly higher in MG than in SOL. The contraction-induced change in shear modulus (7.4 ± 20.3% and the alternate muscle activity (37 [20–45] times of LG with the lowest magnitude of muscle activation during the fatiguing task among the plantar flexors were not significantly different from those of the other muscles. These results suggest that the degree of increase in muscle shear modulus induced by prolonged contraction corresponds to the frequency of alternate muscle activity between MG and SOL during prolonged contraction. Thus, it is likely that, compared with

  8. Contributions of foot muscles and plantar fascia morphology to foot posture.

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    Angin, Salih; Mickle, Karen J; Nester, Christopher J

    2018-03-01

    The plantar foot muscles and plantar fascia differ between different foot postures. However, how each individual plantar structure contribute to foot posture has not been explored. The purpose of this study was to investigate the associations between static foot posture and morphology of plantar foot muscles and plantar fascia and thus the contributions of these structures to static foot posture. A total of 111 participants were recruited, 43 were classified as having pes planus and 68 as having normal foot posture using Foot Posture Index assessment tool. Images from the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles, and the calcaneal (PF1), middle (PF2) and metatarsal (PF3) regions of the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. In order of decreasing contribution, PF3 > FHB > FHL > PER > FDB were all associated with FPI and able to explain 69% of the change in FPI scores. PF3 was the highest contributor explaining 52% of increases in FPI score. Decreased thickness was associated with increased FPI score. Smaller cross sectional area (CSA) in FHB and PER muscles explained 20% and 8% of increase in FPI score. Larger CSA of FDB and FHL muscles explained 4% and 14% increase in FPI score respectively. The medial plantar structures and the plantar fascia appear to be the major contributors to static foot posture. Elucidating the individual contribution of multiple muscles of the foot could provide insight about their role in the foot posture. Copyright © 2018. Published by Elsevier B.V.

  9. Potential Relationship between Passive Plantar Flexor Stiffness and Running Performance.

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    Ueno, Hiromasa; Suga, Tadashi; Takao, Kenji; Tanaka, Takahiro; Misaki, Jun; Miyake, Yuto; Nagano, Akinori; Isaka, Tadao

    2018-02-01

    The present study aimed to determine the relationship between passive stiffness of the plantar flexors and running performance in endurance runners. Forty-eight well-trained male endurance runners and 24 untrained male control subjects participated in this study. Plantar flexor stiffness during passive dorsiflexion was calculated from the slope of the linear portion of the torque-angle curve. Of the endurance runners included in the present study, running economy in 28 endurance runners was evaluated by measuring energy cost during three 4-min trials (14, 16, and 18 km/h) of submaximal treadmill running. Passive stiffness of the plantar flexors was significantly higher in endurance runners than in untrained subjects. Moreover, passive plantar flexor stiffness in endurance runners was significantly correlated with a personal best 5000-m race time. Furthermore, passive plantar flexor stiffness in endurance runners was significantly correlated with energy cost during submaximal running at 16 km/h and 18 km/h, and a trend towards such significance was observed at 14 km/h. The present findings suggest that stiffer plantar flexors may help achieve better running performance, with greater running economy, in endurance runners. Therefore, in the clinical setting, passive stiffness of the plantar flexors may be a potential parameter for assessing running performance. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Accurate assessment of in situ isometric contractile properties of hindlimb plantar and dorsal flexor muscle complex of intact mice

    NARCIS (Netherlands)

    Gorselink, M.; Drost, M.R.; Louw, de J.; Willems, P.J.B.; Rosielle, P.C.J.N.; Janssen, J.D.; Vusse, van der G.J.

    2000-01-01

    An isometric torque sensor for measuring in situ contractions of plantar or dorsal flexors of intact mouse hindlimb has been developed and evaluated. With this device, muscle torque can be accurately measured within the range of -14 mN·m to +14 mN·m. Special attention was paid to fixation of the

  11. Acute effects of 15min static or contract-relax stretching modalities on plantar flexors neuromuscular properties.

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    Babault, Nicolas; Kouassi, Blah Y L; Desbrosses, Kevin

    2010-03-01

    The present study aimed to investigate the immediate effects of 15 min static or sub-maximal contract-relax stretching modalities on the neuromuscular properties of plantar flexor muscles. Ten male volunteers were tested before and immediately after 15 min static or contract-relax stretching programs of plantar flexor muscles (20 stretches). Static stretching consisted in 30s stretches to the point of discomfort. For the contract-relax stretching modality, subjects performed 6s sub-maximal isometric plantar flexion before 24s static stretches. Measurements included maximal voluntary isometric torque (MVT) and the corresponding electromyographic activity of soleus (SOL) and medial gastrocnemius (MG) muscles (RMS values), as well as maximal peak torque (Pt) elicited at rest by single supramaximal electrical stimulation of the tibial nerve. After 15 min stretching, significant MVT and SOL RMS decreases were obtained (-6.9+/-11.6% and -6.5+/-15.4%, respectively). No difference was obtained between stretching modalities. Pt remained unchanged after stretching. MG RMS changes were significantly different between stretching modalities (-9.4+/-18.3% and +3.5+/-11.6% after static and contract-relax stretching modalities, respectively). These findings indicated that performing 15 min static or contract-relax stretching had detrimental effects on the torque production capacity of plantar flexor muscles and should be precluded before competition. Mechanisms explaining this alteration seemed to be stretch modality dependent. Copyright 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  12. Are repeated single-limb heel raises and manual muscle testing associated with peak plantar-flexor force in people with inclusion body myositis?

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    Harris-Love, Michael O; Shrader, Joseph A; Davenport, Todd E; Joe, Galen; Rakocevic, Goran; McElroy, Beverly; Dalakas, Marinos

    2014-04-01

    Repeated heel raises have been proposed as a method of ankle plantar-flexor strength testing that circumvents the limitations of manual muscle testing (MMT). The study objective was to examine the relationships among ankle plantar-flexion isometric maximum voluntary contraction (MVC), repeated single-limb heel raises (SLHRs), and MMT in people with myositis. This was a cross-sectional study with a between-group design. The ability to complete 1 SLHR determined group assignment (SLHR group, n=24; no-SLHR group, n=19). Forty-three participants with myositis (13 women; median age=64.9 years) participated. Outcome measures included MVC, predicted MVC, Kendall MMT, and Daniels-Worthingham MMT. The Kendall MMT was unable to detect significant ankle plantar-flexor weakness established by quantitative methods and was unable to discriminate between participants who could and those who could not perform the SLHR task. Ankle plantar-flexion MVC was not associated with the number of heel-raise repetitions in the SLHR group (pseudo R(2)=.13). No significant relationship was observed between MVC values and MMT grades in the SLHR and no-SLHR groups. However, a moderate relationship between MVC values and MMT grades was evident in a combined-group analysis (ρ=.50-.67). The lower half of both MMT grading scales was not represented in the study despite the profound weakness of the participants. Both Kendall MMT and Daniels-Worthingham MMT had limited utility in the assessment of ankle plantar-flexor strength. Repeated SLHRs should not be used as a proxy measure of ankle plantar-flexion MVC in people with myositis.

  13. Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy.

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    Frisk, Rasmus F; Jensen, Peter; Kirk, Henrik; Bouyer, Laurent J; Lorentzen, Jakob; Nielsen, Jens B

    2017-12-01

    Exaggerated sensory activity has been assumed to contribute to functional impairment following lesion of the central motor pathway. However, recent studies have suggested that sensory contribution to muscle activity during gait is reduced in stroke patients and children with cerebral palsy (CP). We investigated whether this also occurs in CP adults and whether daily treadmill training is accompanied by alterations in sensory contribution to muscle activity. Seventeen adults with CP and 12 uninjured individuals participated. The participants walked on a treadmill while a robotized ankle-foot orthosis applied unload perturbations at the ankle, thereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were obtained after 6 wk of gait training. We found that sensory contribution to soleus EMG activation was reduced in CP adults compared with uninjured adults. The lowest contribution of sensory feedback was found in participants with lowest maximal gait speed. This was related to increased ankle plantar flexor stiffness. Six weeks of gait training did not alter the contribution of sensory feedback. We conclude that exaggerated sensory activity is unlikely to contribute to impaired gait in CP adults, because sensory contribution to muscle activity during gait was reduced compared with in uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait so that a larger part of plantar flexor muscle activity must be generated by descending motor commands. NEW & NOTEWORTHY Findings suggest that adults with cerebral palsy have less contribution of sensory feedback to ongoing soleus muscle activation during push-off than uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory

  14. Ultrasound evaluation of foot muscles and plantar fascia in pes planus.

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    Angin, Salih; Crofts, Gillian; Mickle, Karen J; Nester, Christopher J

    2014-01-01

    Multiple intrinsic and extrinsic soft tissue structures that apply forces and support the medial longitudinal arch have been implicated in pes planus. These structures have common functions but their interaction in pes planus is not fully understood. The aim of this study was to compare the cross-sectional area (CSA) and thickness of the intrinsic and extrinsic foot muscles and plantar fascia thickness between normal and pes planus feet. Forty-nine adults with a normal foot posture and 49 individuals with pes planus feet were recruited from a university population. Images of the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles and the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. The CSA and thickness of AbH, FHB and PER muscles were significantly smaller (AbH -12.8% and -6.8%, FHB -8.9% and -7.6%, PER -14.7% and -10%), whilst FDL (28.3% and 15.2%) and FHL (24% and 9.8%) were significantly larger in the pes planus group. The middle (-10.6%) and anterior (-21.7%) portions of the plantar fascia were thinner in pes planus group. Greater CSA and thickness of the extrinsic muscles might reflect compensatory activity to support the MLA if the intrinsic foot muscle function has been compromised by altered foot structure. A thinner plantar fascia suggests reduced load bearing, and regional variations in structure and function in feet with pes planus. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Synergistic co-activation increases the extent of mechanical interaction between rat ankle plantar-flexors

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    Chris Tijs

    2016-09-01

    Full Text Available Force transmission between rat ankle plantar-flexors has been found for physiological muscle lengths and relative positions, but only with all muscles maximally activated. The aims of this study were to assess intermuscular mechanical interactions between ankle plantar-flexors during (i fully passive conditions, (ii excitation of soleus (SO, (iii excitation of lateral gastrocnemius (LG, and (iv during co-activation of SO and LG (SO&LG. We assessed effects of proximal lengthening of LG and plantaris (PL muscles (i.e. simulating knee extension on forces exerted at the distal SO tendon (FSO and on the force difference between the proximal and distal LG+PL tendons (ΔFLG+PL of the rat. LG+PL lengthening increased FSO to a larger extent (p=0.017 during LG excitation (0.0026 N/mm than during fully passive conditions (0.0009 N/mm. Changes in FSO in response to LG+PL lengthening were lower (p=0.002 during SO only excitation (0.0056 N/mm than during SO&LG excitation (0.0101 N/mm. LG+PL lengthening changed ∆FLG+PL to a larger extent (p=0.007 during SO excitation (0.0211 N/mm than during fully passive conditions (0.0157 N/mm. In contrast, changes in ∆FLG+PL in response to LG+PL lengthening during LG excitation (0.0331 N/mm were similar (p=0.161 to that during SO&LG excitation (0.0370 N/mm. In all conditions, changes of FSO were lower than those of ∆FLG+PL. This indicates that muscle forces were transmitted not only between LG+PL and SO, but also between LG+PL and other surrounding structures. In addition, epimuscular myofascial force transmission between rat ankle plantar-flexors was enhanced by muscle activation. However, the magnitude of this interaction was limited.

  16. Effect of knee angle on neuromuscular assessment of plantar flexor muscles: A reliability study

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    Cornu, Christophe; Jubeau, Marc

    2018-01-01

    Introduction This study aimed to determine the intra- and inter-session reliability of neuromuscular assessment of plantar flexor (PF) muscles at three knee angles. Methods Twelve young adults were tested for three knee angles (90°, 30° and 0°) and at three time points separated by 1 hour (intra-session) and 7 days (inter-session). Electrical (H reflex, M wave) and mechanical (evoked and maximal voluntary torque, activation level) parameters were measured on the PF muscles. Intraclass correlation coefficients (ICC) and coefficients of variation were calculated to determine intra- and inter-session reliability. Results The mechanical measurements presented excellent (ICC>0.75) intra- and inter-session reliabilities regardless of the knee angle considered. The reliability of electrical measurements was better for the 90° knee angle compared to the 0° and 30° angles. Conclusions Changes in the knee angle may influence the reliability of neuromuscular assessments, which indicates the importance of considering the knee angle to collect consistent outcomes on the PF muscles. PMID:29596480

  17. The Artificial Gravity Bed Rest Pilot Project: Effects on Knee Extensor and Plantar Flexor Muscle Groups

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    Caiozzo, V. J.; Haddad, F.; Lee, S.; Baker, M.; Baldwin, K. M.

    2007-01-01

    The goal of this project was to examine the effects of artificial gravity (2.5 g) on skeletal muscle strength and key anabolic/catabolic markers known to regulate muscle mass. Two groups of subjects were selected for study: 1) a 21 day-bed rest (BR) control (C) group (N=7); and 2) an AG group (N=8), which was exposed to 21 days of bed-rest plus daily 1 hr exposures to AG (2.5 g). This particular experiment was part of an integrated AG Pilot Project sponsored by NASA/Johnson Space Center. The in vivo torque-velocity relationships of the knee extensors and plantar flexors of the ankle were determined pre and post treatment. Also, pre- and post treatment biopsy samples were obtained from both the vastus lateralis and soleus muscles and were used, in part, for a series of analyses on gene expression (mRNA abundance) of key factors implicated in the anabolic versus catabolic state of the muscle. Post/Pre toque-velocity determinations revealed greater decrements in knee extensor performance in the C versus AG group (P less than 0.04). The plantar flexor muscle group of the AG subjects actually demonstrated a net gain in torque-velocity relationship; whereas, in the C group the overall post/pre responses declined (AG vs C; P less than 0.001). Measurements of muscle fiber cross-sectional area (for both muscles) demonstrated a loss of approx. 20% in the C group while no losses were evident in the AG group. RT-PCR analyses of muscle biopsy specimens demonstrated that markers of growth and cytoskeletal integrity (IGF-1, IGF-1 BP4, mechano growth factor, total RNA, and pro-collagen 3a) were higher in the AG group, whereas catabolic markers (myostatin and atrogen) were elevated in the C group. Importantly, these patterns were seen in both muscles. Based on these observations we conclude that paradigms of AG have the potential to maintain the functional, biochemical, and structural homeostasis of skeletal muscle in the face of chronic unloading states. These findings also

  18. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

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    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

  19. Impact of the difference in the plantar flexor strength of the ankle joint in the affected side among hemiplegic patients on the plantar pressure and walking asymmetry.

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    You, Young Youl; Chung, Sin Ho; Lee, Hyung Jin

    2016-11-01

    [Purpose] This study was to examine the changes in the gait lines and plantar pressures in static and dynamic circumstances, according to the differences in the strengths of the plantar flexors in the ankle joints on the affected sides of hemiplegic patients, and to determine their impacts on walking symmetry. [Subjects and Methods] A total of thirty hospitalized stroke patients suffering from hemiplegia were selected in this study. The subjects had ankylosing patterns in the ankle joints of the affected sides. Fifteen of the patients had plantar flexor manual muscle testing scores between poor and fair, while fifteen of the patients had zero and trace. [Results] The contact pattern of the plantar surface with the ground is a reliable method for walking analysis, which is an important index for understanding the ankle mechanism and the relationship between the plantar surface and the ground. [Conclusion] The functional improvement of patients with stroke could be supported through a verification of the analysis methods of the therapy strategy and walking pattern.

  20. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic children with cerebral palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Andersen, Jacob Buus; Sinkjær, Thomas

    2014-01-01

    abolished in control children, but not in children with CP. Removal of sensory feedback to the soleus muscle in stance by shortening the plantar flexors produced a drop in soleus EMG activity of a similar size and latency in control children and children with CP. Soleus EMG activity was observed in swing...... to foot drop and toe walking....

  1. The epidemiology and clinical manifestations of hamstring muscle and plantar foot flexor shortening.

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    Joźwiak, M; Pietrzak, S; Tobjasz, F

    1997-07-01

    A population of 920 healthy children was studied with the aim of assessing the incidence of hamstring muscle and plantar foot flexor tightness, and to correlate such symptoms with gait, posture, and low back discomfort or pain. Special attention was paid to the popliteal angle and dorsal foot flexion. The borderline values for the popliteal angle in the following age groups were, boys: 3 to 5 years, 40 degrees; 6 to 15 years, 50 degrees; and 16 to 19 years, 40 degrees; girls: 3 to 5 years, 30 degrees; 6 to 14 years, 45 degrees; 15 to 19 years, 30 degrees. The borderline values for dorsal foot flexion in the following age groups were 3 to 4 years, 7 degrees; 5 to 13 years, 10 degrees; and 14 to 19 years, 5 degrees. The results obtained indicate a natural increase in hamstring tightness, particularly shortly before the pubertal growth spurt. This seems to be linked with the natural evolution of lumbar lordosis and pelvic tilt. When hamstring tightness surpassed borderline values, dorsiflexion and lumbar lordosis decreased leading to postural deformities, bending-forward deficit, discomfort when sitting, and a shambling gait.

  2. Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults.

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    Anderson, Dennis E; Madigan, Michael L

    2014-03-21

    Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Plantar flexor stretch reflex responses to whole body loading/unloading during human walking

    DEFF Research Database (Denmark)

    Grey, Michael James; van Doornik, Johannes; Sinkjær, Thomas

    2002-01-01

    Numerous animal and human studies have shown that afferent information from the periphery contributes to the control of walking. In particular, recent studies have consistently shown that load receptor input is an important element of the locomotion control mechanism. The objective of this study...... perturbation during human walking. Three body load conditions were investigated: normal body load, a 30% increase in body load, and a 30% decrease in body load. Healthy subjects walked on a treadmill at approximately 3.6 km/h with the left ankle attached to a portable stretching device. Dorsiflexion...... strongly to the corrective response of the stretch reflex in the plantar flexor muscles during walking....

  4. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus

    Science.gov (United States)

    Lobo, César Calvo; Marín, Alejandro Garrido; Sanz, David Rodríguez; López, Daniel López; López, Patricia Palomo; Morales, Carlos Romero; Corbalán, Irene Sanz

    2016-01-01

    Abstract A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P plantar fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV. PMID:27828846

  5. Comparison of plantar flexor musculotendinous stiffness, geometry, and architecture in male runners with and without a history of tibial stress fracture.

    Science.gov (United States)

    Pamukoff, Derek N; Blackburn, J Troy

    2015-02-01

    Greater lower extremity joint stiffness may be related to the development of tibial stress fractures in runners. Musculotendinous stiffness is the largest contributor to joint stiffness, but it is unclear what factors contribute to musculotendinous stiffness. The purpose of this study was to compare plantar flexor musculotendinous stiffness, architecture, geometry, and Achilles tendon stiffness between male runners with and without a history of tibial stress fracture. Nineteen healthy runners (age = 21 ± 2.7 years; mass = 68.2 ± 9.3 kg; height = 177.3 ± 6.0 cm) and 19 runners with a history of tibial stress fracture (age = 21 ± 2.9 years; mass = 65.3 ± 6.0 kg; height = 177.2 ± 5.2 cm) were recruited from community running groups and the university's varsity and club cross-country teams. Plantar flexor musculotendinous stiffness was estimated from the damped frequency of oscillatory motion about the ankle follow perturbation. Ultrasound imaging was used to measure architecture and geometry of the medial gastrocnemius. Dependent variables were compared between groups via one-way ANOVAs. Previously injured runners had greater plantar flexor musculotendinous stiffness (P < .001), greater Achilles tendon stiffness (P = .004), and lesser Achilles tendon elongation (P = .003) during maximal isometric contraction compared with healthy runners. No differences were found in muscle thickness, pennation angle, or fascicle length.

  6. The role of human ankle plantar flexor muscle-tendon interaction and architecture in maximal vertical jumping examined in vivo.

    Science.gov (United States)

    Farris, Dominic James; Lichtwark, Glen A; Brown, Nicholas A T; Cresswell, Andrew G

    2016-02-01

    Humans utilise elastic tendons of lower limb muscles to store and return energy during walking, running and jumping. Anuran and insect species use skeletal structures and/or dynamics in conjunction with similarly compliant structures to amplify muscle power output during jumping. We sought to examine whether human jumpers use similar mechanisms to aid elastic energy usage in the plantar flexor muscles during maximal vertical jumping. Ten male athletes performed maximal vertical squat jumps. Three-dimensional motion capture and a musculoskeletal model were used to determine lower limb kinematics that were combined with ground reaction force data in an inverse dynamics analysis. B-mode ultrasound imaging of the lateral gastrocnemius (GAS) and soleus (SOL) muscles was used to measure muscle fascicle lengths and pennation angles during jumping. Our results highlighted that both GAS and SOL utilised stretch and recoil of their series elastic elements (SEEs) in a catapult-like fashion, which likely serves to maximise ankle joint power. The resistance of supporting of body weight allowed initial stretch of both GAS and SOL SEEs. A proximal-to-distal sequence of joint moments and decreasing effective mechanical advantage early in the extension phase of the jumping movement were observed. This facilitated a further stretch of the SEE of the biarticular GAS and delayed recoil of the SOL SEE. However, effective mechanical advantage did not increase late in the jump to aid recoil of elastic tissues. © 2016. Published by The Company of Biologists Ltd.

  7. Postactivation Potentiation of the Plantar Flexors Does Not Directly Translate to Jump Performance in Female Elite Young Soccer Players.

    Science.gov (United States)

    Prieske, Olaf; Maffiuletti, Nicola A; Granacher, Urs

    2018-01-01

    High-intensity muscle actions have the potential to temporarily improve muscle contractile properties (i.e., postactivation potentiation, PAP) thereby inducing acute performance enhancements. There is evidence that balance training can improve performance during strength exercises. Taking these findings together, the purpose of this study was to examine the acute effects of a combined balance and strength (B+S) exercise vs. a strength only (S) exercise on twitch contractile properties, maximum voluntary strength, and jump performance in young athletes. Female elite young soccer players ( N = 12) aged 14-15 years conducted three experimental conditions in randomized order: S included 3 sets of 8-10 dynamic leg extensions at 80% of the 1-repetition maximum, B+S consisted of 3 sets of 40 s double-leg stances on a balance board prior to leg extensions (same as S), and a resting control period. Before and 7 min after exercise, participants were tested for their electrically-evoked isometric twitches (i.e., twitch peak torque, twitch rate of torque development) and maximal voluntary contraction (MVC) torque of the plantar flexor muscles. Additionally, countermovement (CMJ) and drop jump (DJ) performances (i.e., CMJ/DJ height, DJ ground contact time) were assessed. Significant effects of condition on twitch contractile properties ( p jump performance outputs ( p jump performance. It is concluded that PAP effects in the plantar flexors may not directly translate to improved jump performance in female elite young soccer players. Therefore, the observed gains in jump performance following B+S are most likely related to neuromuscular changes (e.g., intramuscular coordination) rather than improved contractile properties.

  8. Healthy Older Adults Have Insufficient Hip Range of Motion and Plantar Flexor Strength to Walk Like Healthy Young Adults

    OpenAIRE

    Anderson, Dennis Earl; Madigan, Michael L.

    2014-01-01

    Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint R...

  9. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus: A case-control study.

    Science.gov (United States)

    Lobo, César Calvo; Marín, Alejandro Garrido; Sanz, David Rodríguez; López, Daniel López; López, Patricia Palomo; Morales, Carlos Romero; Corbalán, Irene Sanz

    2016-11-01

    A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P plantar fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV.

  10. Cortical and spinal excitability during and after lengthening contractions of the human plantar flexor muscles performed with maximal voluntary effort.

    Directory of Open Access Journals (Sweden)

    Daniel Hahn

    Full Text Available This study was designed to investigate the sites of potential specific modulations in the neural control of lengthening and subsequent isometric maximal voluntary contractions (MVCs versus purely isometric MVCs of the plantar flexor muscles, when there is enhanced torque during and following stretch. Ankle joint torque during maximum voluntary plantar flexion was measured by a dynamometer when subjects (n = 10 lay prone on a bench with the right ankle tightly strapped to a foot-plate. Neural control was analysed by comparing soleus motor responses to electrical nerve stimulation (M-wave, V-wave, electrical stimulation of the cervicomedullary junction (CMEP and transcranial magnetic stimulation of the motor cortex (MEP. Enhanced torque of 17 ± 8% and 9 ± 8% was found during and 2.5-3 s after lengthening MVCs, respectively. Cortical and spinal responsiveness was similar to that in isometric conditions during the lengthening MVCs, as shown by unchanged MEPs, CMEPs and V-waves, suggesting that the major voluntary motor pathways are not subject to substantial inhibition. Following the lengthening MVCs, enhanced torque was accompanied by larger MEPs (p ≤ 0.05 and a trend to greater V-waves (p ≤ 0.1. In combination with stable CMEPs, increased MEPs suggest an increase in cortical excitability, and enlarged V-waves indicate greater motoneuronal output or increased stretch reflex excitability. The new results illustrate that neuromotor pathways are altered after lengthening MVCs suggesting that the underlying mechanisms of the enhanced torque are not purely mechanical in nature.

  11. Mechanical performance of artificial pneumatic muscles to power an ankle-foot orthosis.

    Science.gov (United States)

    Gordon, Keith E; Sawicki, Gregory S; Ferris, Daniel P

    2006-01-01

    We developed a powered ankle-foot orthosis that uses artificial pneumatic muscles to produce active plantar flexor torque. The purpose of this study was to quantify the mechanical performance of the orthosis during human walking. Three subjects walked at a range of speeds wearing ankle-foot orthoses with either one or two artificial muscles working in parallel. The orthosis produced similar total peak plantar flexor torque and network across speeds independent of the number of muscles used. The orthosis generated approximately 57% of the peak ankle plantar flexor torque during stance and performed approximately 70% of the positive plantar flexor work done during normal walking. Artificial muscle bandwidth and force-length properties were the two primary factors limiting torque production. The lack of peak force and work differences between single and double muscle conditions can be explained by force-length properties. Subjects altered their ankle kinematics between conditions resulting in changes in artificial muscle length. In the double muscle condition greater plantar flexion yielded shorter artificial muscles lengths and decreased muscle forces. This finding emphasizes the importance of human testing in the design and development of robotic exoskeleton devices for assisting human movement. The results of this study outline the mechanical performance limitations of an ankle-foot orthosis powered by artificial pneumatic muscles. This orthosis could be valuable for gait rehabilitation and for studies investigating neuromechanical control of human walking.

  12. EMG and force production of the flexor hallucis longus muscle in isometric plantarflexion and the push-off phase of walking.

    Science.gov (United States)

    Péter, Annamária; Hegyi, András; Stenroth, Lauri; Finni, Taija; Cronin, Neil J

    2015-09-18

    Large forces are generated under the big toe in the push-off phase of walking. The largest flexor muscle of the big toe is the flexor hallucis longus (FHL), which likely contributes substantially to these forces. This study examined FHL function at different levels of isometric plantarflexion torque and in the push-off phase at different speeds of walking. FHL and calf muscle activity were measured with surface EMG and plantar pressure was recorded with pressure insoles. FHL activity was compared to the activity of the calf muscles. Force and impulse values were calculated under the big toe, and were compared to the entire pressed area of the insole to determine the relative contribution of big toe flexion forces to the ground reaction force. FHL activity increased with increasing plantarflexion torque level (F=2.8, P=0.024) and with increasing walking speed (F=11.608, Ppush-off phase of walking, peak force under the big toe increased at a higher rate than force under the other areas of the plantar surface (F=3.801, P=0.018), implying a greater relative contribution to total force at faster speeds. Moreover, substantial differences were found between isometric plantarflexion and walking concerning FHL activity relative to that of the calf muscles, highlighting the task-dependant behaviour of FHL. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis

    International Nuclear Information System (INIS)

    Abreu, M.R.; Chung, C.B.; Mendes, L.; Mohana-Borges, A.; Trudell, D.; Resnick, D.

    2003-01-01

    To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens.Design and patients. Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that were selected from all the ankle MR examinations performed during the past year. Data derived from these MR examinations were the following: the size of the enthesophyte; its location in relation to the plantar fascia (PF) and flexor muscles; and the thickness and signal of the PF. The corresponding radiographs of the ankles were evaluated at a different time by the same observers for the presence or absence of plantar enthesophytes and, when present, their measurements. A third observer reviewed all the discordant observations of MR imaging and radiographic examinations. Two observers analyzed 22 calcaneal specimens with plantar enthesophytes at an anthropology museum to determine the orientation of each plantar enthesophyte. MR imaging of a cadaveric foot with a plantar enthesophyte with subsequent sagittal sectioning was performed to provide further anatomic understanding.Results. With regard to MR imaging, the mean size of the plantar enthesophytes was 4.41 mm (SD 2.4). Twenty (50%) enthesophytes were located above the PF, 16 (40%) between the fascia and abductor digiti minimi, flexor digitorum brevis and abductor hallucis muscles, and only one (3%) was located within the PF. In three (8%) cases the location was not determined. The size of enthesophytes seen with MR imaging and radiographs was highly correlated (P 0.8, kappa >0.9). Eleven of the 22 bone specimens had plantar enthesophytes oriented in the direction of the abductor digiti minimi and 11 oriented in the direction of the flexor digitorum brevis and PF. The cadaveric sections revealed different

  14. Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, M.R.; Chung, C.B.; Mendes, L.; Mohana-Borges, A.; Trudell, D.; Resnick, D. [Department of Radiology, Musculoskeletal Section, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161 (United States)

    2003-01-01

    To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens.Design and patients. Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that were selected from all the ankle MR examinations performed during the past year. Data derived from these MR examinations were the following: the size of the enthesophyte; its location in relation to the plantar fascia (PF) and flexor muscles; and the thickness and signal of the PF. The corresponding radiographs of the ankles were evaluated at a different time by the same observers for the presence or absence of plantar enthesophytes and, when present, their measurements. A third observer reviewed all the discordant observations of MR imaging and radiographic examinations. Two observers analyzed 22 calcaneal specimens with plantar enthesophytes at an anthropology museum to determine the orientation of each plantar enthesophyte. MR imaging of a cadaveric foot with a plantar enthesophyte with subsequent sagittal sectioning was performed to provide further anatomic understanding.Results. With regard to MR imaging, the mean size of the plantar enthesophytes was 4.41 mm (SD 2.4). Twenty (50%) enthesophytes were located above the PF, 16 (40%) between the fascia and abductor digiti minimi, flexor digitorum brevis and abductor hallucis muscles, and only one (3%) was located within the PF. In three (8%) cases the location was not determined. The size of enthesophytes seen with MR imaging and radiographs was highly correlated (P<0.01). The interobserver agreement for all measurements was good (Pearson >0.8, kappa >0.9). Eleven of the 22 bone specimens had plantar enthesophytes oriented in the direction of the abductor digiti minimi and 11 oriented in the direction of the

  15. Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy

    Directory of Open Access Journals (Sweden)

    Willems Paul JB

    2009-02-01

    Full Text Available Abstract Background Patients with diabetic polyneuropathy (DPN are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. Methods Three groups of subjects participated: people diagnosed with diabetes without polyneuropathy (DC, people diagnosed with diabetic polyneuropathy (DPN and healthy, age-matched controls (HC. In all subjects isometric strength of plantar and dorsal flexors was assessed. Moreover, joint moments at ankle, knee and hip joints were determined while walking barefoot at a velocity of 1.4 m/s. Simultaneously plantar pressure patterns were measured. Results Compared to HC-subjects, DPN-participants walked with a significantly increased internal plantar flexor moment at the first half of the stance phase. Also in DPN-subjects the maximal braking and propelling force applied to the floor was decreased. Moreover, in DPN-subjects the ratio of forefoot-to-rear foot plantar pressures was increased. Body-mass normalized strength of dorsal flexors showed a trend to be reduced in people with diabetes, both DC and DPN, compared to HC-subjects. Plantar flexors tended to be less weak in DC compared to HC and in DPN relative to DC. Conclusion The results of this study suggest that adverse plantar pressure patterns are associated with redistribution of joint moments, and a consequent reduced capacity to control forward velocity at heel strike.

  16. Quantification of muscle oxygenation and flow of healthy volunteers during cuff occlusion of arm and leg flexor muscles and plantar flexion exercise

    Science.gov (United States)

    Durduran, Turgut; Yu, Guoqiang; Zhou, Chao; Lech, Gwen; Chance, Britton; Yodh, Arjun G.

    2003-07-01

    A hybrid instrument combining near infrared and diffuse correlation spectroscopies was used to measure muscle oxygenation and blood flow dynamics during cuff occlusion and ischemia. Measurements were done on six healthy subjects on their arm and leg flexor muscles. Hemodynamic response was characterized for blood oxygen saturation, total hemoglobin concenration and relative blood flow speed. The characterization allowed us to define the normal response range as well as showing the feasibility of using a hybrid instrument for dynamic measurements.

  17. Tennis in hot and cool conditions decreases the rapid muscle torque production capacity of the knee extensors but not of the plantar flexors

    Science.gov (United States)

    Girard, Olivier; Racinais, Sébastien; Périard, Julien D

    2014-01-01

    Objectives To assess the time course of changes in rapid muscle force/torque production capacity and neuromuscular activity of lower limb muscles in response to prolonged (∼2 h) match-play tennis under heat stress. Methods The rates of torque development (RTD) and electromyographic activity (EMG; ie, root mean square) rise were recorded from 0 to 30, –50, –100 and –200 ms during brief (3–5 s) explosive maximal isometric voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), along with the peak RTD within the entirety of the torque-time curve. These values were recorded in 12 male tennis players before (prematch) and after (postmatch, 24 and 48 h) match-play in HOT (∼37°C) and COOL (∼22°C) conditions. Results The postmatch core temperature was greater in the HOT (∼39.4°C) vs COOL (∼38.7°C) condition (ptorque. Furthermore, the rate of KE EMG activity rise remained unchanged. Conversely, the PF contractile RTD and rate of EMG activity rise were unaffected by the exercise or environmental conditions. Conclusions In the KE, a reduction in maximal torque production capacity following prolonged match-play tennis appears to account for the decrease in the rate of torque development, independent of environmental conditions, while remaining unchanged in the PF. PMID:24668381

  18. Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

    Directory of Open Access Journals (Sweden)

    Logan S. W. Bale

    2017-01-01

    Full Text Available Muscle variants are routinely encountered in the dissection laboratory and in clinical practice and therefore anatomists and clinicians need to be aware of their existence. Here we describe two different accessory muscles identified while performing educational dissection of a 51-year-old male cadaver. Tensor fasciae suralis, a rare muscle variant, was identified bilaterally and accessory flexor digitorum longus, a more common muscle variant, was present unilaterally. Tensor fasciae suralis and accessory flexor digitorum longus are clinically relevant muscle variants. To our knowledge, the coexistence of tensor fasciae suralis and accessory flexor digitorum longus in the same individual has not been reported in either cadaveric or imaging studies.

  19. An ankle-foot orthosis powered by artificial pneumatic muscles.

    Science.gov (United States)

    Ferris, Daniel P; Czerniecki, Joseph M; Hannaford, Blake

    2005-05-01

    We developed a pneumatically powered orthosis for the human ankle joint. The orthosis consisted of a carbon fiber shell, hinge joint, and two artificial pneumatic muscles. One artificial pneumatic muscle provided plantar flexion torque and the second one provided dorsiflexion torque. Computer software adjusted air pressure in each artificial muscle independently so that artificial muscle force was proportional to rectified low-pass-filtered electromyography (EMG) amplitude (i.e., proportional myoelectric control). Tibialis anterior EMG activated the artificial dorsiflexor and soleus EMG activated the artificial plantar flexor. We collected joint kinematic and artificial muscle force data as one healthy participant walked on a treadmill with the orthosis. Peak plantar flexor torque provided by the orthosis was 70 Nm, and peak dorsiflexor torque provided by the orthosis was 38 Nm. The orthosis could be useful for basic science studies on human locomotion or possibly for gait rehabilitation after neurological injury.

  20. Adaptações neuromusculares de flexores dorsais e plantares a duas semanas de imobilização após entorse de tornozelo Dorsiflexor and plantarflexor neuromuscular adaptations at two-week immobilization after ankle sprain

    Directory of Open Access Journals (Sweden)

    Bruno Manfredini Baroni

    2010-10-01

    Full Text Available INTRODUÇÃO: A entorse de tornozelo é uma lesão de alta incidência comumente tratada com períodos de imobilização, levando a adaptações estruturais e funcionais dos músculos atuantes nesta articulação. OBJETIVO: Identificar as adaptações dos músculos flexores dorsais e flexores plantares após duas semanas de imobilização em sujeitos que sofreram entorse de tornozelo. MÉTODOS: Onze indivíduos (seis mulheres e cinco homens acometidos por entorse de tornozelo grau II foram submetidos a 14 dias de imobilização por tala gessada. Após a retirada da imobilização, foram realizadas avaliações bilaterais de (1 perimetria da perna, (2 amplitude de movimento (ADM do tornozelo, (3 torque isométrico máximo de flexores dorsais e flexores plantares em sete ângulos do tornozelo e (4 ativação eletromiográfica dos músculos tibial anterior (TA, sóleo (SO e gastrocnêmio medial (GM. Os resultados obtidos no segmento imobilizado foram comparados com os do segmento saudável contralateral através de um teste t de Student pareado (p INTRODUCTION: Ankle sprains are a kind of injury with high incidence that is usually treated with an immobilization period, leading to structural and functional adaptation in the muscles around this joint. PURPOSE: To identify the dorsiflexor and plantarflexor muscles adaptations after two weeks of immobilization in subjects who suffered ankle sprain. METHODS: Eleven subjects (six women and five men who suffered a second degree ankle sprain underwent 14 days of ankle joint immobilization with a plaster cast. After removal of the plaster cast, the following bilaterally evaluations were obtained: (1 leg circumference; (2 ankle joint range of motion (ROM; (3 maximal isometric torque of plantar and dorsiflexors obtained in seven different angles; and (4 electromyographic signals of the tibialis anterior (TA, gastrocnemius medialis (GM and soleus (SO muscles. Results obtained in the immobilized side were

  1. In vivo fascicle behavior of the flexor hallucis longus muscle at different walking speeds.

    Science.gov (United States)

    Péter, A; Hegyi, A; Finni, T; Cronin, N J

    2017-12-01

    Ankle plantar flexor muscles support and propel the body in the stance phase of locomotion. Besides the triceps surae, flexor hallucis longus muscle (FHL) may also contribute to this role, but very few in vivo studies have examined FHL function during walking. Here, we investigated FHL fascicle behavior at different walking speeds. Ten healthy males walked overground at three different speeds while FHL fascicle length changes were recorded with ultrasound and muscle activity was recorded with surface electromyography (EMG). Fascicle length at heel strike at toe off and at peak EMG activity did not change with speed. Range of FHL fascicle length change (3.5-4.5 and 1.9-2.9 mm on average in stance and push-off phase, respectively), as well as minimum (53.5-54.9 and 53.8-55.7 mm) and maximum (58-58.4 and 56.8-57.7 mm) fascicle length did not change with speed in the stance or push-off phase. Mean fascicle velocity did not change in the stance phase, but increased significantly in the push-off phase between slow and fast walking speeds (P=.021). EMG activity increased significantly in both phases from slow to preferred and preferred to fast speed (P<.02 in all cases). FHL muscle fascicles worked near-isometrically during the whole stance phase (at least during slow walking) and operated at approximately the same length at different walking speeds. FHL and medial gastrocnemius (MG) have similar fiber length to muscle belly length ratios and, according to our results, also exhibit similar fascicle behavior at different walking speeds. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer's muscles)

    Science.gov (United States)

    JONES, M.; ABRAHAMS, P. H.; SAÑUDO, J. R.; CAMPILLO, M.

    1997-01-01

    In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name (Wood, 1868; Macalister, 1875; Testut, 1884; Le Double, 1897). The more frequent of the 2 accessory muscles or ‘accessorius ad pollicem’ was found to arise from the coronoid process of the ulna, coursing distally to attach into the flexor pollicis longus muscle (flexor pollicis longus accessory head, FPLah). The less frequently observed or ‘accessorius ad flexorem profundum digitorum’ was again found to arise from the coronoid process and course to join into the flexor digitorum profundus (flexor digitorum profundus accessory head, FDPah). Since their initial description, they have been examined in further detail by a number of authors (Wood, 1868; Macalister, 1875; Le Double, 1897; Dykes & Anson, 1944; Mangini, 1960; Malhotra et al. 1982; Dellon & McKinnon, 1987; Kida, 1988). These studies, most of them focusing on the FPLah, all show different results of prevalence, origin, insertion, relations and nerve supply. We undertook this study with the aim of providing a more accurate account of the detailed morphology of both accessory muscles because of the above-mentioned inconsistent anatomical descriptions and the lack of information as to important aspects such as vascular supply, morphology (shape and length) and the coexistence of both accessory heads. PMID:9419002

  3. The Impact of Muscle Disuse on Muscle Atrophy in Severely Burned Rats

    Science.gov (United States)

    2010-12-01

    fascia around the opened wound were retracted to make a reservoir to hold warm mineral oil to maintain the temperature between 36.5°C to 37.5°C monitored...EDL) as the representative fast-twitch muscle. The EDL is a dorsi flexor, while the PL is a planter flexor. It is possible, as with HLU, plantar

  4. Effect of strength training on regional hypertrophy of the elbow flexor muscles.

    Science.gov (United States)

    Drummond, Marcos D M; Szmuchrowski, Leszek A; Goulart, Karine N O; Couto, Bruno P

    2016-10-01

    Muscle hypertrophy is the main structural adaptation to strength training. We investigated the chronic effects of strength training on muscle hypertrophy in different regions of the elbow flexor muscles. Eleven untrained men (21.8 ± 1.62 years) underwent magnetic resonance imaging to determine the proximal, medial, distal, and mean cross-sectional areas (CSA) of the elbow flexors. The volunteers completed 12 weeks of strength training. The training protocol consisted of 4 sets of 8-10 maximum repetitions of unilateral elbow flexion. The interval between sets was 120 s. The training frequency was 3 sessions per week. The magnetic resonance images verified the presence of significant and similar hypertrophy in the distal, medial, and proximal portions of the elbow flexor muscles. Muscle hypertrophy may be assessed using only the medial CSA. We should not expect different degrees of hypertrophy among the regions of the elbow flexor muscles. Muscle Nerve 54: 750-755, 2016. © 2016 Wiley Periodicals, Inc.

  5. Postactivation Potentiation of the Plantar Flexors Does Not Directly Translate to Jump Performance in Female Elite Young Soccer Players

    Directory of Open Access Journals (Sweden)

    Olaf Prieske

    2018-03-01

    Full Text Available High-intensity muscle actions have the potential to temporarily improve muscle contractile properties (i.e., postactivation potentiation, PAP thereby inducing acute performance enhancements. There is evidence that balance training can improve performance during strength exercises. Taking these findings together, the purpose of this study was to examine the acute effects of a combined balance and strength (B+S exercise vs. a strength only (S exercise on twitch contractile properties, maximum voluntary strength, and jump performance in young athletes. Female elite young soccer players (N = 12 aged 14–15 years conducted three experimental conditions in randomized order: S included 3 sets of 8–10 dynamic leg extensions at 80% of the 1-repetition maximum, B+S consisted of 3 sets of 40 s double-leg stances on a balance board prior to leg extensions (same as S, and a resting control period. Before and 7 min after exercise, participants were tested for their electrically-evoked isometric twitches (i.e., twitch peak torque, twitch rate of torque development and maximal voluntary contraction (MVC torque of the plantar flexor muscles. Additionally, countermovement (CMJ and drop jump (DJ performances (i.e., CMJ/DJ height, DJ ground contact time were assessed. Significant effects of condition on twitch contractile properties (p < 0.05, d = 1.1 and jump performance outputs (p < 0.05, 1.1 ≤ d ≤ 1.2 were found. Post-hoc tests revealed that S compared to control produced larger PAP for twitch peak torques by trend (p = 0.07, d = 1.8, 33 vs. 21% and significantly larger PAP for twitch rate of torque development (p < 0.05, d = 2.4, 55 vs. 43%. Following B+S compared to control, significant improvements in CMJ height (p < 0.01, d = 1.9, 3% and DJ contact time were found (p < 0.01, d = 2.0, 10%. This study revealed protocol-specific acute performance improvements. While S resulted in significant increases in twitch contractile properties, B+S produced

  6. Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon Associated with the Plantar Capsular Accessory Ossicle at the Interphalangeal Joint of the Great Toe

    Directory of Open Access Journals (Sweden)

    Song Ho Chang

    2017-01-01

    Full Text Available This report presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon associated with the plantar capsular accessory ossicle at the interphalangeal joint of the great toe, which was confirmed by intraoperative observation and was successfully treated with surgical resection of the ossicle. As the plantar capsular accessory ossicle was not visible radiographically due to the lack of ossification, ultrasonography was helpful for diagnosing this disorder.

  7. Accessory muscle of the flexor digitorum superficialis and its clinical implications

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    Edie Benedito Caetano

    Full Text Available ABSTRACT Anatomical variations of the flexor digitorum superficialis (FDS muscle and tendon unit are frequently reported by anatomists and clinicians. Anatomical muscle variations of the FDS and its tendons may include variations of muscle belly, presence of accessory or duplicate tendons, abnormal tendon connections, and absence of muscle or tendon components. Such variations may or may not have clinical implications. This report presents a case not described previously: a unilateral accessory muscle of the flexor digitorum superficialis which was connected by a thick tendon to the flexor digitorum superficialis muscle; it was directed proximally to the insertion of the medial epicondyle of the humerus, next to the superficialis head of the pronator teres muscle. The belly of the accessory muscle was positioned anterior to the median and anterior interosseous nerve. This anatomical variation is known as type V in the classification of Elliot et al. The knowledge of these anatomical variations helps hand surgeons interpret the clinical examination, particularly in the evaluation of patients who have suffered tendon injuries or show sign s of possible peripheral nerve entrapment.

  8. Measurement of fatigue in knee flexor and extensor muscles.

    Science.gov (United States)

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

    2000-04-01

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

  9. Relationship between isometric contraction intensity and muscle hardness assessed by ultrasound strain elastography.

    Science.gov (United States)

    Inami, Takayuki; Tsujimura, Toru; Shimizu, Takuya; Watanabe, Takemasa; Lau, Wing Yin; Nosaka, Kazunori

    2017-05-01

    Ultrasound elastography is used to assess muscle hardness or stiffness; however, no previous studies have validated muscle hardness measures using ultrasound strain elastography (SE). This study investigated the relationship between plantar flexor isometric contraction intensity and gastrocnemius hardness assessed by SE. We hypothesised that the muscle would become harder linearly with an increase in the contraction intensity of the plantar flexors. Fifteen young women (20.1 ± 0.8 years) performed isometric contractions of the ankle plantar flexors at four different intensities (25, 50, 75, 100% of maximal voluntary contraction force: MVC) at 0° plantar flexion. Using SE images, the strain ratio (SR) between the muscle and an acoustic coupler (elastic modulus 22.6 kPa) placed over the skin was calculated (muscle/coupler); pennation angle and muscle thickness were measured for the resting and contracting conditions. SR decreased with increasing contraction intensity from rest (1.28 ± 0.20) to 25% (0.99 ± 0.21), 50% (0.61 ± 0.15), 75% (0.34 ± 0.1) and 100% MVC (0.20 ± 0.05). SR decreased linearly (P < 0.05) with increasing MVC from rest to 75% MVC, but levelled off from 75 and 100% MVC. SR was negatively correlated with pennation angle (r = -0.80, P < 0.01) and muscle thickness ( r= -0.78,  P< 0.01). SR appears to represent muscle hardness changes in response to contraction intensity changes, in the assumption that the gastrocnemius muscle contraction intensity is proportional to the plantar flexion intensity. We concluded that gastrocnemius muscle hardness changes could be validly assessed by SR, and the force-hardness relationship was not linear.

  10. Elbow flexor and extensor muscle weakness in lateral epicondylalgia.

    Science.gov (United States)

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

    2012-05-01

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

  11. Flexor origin slide for contracture of spastic finger flexor muscles: a retrospective study.

    Science.gov (United States)

    Thevenin-Lemoine, Camille; Denormandie, Philippe; Schnitzler, Alexis; Lautridou, Christine; Allieu, Yves; Genêt, François

    2013-03-06

    Contracture of the wrist and extrinsic finger flexor and pronator muscles is a common consequence of central nervous system disorders. The proximal release of the extrinsic flexor and pronator muscles was first described by Page and Scaglietti for a Volkmann contracture. The aim of the present study was to assess the amount of increase in extension and the improvements in global hand function that can be expected following this lengthening procedure in patients with central nervous system disorders. A single-center retrospective review of patients with central nervous system lesions and contractures of the wrist and extrinsic finger flexor and forearm pronator muscles, causing aesthetic, hygienic, or functional impairment, was carried out. The Page-Scaglietti technique was used for all interventions. Before the operation, motor nerve blocks were used to distinguish between spasticity and contractures with surgical intervention only for contractures. The Zancolli and House classifications were used to evaluate improvements. Data from fifty-four hands and fifty patients (thirty-five men and fifteen women) were evaluated. The mean duration of follow-up (and standard deviation) was 26 ± 21 months (range, three to 124 months). The mean gain (and standard deviation) in wrist extension with fingers extended was 67° ± 25° (range, -10° to 110°). Preoperatively, no hands were classified as Zancolli Group 1, whereas twenty-five hands were classified as Zancolli Group 1 at the latest follow-up review. Ten nonfunctional hands (rated as House Group 0 or Group 1) became functional as a supporting hand postoperatively. Zancolli and House classifications increased significantly (p contracture of the intrinsic muscles, which required further intervention. The Page-Scaglietti technique appears to improve range of motion and function in people with wrist and finger contractures due to central nervous system disorders.

  12. Calf-raise senior: a new test for assessment of plantar flexor muscle strength in older adults: protocol, validity, and reliability.

    Science.gov (United States)

    André, Helô-Isa; Carnide, Filomena; Borja, Edgar; Ramalho, Fátima; Santos-Rocha, Rita; Veloso, António P

    2016-01-01

    This study aimed to develop a new field test protocol with a standardized measurement of strength and power in plantar flexor muscles targeted to functionally independent older adults, the calf-raise senior (CRS) test, and also evaluate its reliability and validity. Forty-one subjects aged 65 years and older of both sexes participated in five different cross-sectional studies: 1) pilot (n=12); 2) inter- and intrarater agreement (n=12); 3) construct (n=41); 4) criterion validity (n=33); and 5) test-retest reliability (n=41). Different motion parameters were compared in order to define a specifically designed protocol for seniors. Two raters evaluated each participant twice, and the results of the same individual were compared between raters and participants to assess the interrater and intrarater agreement. The validity and reliability studies involved three testing sessions that lasted 2 weeks, including a battery of functional fitness tests, CRS test in two occasions, accelerometry, and strength assessments in an isokinetic dynamometer. The CRS test presented an excellent test-retest reliability (intraclass correlation coefficient [ICC] =0.90, standard error of measurement =2.0) and interrater reliability (ICC =0.93-0.96), as well as a good intrarater agreement (ICC =0.79-0.84). Participants with better results in the CRS test were younger and presented higher levels of physical activity and functional fitness. A significant association between test results and all strength parameters (isometric, r =0.87, r 2 =0.75; isokinetic, r =0.86, r 2 =0.74; and rate of force development, r =0.77, r 2 =0.59) was shown. This study was successful in demonstrating that the CRS test can meet the scientific criteria of validity and reliability. The test can be a good indicator of ankle strength in older adults and proved to discriminate significantly between individuals with improved functionality and levels of physical activity.

  13. Muscle function and fatigability of trunk flexors in males and females.

    Science.gov (United States)

    Deering, Rita E; Senefeld, Jonathon W; Pashibin, Tatyana; Neumann, Donald A; Hunter, Sandra K

    2017-01-01

    Optimal function of the abdominal muscles is necessary for several life functions including lifting and carrying tasks. Sex differences in strength and fatigability are established for many limb muscles and back extensor muscles, but it is unknown if sex differences exist for the abdominal muscles despite their functional importance. Eighteen females (24.3 ± 4.8 years) and 15 males (24.1 ± 6.6 years) performed (1) isometric trunk flexion maximal voluntary contractions (MVCs) in a range of trunk positions to establish a torque-angle curve and (2) submaximal (50% MVC), intermittent isometric contraction (6 s on, 4 s off) until task failure to determine fatigability of the trunk flexor muscles. Dual X-ray absorptiometry quantified body fat and lean mass. Physical activity levels were quantified with a questionnaire. Torque-angle curves, electromyography (EMG), MVC torque, and torque steadiness were compared with repeated measures ANOVA with sex as a between-subjects factor. For the torque-angle curve, MVC torque was reduced as the trunk angle increased toward flexion ( p    0.05). Time-to-task failure for the submaximal fatigability task in upright sitting was similar between males and females (12.4 ± 7 vs 10.5 ± 6 min). Time-to-task failure was positively associated with strength ( r  = 0.473, p  = 0.005) and self-reported physical activity ( r  = 0.456, p  = 0.030). Lean mass in the trunk was positively associated with trunk flexor strength ( r  = 0.378, p  = 0.011) and self-reported physical activity ( r  = 0.486, p  = 0.007). Finally, torque steadiness [coefficient of variation of torque (CV)] during submaximal isometric contractions decreased with contraction intensity and was similar for males and females across all intensities. Unlike many limb muscle groups, males and females had similar fatigability and torque steadiness of the trunk flexor muscles during isometric contractions. Stronger individuals

  14. Investigation Of Wrist Flexor/Extensor Muscle Strength Following Arthroscopic Surgical Treatment Of Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    Mustafa Onur SERBEST

    2016-03-01

    Full Text Available Objective: Lateral epicondylitis is a common disease of elbow joint. Repetitive wrist activities and activities that requires strength are risk factors. Wrist extensor muscle strength are decreased in patients with lateral epicondylitis. Materials and Methods: Eight patients with a diagnosis of lateral epicondylitis enrolled to study. Wrist flexor and extensor muscle strength of patients who were completed one year after surgery were measured by isokinetic dynamometer. Results: There were no statistically significant differences between the flexor and extensor muscle strength of the patients (p>0.05. Conclusion: In this study, arthroscopic extensor carpi radialis brevis tendon release in lateral epicondylitis has shown no negative effect on flexor and extensor wrist muscle stregth.

  15. The relationship between exercise-induced muscle fatigue, arterial blood flow and muscle perfusion after 56 days local muscle unloading.

    Science.gov (United States)

    Weber, Tobias; Ducos, Michel; Mulder, Edwin; Beijer, Åsa; Herrera, Frankyn; Zange, Jochen; Degens, Hans; Bloch, Wilhelm; Rittweger, Jörn

    2014-05-01

    In the light of the dynamic nature of habitual plantar flexor activity, we utilized an incremental isokinetic exercise test (IIET) to assess the work-related power deficit (WoRPD) as a measure for exercise-induced muscle fatigue before and after prolonged calf muscle unloading and in relation to arterial blood flow and muscle perfusion. Eleven male subjects (31 ± 6 years) wore the HEPHAISTOS unloading orthosis unilaterally for 56 days. It allows habitual ambulation while greatly reducing plantar flexor activity and torque production. Endpoint measurements encompassed arterial blood flow, measured in the femoral artery using Doppler ultrasound, oxygenation of the soleus muscle assessed by near-infrared spectroscopy, lactate concentrations determined in capillary blood and muscle activity using soleus muscle surface electromyography. Furthermore, soleus muscle biopsies were taken to investigate morphological muscle changes. After the intervention, maximal isokinetic torque was reduced by 23·4 ± 8·2% (Pflow, tissue oxygenation, lactate concentrations and EMG median frequency kinematics during the exercise test were comparable before and after the intervention, whereas the increase of RMS in response to IIET was less following the intervention (P = 0·03). In conclusion, following submaximal isokinetic muscle work exercise-induced muscle fatigue is unaffected after prolonged local muscle unloading. The observation that arterial blood flow was maintained may underlie the unchanged fatigability. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  16. Intra-subject variability in muscle activity and co-contraction during jumps and landings in children and adults

    DEFF Research Database (Denmark)

    Raffalt, P C; Alkjaer, T; Simonsen, E B

    2017-01-01

    -subject variability in the muscle activity. Co-contraction was quantified for two thigh muscle pairs and one plantar flexor/dorsiflexor muscle pair and group differences were assessed (two-way ANOVA). No significant differences were observed in the less eccentric demanding CMJ while significantly higher muscle...

  17. Anatomical Study of the Neurovascular in Flexor Hallucis Longus Tendon Transfers.

    Science.gov (United States)

    Mao, Haijiao; Dong, Wenwei; Shi, Zengyuan; Yin, Weigang; Xu, Dachuan; Wapner, Keith L

    2017-10-27

    The transfer of the flexor hallucis longus tendon or flexor digitorum longus tendon is frequently used for the treatment of posterior tibial tendon insufficiency or chronic Achilles tendinopathy. According to several anatomical studies, harvesting the flexor hallucis longus (FHL) tendon may cause nerve injury. Sixty-eight embalmed feet were dissected and anatomically classified to define the relationship between Henry's knot and the plantar nerves. Two different configurations were identified. In Pattern 1, which was observed in 64 specimens (94.1%), the distance between the medial plantar nerve and Henry's knot was 5.96 mm (range, 3.34 to 7.84, SD = 1.12). In Pattern 2, which was observed in 4 specimens (5.9%), there was no distance between the medial plantar nerve (MPN) and Henry's knot. No statistically significant difference was observed according to gender or side (p > 0.05). A retraction was performed to harvest the FHL through the posteromedial hindfoot incision using a single minimally invasive technique, and the medial and lateral plantar nerve lesions were scrupulously assessed. In conclusion, medial and lateral plantar nerve injuries did not occur more frequently, even after performing a single minimally invasive incision to harvest the FHL tendon, due to the large distance between the FHL tendon and the medial and lateral plantar nerves.

  18. Forearm Flexor Muscles in Children with Cerebral Palsy Are Weak, Thin and Stiff

    Directory of Open Access Journals (Sweden)

    Eva Pontén

    2017-04-01

    Full Text Available Children with cerebral palsy (CP often develop reduced passive range of motion with age. The determining factor underlying this process is believed to be progressive development of contracture in skeletal muscle that likely changes the biomechanics of the joints. Consequently, to identify the underlying mechanisms, we modeled the mechanical characteristics of the forearm flexors acting across the wrist joint. We investigated skeletal muscle strength (Grippit® and passive stiffness and viscosity of the forearm flexors in 15 typically developing (TD children (10 boys/5 girls, mean age 12 years, range 8–18 yrs and nine children with CP Nine children (6 boys/3 girls, mean age 11 ± 3 years (yrs, range 7–15 yrs using the NeuroFlexor® apparatus. The muscle stiffness we estimate and report is the instantaneous mechanical response of the tissue that is independent of reflex activity. Furthermore, we assessed cross-sectional area of the flexor carpi radialis (FCR muscle using ultrasound. Age and body weight did not differ significantly between the two groups. Children with CP had a significantly weaker (−65%, p < 0.01 grip and had smaller cross-sectional area (−43%, p < 0.01 of the FCR muscle. Passive stiffness of the forearm muscles in children with CP was increased 2-fold (p < 0.05 whereas viscosity did not differ significantly between CP and TD children. FCR cross-sectional area correlated to age (R2 = 0.58, p < 0.01, body weight (R2 = 0.92, p < 0.0001 and grip strength (R2 = 0.82, p < 0.0001 in TD children but only to grip strength (R2 = 0.60, p < 0.05 in children with CP. We conclude that children with CP have weaker, thinner, and stiffer forearm flexors as compared to typically developing children.

  19. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain.

    Science.gov (United States)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter; Bojsen-Møller, Jens; Finni, Taija

    2014-07-15

    High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity and Achilles tendon GU. A longitudinal study design with control (n = 10) and patient (n = 10) groups was used. Surface electromyography (SEMG) from four ankle plantar flexors and GU from the same muscles and the Achilles tendon were measured during submaximal intermittent isometric plantar flexion task. The results indicated that the symptomatic leg was weaker (P eccentric rehabilitation. Additionally, the rehabilitation resulted in greater GU in both soleus (P tendon GU than the controls (P effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative activity in the symptomatic leg compared with both the asymptomatic and control legs (P Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle. Copyright © 2014 the American Physiological Society.

  20. Nonoperative, dynamic treatment of acute achilles tendon rupture

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Bencke, Jesper; Lauridsen, Hanne Bloch

    2015-01-01

    Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle-tendon comp......Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle...... in the terminal part of dorsiflexion was found in the non-weightbearing group. The altered stiffness and strength in the affected limb could affect the coordination of gait and running....

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

    Science.gov (United States)

    Zapparoli, Fabricio Yuri; Riberto, Marcelo

    2017-11-01

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

  2. Changes in muscle cross-sectional area, muscle force, and jump performance during 6 weeks of progressive whole-body vibration combined with progressive, high intensity resistance training

    Science.gov (United States)

    Rosenberger, A.; Beijer, Å.; Johannes, B.; Schoenau, E.; Mester, J.; Rittweger, J.; Zange, J.

    2017-01-01

    Objectives: We hypothesized that progressive whole-body vibration (WBV) superimposed to progressive high intensity resistance training has greater effects on muscle cross-sectional area (CSA), muscle force of leg muscles, and jump performance than progressive high intensity resistance training alone. Methods: Two groups of healthy male subjects performed either 6 weeks of Resistive Vibration Exercise (RVE, squats and heel raises with WBV, n=13) or Resistive Exercise (RE, squats and heel raises without WBV, n=13). Squats under RVE required indispensable weight loading on the forefoot to damp harmful vibrations to the head. Time, intervention, and interaction effects were analyzed. Results: After 6 weeks of training, knee extensor CSA, isometric knee extension force, and counter movement jump height increased equally in both groups (time effect, P<0.001, P≤0.02, and P≤0.03, respectively), whereas only in RVE ankle plantar flexor CSA and isometric ankle plantar flexion force reached significance or a tendency, respectively, (time effect, P=0.015 and P=0.069, respectively; intervention effect also for the latter, P=0.006). Drop jump contact time did significantly more improve in RVE (interaction effect, P=0.042). Conclusions: RVE showed better training effects than RE only in plantar flexor muscles. RVE seems to be suitable in professional sports with a special focus on calf muscles. PMID:28574410

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

    Science.gov (United States)

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

    2017-01-01

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

  4. Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls.

    Science.gov (United States)

    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 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Influence of step-height and body mass on gastrocnemius muscle fascicle behavior during stair ascent.

    NARCIS (Netherlands)

    Spanjaard, M.; Reeves, N.D.; van Dieen, J.H.; Baltzopoulos, V.; Maganaris, C.N.

    2008-01-01

    To better understand the role of the ankle plantar flexor muscles in stair negotiation, we examined the effects of manipulation of kinematic and kinetic constraints on the behavior of the gastrocnemius medialis (GM) muscle during stair ascent. Ten subjects ascended a four-step staircase at four

  6. Flexor accessorius longus: A rare variation of the deep extrinsic digital flexors of the leg and its phylogenetic significance

    Directory of Open Access Journals (Sweden)

    Jaijesh P

    2006-01-01

    Full Text Available Anomalies of the calf muscles are rare. One such anomalous muscle, known as the Muscle Flexor accessorius longus (also named accessorius ad accessorium, accessorius secondus, accessory flexor digitorum longus or pronator pedis is of morphological significance. When present, this originates in the deep fascia of the tibia or fibula and inserts in the foot either into the flexor digitorum accessorius or into the tendons of the flexor digitorum longus. In this report we present a discussion of the morphological significance and phylogenetic history of one such muscle observed. In this case report we describe an anomalous calf muscle which extends from the popliteal region, runs along the posterior compartment of the leg, reaches the sole and is inserted to the flexor digitorum longus muscle. This kind of muscle variations are considered to be the higher origin of the flexor digitorum accessorius muscle of the sole. Here we discuss the phylogenetic history of this muscle as this muscle variant is present in some primitive mammals, absent in apes and in this particular case appeared as one of the muscles of the flexor compartment of the leg.

  7. Are Ultrasonographic Measures of Cervical Flexor Muscles Correlated With Flexion Endurance in Chronic Neck Pain and Asymptomatic Participants?

    Science.gov (United States)

    Ghamkhar, Leila; Kahlaee, Amir Hossein

    2017-12-01

    This study compared the relationship between some clinical factors and the size of neck flexors in participants with or without chronic neck pain. In this case-control study, the correlation between flexor endurance capacity as well as thickness, cross-section area, and shape ratio of longus colli/capitis and sternocleidomastoid muscles were examined in 30 patients with chronic neck pain and 30 asymptomatic participants. The patients showed lower flexor endurance (P = 0.02), smaller thickness (P = 0.03), and cross-section area (P pain. In the control group, flexor endurance was negatively correlated with longus colli shape ratio (r = -0.45, P = 0.01) but positively correlated with longus capitis thickness (r = 0.45, P = 0.01) and cross-section area (r = 0.38, P = 0.03). Neck disability and pain intensity indices were not significantly correlated with either flexor muscles endurance or size. The ultrasonographic measures of the deep neck flexor muscles and the flexor endurance test, being associated with each other, could successfully differentiate patients with chronic neck pain from asymptomatic participants. However, the endurance test scores were not correlated with self-reported disability or pain intensity indices.

  8. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A Three-Month Study with Proprioceptive Neuromuscular Facilitation

    Directory of Open Access Journals (Sweden)

    Zhihao Zhou

    2016-11-01

    Full Text Available In this paper, we aim to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS. A modified robot-assisted system was proposed and seven post-stroke patients with hemiplegic spastic ankles participated a three-month of robotic PNF training. Their impaired sides were used as the experimental group while their unimpaired sides as the control group. A robotic intervention for the experimental group generally started from a two minutes passive stretching to warm-up or relax the soleus and gastrocnemius muscle and also ended with the same one. Then a PNF training session included 30 trails was activated between them. The rehabilitation trainings were carried out three times a week as an addition of their regular rehabilitation exercise. Passive ankle joint range of motion, resistance torque and stiffness were measured in both ankles before and after the intervention. The changes in Achilles' tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the three months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased ( p0.05 . The robotic rehabilitation also improved the muscle strength ( p0.05 and fast walking speed ( p<0.05 . These results indicated that PNF based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in post-stroke rehabilitation training.

  9. Desequilíbrios musculares entre flexores dorsais e plantares do tornozelo após tratamento conservador e acelerado da ruptura do tendão calcâneo

    OpenAIRE

    Mayer,Alexandre; Frasson,Viviane Bortoluzzi; Ott,Rafael; Fortuna,Rafael de Oliveira; Vaz,Marco Aurélio

    2010-01-01

    A ruptura do tendão calcâneo (TC) reduz a sobrecarga mecânica dos flexores plantares (FP) do tornozelo. Essa alteração muda o equilíbrio natural entre os FP e flexores dorsais (FD) do tornozelo. O objetivo do estudo foi avaliar as razões isocinéticas concêntricas convencionais de torque de pacientes submetidos a tratamento cirúrgico de ruptura aguda do TC após dois protocolos diferentes de reabilitação. Após procedimento cirúrgico para reconstrução do TC, a amostra foi dividida de forma inten...

  10. The ratio of change in muscle thickness between superficial and deep cervical flexor muscles during the craniocervical flexion test and a suggestion regarding clinical treatment of patients with musculoskeletal neck pain.

    Science.gov (United States)

    Goo, Miran; Kim, Seong-Gil; Jun, Deokhoon

    2015-08-01

    [Purpose] The purpose of this study was to identify the imbalance of muscle recruitment in cervical flexor muscles during the craniocervical flexion test by using ultrasonography and to propose the optimal level of pressure in clinical craniocervical flexion exercise for people with neck pain. [Subjects and Methods] A total of 18 students (9 males and 9 females) with neck pain at D University in Gyeongsangbuk-do, South Korea, participated in this study. The change in muscle thickness in superficial and deep cervical flexor muscles during the craniocervical flexion test was measured using ultrasonography. The ratio of muscle thickness changes between superficial and deep muscles during the test were obtained to interpret the imbalance of muscle recruitment in cervical flexor muscles. [Results] The muscle thickness ratio of the sternocleidomastoid muscle/deep cervical flexor muscles according to the incremental pressure showed significant differences between 22 mmHg and 24 mmHg, between 24 mmHg and 28 mmHg, between 24 mmHg and 30 mmHg, and between 26 mmHg and 28 mmHg. [Conclusion] Ultrasonography can be applied for examination of cervical flexor muscles in clinical environment, and practical suggestion for intervention exercise of craniocervical flexors can be expected on the pressure level between 24 mmHg and 26 mmHg enabling the smallest activation of the sternocleidomastoid muscle.

  11. Does the Morphology of the Forelimb Flexor Muscles Differ Between Lizards Using Different Habitats?

    Science.gov (United States)

    Lowie, Aurélien; Herrel, Anthony; Abdala, Virginia; Manzano, Adriana S; Fabre, Anne-Claire

    2018-03-01

    Lizards are an interesting group to study how habitat use impacts the morphology of the forelimb because they occupy a great diversity of ecological niches. In this study, we specifically investigated whether habitat use impacts the morphology of the forelimb flexor muscles in lizards. To do so, we performed dissections and quantified the physiological cross sectional area (PCSA), the fiber length, and the mass of four flexor muscles in 21 different species of lizards. Our results show that only the PCSA of the m. flexor carpi radialis is different among lizards with different ecologies (arboreal versus non-arboreal). This difference disappeared, however, when taking phylogeny into account. Arboreal species have a higher m. flexor carpi radialis cross sectional area likely allowing them to flex the wrist more forcefully which may allow them climb and hold on to branches better. In contrast, other muscles are not different between arboreal and non-arboreal species. Further studies focusing on additional anatomical features of the lizard forelimb as well as studies documenting how lizards use the arboreal niche are needed to fully understand how an arboreal life style may constrain limb morphology in lizards. Anat Rec, 301:424-433, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  12. Eccentric muscle damage has variable effects on motor unit recruitment thresholds and discharge patterns in elbow flexor muscles.

    Science.gov (United States)

    Dartnall, Tamara J; Rogasch, Nigel C; Nordstrom, Michael A; Semmler, John G

    2009-07-01

    The purpose of this study was to determine the effect of eccentric muscle damage on recruitment threshold force and repetitive discharge properties of low-threshold motor units. Ten subjects performed four tasks involving isometric contraction of elbow flexors while electromyographic (EMG) data were recorded from human biceps brachii and brachialis muscles. Tasks were 1) maximum voluntary contraction (MVC); 2) constant-force contraction at various submaximal targets; 3) motor unit recruitment threshold task; and 4) minimum motor unit discharge rate task. These tasks were performed on three separate days before, immediately after, and 24 h after eccentric exercise of elbow flexor muscles. MVC force declined (42%) immediately after exercise and remained depressed (29%) 24 h later, indicative of muscle damage. Mean motor unit recruitment threshold for biceps brachii was 8.4+/-4.2% MVC, (n=34) before eccentric exercise, and was reduced by 41% (5.0+/-3.0% MVC, n=34) immediately after and by 39% (5.2+/-2.5% MVC, n=34) 24 h after exercise. No significant changes in motor unit recruitment threshold were observed in the brachialis muscle. However, for the minimum tonic discharge rate task, motor units in both muscles discharged 11% faster (10.8+/-2.0 vs. 9.7+/-1.7 Hz) immediately after (n=29) exercise compared with that before (n=32). The minimum discharge rate variability was greater in brachialis muscle immediately after exercise (13.8+/-3.1%) compared with that before (11.9+/-3.1%) and 24 h after exercise (11.7+/-2.4%). No significant changes in minimum discharge rate variability were observed in the biceps brachii motor units after exercise. These results indicate that muscle damage from eccentric exercise alters motor unit recruitment thresholds for >or=24 h, but the effect is not the same in the different elbow flexor muscles.

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

    Science.gov (United States)

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

    2018-01-01

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

  14. Occasional head of flexor pollicis longus muscle: a study of its morphology and clinical significance.

    Directory of Open Access Journals (Sweden)

    Hemmady M

    1993-01-01

    Full Text Available A cadaveric dissection study of 54 upper extremities to determine the incidence of occurrence, morphology and relations of the occasional head of the flexor pollicis longus muscle is presented. The occasional head of the flexor pollicis longus muscle was found to be present more frequently (66.66% than absent. It mainly arose from the medical epicondyle of the humerus (55.55% and the medial border of the coronoid process of the ulna (16.66%. It was found to be in close association with the median nerve (anteriorly and the anterior interosseous nerve (posteriorly. The clinical implications of these findings are discussed viz. entrapment neuropathies of the median and anterior interosseous nerves, cicatricial contraction of the occasional head leading to flexion deformity of the thumb and the likely necessity to lengthen/release the occasional head in spastic paralysis of the flexor pollicis longus muscle.

  15. The Reliability of Isometer 2 Device in Measuring of Cervical Flexor and Extensor Muscles Strength

    Directory of Open Access Journals (Sweden)

    Asghar Reza Soltan-Zadeh

    2006-07-01

    Full Text Available Objective: The strength of a group of muscles can be measured by muscle strength test, employing a force measuring instrument. In order to monitor the effectiveness of a therapeutic or training programs we need a reliable technique which is also accurate in repeated measurements. The purpose of this study was to examine the reliability of an isometric neck muscle force measurement device.  Materials & Methods: Thirty seven healthy non athlete subjects (18 males and 19 females, aged 18-25 participated in this analytical study. The maximal isometric contractions of the neck extensor and flexor muscles were measured in different times and different days and by two different testers. A new sensitive “load cell” was applied to our previously designed neck muscle force measurement apparatus. Results: The results of the inter-trail, test retest, and inter rater reliability (0.86 < ICC < 0.98 , 2.2< Sw <5.1 N indicated that the neck muscle force measurements were highly repeatable and less variable between measurements. There were no statistically significant differences in neck muscle force measurements, between times, between days and between retsters. Maximum isometric contractions were significantly higher in males than in the females (p < 0.001. Women’s neck muscle strengths were 30.8% and 46.1% of men in cervical extension and cervical flexion. Conclusion: In this study we used a new model (Isometer 2 of our previous apparatus (Isometer. The isometric strength of neck flexor and extensor muscles which was measured by Isometer 2 appeared to be a reliable and useful method for measuring the force of the neck extensor and flexor muscles.

  16. Plantar pain is not always fasciitis

    Directory of Open Access Journals (Sweden)

    N. Romano

    2017-12-01

    Full Text Available The case is described of a patient with chronic plantar pain, diagnosed as fasciitis, which was not improved by conventional treatment. Magnetic resonance imaging revealed flexor hallucis longus tenosynovitis, which improved after local glucocorticoid injection.

  17. Effect of Active-Assisted Stretching of 30 Seconds and 60 Seconds in Muscle Force

    Directory of Open Access Journals (Sweden)

    Mirian dos Santos Monteiro

    2018-01-01

    Full Text Available This study aims to analyze the interference of the active-assisted stretching technique in muscle strength. Participating in this study were 39 healthy and physically active individuals subdivided into three groups of active-assisted stretching G30 - 30 seconds, G60 - 60 seconds and CG - control. The muscular strength was evaluated using the isokinetic dynamometer, obtaining the analyzed conditions of torque peak, total work and agonist and antagonist relationship of the dorsiflexor and flexor muscles ankle. The values obtained were statistically analyzed by the SPSS from the “t-test for paired sample” (p ≤ 0.05. When analyzing the effect produced by the stretching, it was observed that the 30-second elongation showed a reduction of the average of the muscular torque in all conditions analyzed, with the exception of the relation between the agonist and the left antagonist and the total work of the right plantar flexors, the G60 - 60 seconds group had a reduction in average muscle torque in all conditions analyzed, except for the relation between agonist and left antagonist that obtained an increase in muscle torque and the CG - control group, there was a reduction in the average of the muscular torque in all the analyzed conditions, except for the torque and total work of the left plantar flexor muscles that presented increase. Thus, it can be concluded that there were differences between the groups of active-assisted stretching of 30 and 60 and that the effect produced by stretching did not present a significant reduction of muscle strength.

  18. Mouse Plantar Flexor Muscle Size and Strength After Inactivity and Training

    Science.gov (United States)

    2010-07-01

    atrophy and weakness as a function of the intensity of the train- ing ( 15 ). Although the hind limb suspension resulted in loss of muscle mass in...Muscle Biology Laboratory, Department of Health and Kinesiology , Texas A&M University, College Station, TX, and Gordon L. Warren, Ph.D., Division of

  19. Sonographically guided deep plantar fascia injections: where does the injectate go?

    Science.gov (United States)

    Maida, Eugene; Presley, James C; Murthy, Naveen; Pawlina, Wojciech; Smith, Jay

    2013-08-01

    To determine the distribution of sonographically guided deep plantar fascia injections in an unembalmed cadaveric model. A single experienced operator completed 10 sonographically guided deep plantar fascia injections in 10 unembalmed cadaveric specimens (5 right and 5 left) obtained from 6 donors (2 male and 4 female) aged 49 to 95 years (mean, 77.5 years) with a mean body mass index of 23.2 kg/m(2) (range, 18.4-26.3 kg/m(2)). A 12-3-MHz linear array transducer was used to direct a 22-gauge, 38-mm stainless steel needle deep to the plantar fascia at the anterior aspect of the calcaneus using an in-plane, medial-to-lateral approach. In each case, 1.5 mL of 50% diluted colored latex was injected deep to the plantar fascia. After a minimum of 72 hours, study coinvestigators dissected each specimen to assess injectate placement. All 10 injections accurately placed latex adjacent to the deep side of the plantar fascia at the anterior calcaneus. However, the flexor digitorum brevis (FDB) origin from the plantar fascia variably limited direct latex contact with the plantar fascia, and small amounts of latex interdigitated with the FDB origin in 90% (9 of 10). In all 10 specimens, latex also covered the traversing first branch of the lateral plantar nerve (FBLPN, ie, Baxter nerve) between the FDB and quadratus plantae muscles. No latex was found in the plantar fat pad or plantar fascia in any specimen. Sonographically guided deep plantar fascia injections reliably deliver latex deep to the plantar fascia while avoiding intrafascial injection. However, the extent of direct plantar fascia contact is variable due to the intervening FDB. On the contrary, the traversing FBLPN is reliably covered by the injection. Deep plantar fascia injections may have a role in the management of refractory plantar fasciitis, particularly following failed superficial perifascial or intrafascial injections, in cases of preferential deep plantar fascia involvement, or when entrapment

  20. A new strength assessment to evaluate the association between muscle weakness and gait pathology in children with cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Marije Goudriaan

    Full Text Available The main goal of this validation study was to evaluate whether lower limb muscle weakness and plantar flexor rate of force development (RFD related to altered gait parameters in children with cerebral palsy (CP, when weakness was assessed with maximal voluntary isometric contractions (MVICs in a gait related test position. As a subgoal, we analyzed intra- and intertester reliability of this new strength measurement method.Part 1 -Intra- and intertester reliability were determined with the intra-class correlation coefficient (ICC2,1 in 10 typical developing (TD children (age: 5-15. We collected MVICs in four lower limb muscle groups to define maximum joint torques, as well as plantar flexor RFD. Part 2 -Validity of the strength assessment was explored by analyzing the relations of lower limb joint torques and RFD to a series of kinematic- and kinetic gait features, the GDI (gait deviation index, and the GDI-kinetic in 23 children with CP (GMFCS I-II; age: 5-15 and 23 TD children (age: 5-15 with Spearman's rank correlation coefficients.Part 1 -The best reliability was found for the torque data (Nm, with the highest ICC2,1 (0.951 for knee extension strength (inter and the lowest (0.693 for dorsiflexion strength (intra. For plantar flexor RFD, the most reliable window size was 300 milliseconds (ICC2,1: 0.828 (inter and 0.692 (intra. Part 2 -The children with CP were significantly weaker than the TD children (p <0.001. Weakness of the dorsiflexors and plantar flexors associated with delayed and decreased knee flexion angle during swing, respectively. No other significant correlations were found.While our new strength assessment was reliable, intra-joint correlations between weakness, RFD, and gait deviations were low. However, we found inter-joint associations, reflected by a strong association between plantar- and dorsiflexor weakness, and decreased and delayed knee flexion angle during swing.

  1. Determinants of footwear difficulties in people with plantar heel pain.

    Science.gov (United States)

    Sullivan, Justin; Pappas, Evangelos; Adams, Roger; Crosbie, Jack; Burns, Joshua

    2015-01-01

    Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference -24.4; p footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.

  2. Evaluation of clinical methods for peroneal muscle testing.

    Science.gov (United States)

    Sarig-Bahat, Hilla; Krasovsky, Andrei; Sprecher, Elliot

    2013-03-01

    Manual muscle testing of the peroneal muscles is well accepted as a testing method in musculoskeletal physiotherapy for the assessment of the foot and ankle. The peroneus longus and brevis are primary evertors and secondary plantar flexors of the ankle joint. However, some international textbooks describe them as dorsi flexors, when instructing peroneal muscle testing. The identified variability raised a question whether these educational texts are reflected in the clinical field. The purposes of this study were to investigate what are the methods commonly used in the clinical field for peroneal muscle testing and to evaluate their compatibility with functional anatomy. A cross-sectional study was conducted, using an electronic questionnaire sent to 143 Israeli physiotherapists in the musculoskeletal field. The survey questioned on the anatomical location of manual resistance and the combination of motions resisted. Ninety-seven responses were received. The majority (69%) of respondents related correctly to the peronei as evertors, but asserted that resistance should be located over the dorsal aspect of the fifth metatarsus, thereby disregarding the peroneus longus. Moreover, 38% of the respondents described the peronei as dorsi flexors, rather than plantar flexors. Only 2% selected the correct method of resisting plantarflexion and eversion at the base of the first metatarsus. We consider this technique to be the most compatible with the anatomy of the peroneus longus and brevis. The Fisher-Freeman-Halton test indicated that there was a significant relationship between responses on the questions (P = 0.0253, 95% CI 0.0249-0.0257), thus justifying further correspondence analysis. The correspondence analysis found no clustering of the answers that were compatible with anatomical evidence and were applied in the correct technique, but did demonstrate a common error, resisting dorsiflexion rather than plantarflexion, which was in agreement with the described

  3. Influence of dorsiflexion shoes on neuromuscular fatigue of the plantar flexors after combined tapping-jumping exercises in volleyball players.

    Science.gov (United States)

    Lapole, Thomas; Ahmaidi, Said; Gaillien, Benjamin; Leprêtre, Pierre-Marie

    2013-07-01

    Dorsiflexion shoes could be useful to increase jumping performance. The aim of the present study was to investigate the impact of wearing shoes inducing moderate dorsiflexion (2°) on neuromuscular fatigue induced by volleyball exercises involving multiple stretch-shortening cycles. Squat jump (SJ) and countermovement jump (CMJ) performance, and plantar flexors isometric voluntary and evoked contractile properties were assessed in 10 unfamiliarized trained volleyball players before and after a 10-minute intensive combined tapping-jumping volleyball exercise performed, in blinded randomized conditions, with neutral (0°) or moderate dorsiflexion (2°). No significant difference was observed on SJ performance in neutral and moderate dorsiflexion conditions. However, CMJ height was initially lower with 2° dorsiflexion compared with 0° (p volleyball exercise also induced a significant decrease in maximal voluntary contraction (p volleyball players.

  4. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain

    DEFF Research Database (Denmark)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter

    2014-01-01

    High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity......, while the asymptomatic leg displayed higher uptake for medial gastrocnemius and flexor hallucis longus (P tendon GU than the controls (P effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative...... within- or between-group differences. Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle....

  5. Coexistence of a pectoralis quartus muscle, a supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle.

    Science.gov (United States)

    Song, Halim; Kim, Jinu; Yoon, Sang-Pil

    2018-05-26

    Although anatomical variations in the upper limb are frequent, coexistence of multiple combined variations is rare. During a routine educational dissection at Jeju National University Medical School, three muscular variations were found in a 75-year-old Korean male cadaver, in which a supraclavicular cephalic vein was also found in ipsilateral upper extremity during skinning (Go et al., 2017). Here we describe characteristics of the pectoralis quartus muscle, the supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle, and discuss their coexistence from morphological and embryological points of view.

  6. The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain.

    Science.gov (United States)

    Javanshir, Khodabakhsh; Amiri, Mohsen; Mohseni Bandpei, Mohammad Ali; De las Penas, Cesar Fernandez; Rezasoltani, Asghar

    2015-01-01

    The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain is yet to be demonstrated. The purpose of this study was to assess the effect of two exercise programs; craniocervical flexion (CCF) and cervical flexion (CF), on flexor muscles dimensions in patients with chronic neck pain. Following ethical approval, 60 patients were randomly assigned into either a CCF group or a CF group. Patients in the CCF group were given CCF exercises and those in the CF group received CF exercises. All patients received interventions for a period of ten weeks. Pain intensity and functional disability were assessed using numerical pain rate scale and neck disability index, respectively. Dimensions of longus colli (LC) and sternoclidomastoid (SCM) muscles were measured using ultrasonography (US). All measurements were taken before and after interventions. Following intervention, the CCF group demonstrated a significant increase in LC muscle dimensions including cross sectional area, width and thickness compared with the CF group. A statistically significant increase was found on SCM thickness in the CF group. Following intervention, SCM thickness measurement in the CCF group showed no significant changes. Statistically significant decrease on pain intensity and disability were also found in both groups. Present findings demonstrated that craniocervical flexion program which specifically recruiting deep cervical flexor muscles increased LC muscle dimension significantly and CF program as an endurance training program increased SCM thickness.

  7. Tendons in the plantar aspect of the foot: MR imaging and anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Rodrigo [University of California San Diego, Radiology, San Diego, CA (United States); Fleury Medical Center, Radiology, Sao Paulo, SP (Brazil); Aguiar, Rodrigo; Trudell, Debra; Resnick, Donald [University of California San Diego, Radiology, San Diego, CA (United States)

    2007-02-15

    The purpose of this anatomic imaging study was to illustrate the normal complex anatomy of tendons of the plantar aspect of the ankle and foot using magnetic resonance (MR) imaging with anatomic correlation in cadavers. Seven fresh cadaveric feet (obtained and used according to institutional guidelines, with informed consent from relatives of the deceased) were studied with intermediate-weighted fast-spin-echo MR imaging. For anatomic analysis, cadaveric specimens were sectioned in 3-mm-thick slices in the coronal and axial planes that approximated the sections acquired at MR imaging. The entire courses of the tendons into the plantar aspect of the foot were analyzed. The tibialis posterior tendon has a complex distal insertion. The insertions in the navicular, second, and third cuneiforms bones were identify in all cases using axial and coronal planes. A tendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons was identified in five of our specimens (71%). The coronal plane provided the best evaluation. The peroneus longus tendon changes its direction at three points then obliquely crosses the sole and inserts in the base of the first metatarsal bone and the plantar aspect of the first cuneiform. MR imaging provides detailed information about the anatomy of tendons in the plantar aspect of the ankle and foot. It allows analysis of their insertions and the intertendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons. (orig.)

  8. Flexor Tendon Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... fields From * To * DESCRIPTION The muscles that bend (flex) the fingers are called flexor ...

  9. Voluntary activation of ankle muscles is accompanied by subcortical facilitation of their antagonists

    DEFF Research Database (Denmark)

    Geertsen, Svend S.; Zuur, Abraham Theodoor; Nielsen, Jens B.

    2010-01-01

    Flexion and extension movements are organized reciprocally, so that extensor motoneurones in the spinal cord are inhibited when flexor muscles are active and vice versa. During and just prior to dorsiflexion of the ankle, soleus motoneurones are thus inhibited as evidenced by a depression......) or soleus muscle of the left ankle. TMS was applied to the hotspot of TA and soleus muscles on separate days. Stimuli were delivered prior to and at the beginning of contraction. Soleus MEPs were significantly facilitated when TMS was applied 50 ms prior to onset of plantar flexion. Surprisingly, soleus...... was increased prior to plantar flexion, but not prior to dorsiflexion. These findings suggest that voluntary contraction at the ankle is accompanied by preceding facilitation of antagonists by a subcortical motor programme. This may help to ensure that the direction of movement may be changed quickly...

  10. Age-Related Changes in Dynamic Postural Control and Attentional Demands are Minimally Affected by Local Muscle Fatigue

    Science.gov (United States)

    Remaud, Anthony; Thuong-Cong, Cécile; Bilodeau, Martin

    2016-01-01

    Normal aging results in alterations in the visual, vestibular and somtaosensory systems, which in turn modify the control of balance. Muscle fatigue may exacerbate these age-related changes in sensory and motor functions, and also increase the attentional demands associated with dynamic postural control. The purpose of this study was to investigate the effect of aging on dynamic postural control and posture-related attentional demands before and after a plantar flexor fatigue protocol. Participants (young adults: n = 15; healthy seniors: n = 13) performed a dynamic postural task along the antero-posterior (AP) and the medio-lateral (ML) axes, with and without the addition of a simple reaction time (RT) task. The dynamic postural task consisted in following a moving circle on a computer screen with the representation of the center of pressure (COP). This protocol was repeated before and after a fatigue task where ankle plantar flexor muscles were targeted. The mean COP-target distance and the mean COP velocity were calculated for each trial. Cross-correlation analyses between the COP and target displacements were also performed. RTs were recorded during dual-task trials. Results showed that while young adults adopted an anticipatory control mode to move their COP as close as possible to the target center, seniors adopted a reactive control mode, lagging behind the target center. This resulted in longer COP-target distance and higher COP velocity in the latter group. Concurrently, RT increased more in seniors when switching from static stance to dynamic postural conditions, suggesting potential alterations in the central nervous system (CNS) functions. Finally, plantar flexor muscle fatigue and dual-tasking had only minor effects on dynamic postural control of both young adults and seniors. Future studies should investigate why the fatigue-induced changes in quiet standing postural control do not seem to transfer to dynamic balance tasks. PMID:26834626

  11. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

    Science.gov (United States)

    Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

    2016-07-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage.

  12. [Reconstruction of chronic Achilles tendon rupture with flexor hallucis longus tendon harvested using a minimally invasive technique].

    Science.gov (United States)

    Miao, Xudong; Wu, Yongping; Tao, Huimin; Yang, Disheng

    2011-07-01

    To evaluate the effectiveness of flexor hallucis longus tendon harvested using a minimally invasive technique in reconstruction of chronic Achilles tendon rupture. Between July 2006 and December 2009, 22 patients (22 feet) with chronic Achilles tendon rupture were treated, including 16 males and 6 females with a median age of 48 years (range, 28-65 years). The disease duration was 27-1,025 days (median, 51 days). Twenty-one patients had hooflike movement's history and 1 patient had no obvious inducement. The result of Thompson test was positive in 22 cases. The score was 53.04 +/- 6.75 according to American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. MRI indicated that the gap of the chronic Achilles tendon rupture was 4.2-8.0 cm. A 3 cm-long incision was made vertically in the plantar aspect of the midfoot and a 1 cm-long transverse incision was made in a plantar flexor crease at the base of the great toe to harvest flexor hallucis longus tendon. The flexor hallucis longus tendon was 10.5-13.5 cm longer from tuber calcanei to the end of the Achilles tendon, and then the tendon was fixed to the tuber calcanei using interface screws or anchor nail after they were woven to form reflexed 3-bundle and sutured. Wound healed by first intention in all patients and no early complication occurred. Twenty-two patients were followed up 12-42 months (mean, 16.7 months). At 12 months after operation, The AOFAS ankle and hindfoot score was 92.98 +/- 5.72, showing significant difference when compared with that before operation (t= -40.903, P=0.000). The results were excellent in 18 cases, good in 2 cases, and fair in 2 cases with an excellent and good rate of 90.9%. No sural nerve injury, posterior tibial nerve injury, plantar painful scar, medial plantar nerve injury, and lateral plantar nerve injury occurred. Chronic Achilles tendon rupture reconstruction with flexor hallucis longus tendon harvested using a minimally invasive technique offers a

  13. The effectiveness of combined prescription of ankle–foot orthosis and stretching program for the treatment of recalcitrant plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Rehab A.E. Sallam

    2016-01-01

    Combined prescription of night-stretch ankle–foot orthosis and stretching exercises for plantar flexors and fascia had greater therapeutic effects compared with each treatment alone. Stretching exercises alone are not beneficial in the treatment of recalcitrant plantar fasciitis.

  14. Desequilíbrios musculares entre flexores dorsais e plantares do tornozelo após tratamento conservador e acelerado da ruptura do tendão calcâneo Muscle imbalance between ankle dorsiflexors and plantarflexors after conservative and accelerated treatment of Achilles tendon rupture

    Directory of Open Access Journals (Sweden)

    Alexandre Mayer

    2010-06-01

    Full Text Available A ruptura do tendão calcâneo (TC reduz a sobrecarga mecânica dos flexores plantares (FP do tornozelo. Essa alteração muda o equilíbrio natural entre os FP e flexores dorsais (FD do tornozelo. O objetivo do estudo foi avaliar as razões isocinéticas concêntricas convencionais de torque de pacientes submetidos a tratamento cirúrgico de ruptura aguda do TC após dois protocolos diferentes de reabilitação. Após procedimento cirúrgico para reconstrução do TC, a amostra foi dividida de forma intencional em dois grupos: conservador (GC, 11 homens, 41,3±7,9 anos e grupo acelerado (GA, 13 homens, 43,5±13,7 anos. O GC permaneceu com imobilização gessada no tornozelo por seis semanas (tratamento tradicional, enquanto o GA usou uma órtese robofoot em posição neutra e, após duas semanas, iniciou mobilização e apoio precoce do tornozelo, com reabilitação por seis semanas. Após 3 meses de pós-operatório, a razão do torque concêntrico máximo dos FD pelos FP do tornozelo foi avaliada por dinamômetro isocinético. As razões de torque do lado operado se mantiveram superiores às do lado saudável mesmo após 3 meses de pós-operatório (pAchilles tendon rupture reduces ankle plantarflexor (PF muscles mechanical overload. This change in the ankle joint mechanics changes the natural muscle balance between dorsiflexor (DF and PF muscles. The purpose of this study was to assess such imbalance by concentric conventional isokinetic torque ratios of patients who underwent different rehabilitation protocols after surgical repair of the Achilles tendon. After surgery, subjects were assigned to either a conservative or to an accelerated rehabilitation group. The conservative group (11 men, 41.3±7.9 years old remained with a plaster cast for 6 weeks after surgery. The accelerated group (13 men, 43.5±13,7 years old used a"robofoot" cast for 2 weeks and underwent ankle mobilization and early weight bearing for a period of 6 weeks post

  15. Blood pressure and calf muscle oxygen extraction during plantar flexion exercise in peripheral artery disease.

    Science.gov (United States)

    Luck, J Carter; Miller, Amanda J; Aziz, Faisal; Radtka, John F; Proctor, David N; Leuenberger, Urs A; Sinoway, Lawrence I; Muller, Matthew D

    2017-07-01

    Peripheral artery disease (PAD) is an atherosclerotic vascular disease that affects 200 million people worldwide. Although PAD primarily affects large arteries, it is also associated with microvascular dysfunction, an exaggerated blood pressure (BP) response to exercise, and high cardiovascular mortality. We hypothesized that fatiguing plantar flexion exercise that evokes claudication elicits a greater reduction in skeletal muscle oxygenation (SmO 2 ) and a higher rise in BP in PAD compared with age-matched healthy subjects, but low-intensity steady-state plantar flexion elicits similar responses between groups. In the first experiment, eight patients with PAD and eight healthy controls performed fatiguing plantar flexion exercise (from 0.5 to 7 kg for up to 14 min). In the second experiment, seven patients with PAD and seven healthy controls performed low-intensity plantar flexion exercise (2.0 kg for 14 min). BP, heart rate (HR), and SmO 2 were measured continuously using near-infrared spectroscopy (NIRS). SmO 2 is the ratio of oxygenated hemoglobin to total hemoglobin, expressed as a percent. At fatigue, patients with PAD had a greater increase in mean arterial BP (18 ± 2 vs. vs. 10 ± 2 mmHg, P = 0.029) and HR (14 ± 2 vs. 6 ± 2 beats/min, P = 0.033) and a greater reduction in SmO 2 (-54 ± 10 vs. -12 ± 4%, P = 0.001). However, both groups had similar physiological responses to low-intensity, nonpainful plantar flexion exercise. These data suggest that patients with PAD have altered oxygen uptake and/or utilization during fatiguing exercise coincident with an augmented BP response. NEW & NOTEWORTHY In this laboratory study, patients with peripheral artery disease performed plantar flexion exercise in the supine posture until symptoms of claudication occurred. Relative to age- and sex-matched healthy subjects we found that patients had a higher blood pressure response, a higher heart rate response, and a greater reduction in skeletal muscle oxygenation as

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

    Science.gov (United States)

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

    2014-01-01

    To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community-dwelling elderly women. This was a cross-sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community-dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations. Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P women. © 2013 Japan Geriatrics Society.

  17. Effects of low level laser in the morphology of the skeletal muscle fiber during compensatory hypertrophy in plantar muscle of rats

    Science.gov (United States)

    Terena, Stella Maris Lins; Fernandes, Kristianne Porta Santos; Kalil, Sandra; Alves, Agnelo Neves; Mesquita Ferrari, Raquel Agnelli

    2015-06-01

    The hypertrophy is known as an increase the cross-sectional area of the muscle as a result of a muscular work against an overload, and it is compensatory because the overload is induced by functional elimination of synergistic muscles. The importance of study the compensatory hypertrophy is understand how this process can be influenced by the irradiation with regard to the weight and muscle cross-sectional area, to assist in the rehabilitation process and the effectiveness functional return. The aim was evaluate the effects of low-level laser irradiation on morphological aspects of muscle tissue, comparing the weight and cross-sectional area in rat skeletal muscle. Wistar rats were divided into three groups: control, hypertrophy group without irradiation (right plantar muscle) and hypertrophy group and irradiation (left plantar muscle), both analyzed after 7 and 14 days. The irradiation was performed daily immediately after the surgery. The parameters were: λ = 780nm, beam spot of 0.04 cm2, output power of 40mW, power density of 1W/cm2, energy density of 10J / cm2 and 10s exposure time with a total energy of 3.2 J. The results revealed that low level laser irradiation an increase the weight of the plantaris muscle after 7 and 14 days with a difference of 7.06% and 11.51% respectively. In conclusion, low level laser irradiation has an effect on compensatory hypertrophy to produce increased muscle weight and promoted an increase in cross-sectional area of muscle fibers in the compensatory hypertrophy model after 14 days with parameters cited above.

  18. Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

    Science.gov (United States)

    Yun, Sung Joon; Kim, Moon-Hwan; Weon, Jong-Hyuck; Kim, Young; Jung, Sung-Hoon; Kwon, Oh-Yun

    2016-08-01

    [Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

  19. Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain

    Directory of Open Access Journals (Sweden)

    Arun V. Subbarayalu, PhD

    2017-12-01

    Full Text Available Objectives: Information Technology (IT professionals working with computers gradually develop forward head posture and, as a result, these professionals are susceptible to several neck disorders. This study intended to reveal the relationships between pain intensity, disability, head posture and deep cervical flexor (DCF muscle performance in patients with postural neck pain. Methods: A cross-sectional study was conducted on 84 IT professionals who were diagnosed with postural neck pain. The participants were recruited with a random sampling approach. A Visual Analogue Scale (VAS, the Northwick Park Neck Pain Questionnaire (NPQ, the Modified Head Posture Spinal Curvature Instrument (MHPSCI, and the Stabilizer Pressure Biofeedback Unit were used to measure neck pain intensity, neck disability, head posture, and DCF muscle performance, respectively. Results: The Pearson correlation coefficient revealed a significantly strong positive relationship between the VAS and the NPQ (r = 0.734. The cranio-vertebral (CV angle was found to have a significantly negative correlation with the VAS (r = −0.536 and a weak negative correlation with the NPQ (r = −0.389. Conclusion: This study concluded that a smaller CV angle corresponded to greater neck pain intensity and disability. Furthermore, there is no significant relationship between CV angle and DCF muscle performance, indicating that head posture re-education through postural correction exercises would not completely correct the motor control deficits in DCF muscles. In addition, a suitable exercise regimen that exclusively targets the deep cervical flexor muscle to improve its endurance is warranted. Keywords: Craniovertebral angle, Disability deep cervical flexors muscle performance, Head posture, Postural neck pain

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

    Science.gov (United States)

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

    2017-07-01

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

  1. Comparison in muscle damage between maximal voluntary and electrically evoked isometric contractions of the elbow flexors.

    Science.gov (United States)

    Jubeau, Marc; Muthalib, Makii; Millet, Guillaume Y; Maffiuletti, Nicola A; Nosaka, Kazunori

    2012-02-01

    This study compared between maximal voluntary (VOL) and electrically stimulated (ES) isometric contractions of the elbow flexors for changes in indirect markers of muscle damage to investigate whether ES would induce greater muscle damage than VOL. Twelve non-resistance-trained men (23-39 years) performed VOL with one arm and ES with the contralateral arm separated by 2 weeks in a randomised, counterbalanced order. Both VOL and ES (frequency 75 Hz, pulse duration 250 μs, maximally tolerated intensity) exercises consisted of 50 maximal isometric contractions (4-s on, 15-s off) of the elbow flexors at a long muscle length (160°). Changes in maximal voluntary isometric contraction torque (MVC), range of motion, muscle soreness, pressure pain threshold and serum creatine kinase (CK) activity were measured before, immediately after and 1, 24, 48, 72 and 96 h following exercise. The average peak torque over the 50 isometric contractions was greater (P < 0.05) for VOL (32.9 ± 9.8 N m) than ES (16.9 ± 6.3 N m). MVC decreased greater and recovered slower (P < 0.05) after ES (15% lower than baseline at 96 h) than VOL (full recovery). Serum CK activity increased (P < 0.05) only after ES, and the muscles became more sore and tender after ES than VOL (P < 0.05). These results showed that ES induced greater muscle damage than VOL despite the lower torque output during ES. It seems likely that higher mechanical stress imposed on the activated muscle fibres, due to the specificity of motor unit recruitment in ES, resulted in greater muscle damage.

  2. Is passive stiffness in human muscles related to the elasticity of tendon structures?

    Science.gov (United States)

    Kubo, K; Kanehisa, H; Fukunaga, T

    2001-08-01

    The purpose of this study was to examine in vivo whether passive stiffness in human muscles was related to the elasticity of tendon structures and to performance during stretch-shortening cycle exercise. Passive torque of plantar flexor muscles was measured during passive stretch from 90 degrees (anatomical position) to 65 degrees of dorsiflexion at a constant velocity of 5 degrees.s-1. The slope of the linear portion of the passive torque-angle curve during stretching was defined as the passive stiffness of the muscle. The elongation of the tendon and aponeurosis of the medial gastrocnemius muscle (MG) was directly measured using ultrasonography during ramp isometric plantar flexion up to the voluntary maximum. The relationship between the estimated muscle force of MG and tendon elongation was fitted to a linear regression, the slope of which was defined as the stiffness of the tendon. In addition, the dynamic torques during maximal voluntary concentric plantar flexion with and without prior eccentric contraction were determined at a constant velocity of 120 degrees.s-1. There were no significant correlations between passive stiffness and either the tendon stiffness (r = 0.19, P > 0.05) or the relative increase in torque with prior eccentric contraction (r = -0.19, P > 0.05). However, tendon stiffness was negatively correlated to the relative increase in torque output (r = -0.42, P tendon structures, and had no favourable effect on the muscle performance during stretch-shortening cycle exercise.

  3. Changes of postural control and muscle activation pattern in response to external perturbations after neck flexor fatigue in young subjects with and without chronic neck pain.

    Science.gov (United States)

    Cheng, Chih-Hsiu; Chien, Andy; Hsu, Wei-Li; Yen, Ling-Wei; Lin, Yang-Hua; Cheng, Hsin-Yi Kathy

    2015-03-01

    Previous studies have identified sensorimotor disturbances and greater fatigability of neck muscles in patients with neck pain. The purpose of this study was to investigate the effect of neck pain and neck flexor fatigue on standing balance following postural perturbations. Twenty patients with chronic neck pain (CNP) (24.7±3.6 year-old) and 20 age-matched asymptomatic subjects (22.1±2.2 year-old) were recruited. Subjects stood barefoot on a force plate and experienced backward perturbations before and after neck flexor fatigue. Center of pressure, electromyography of cervical and lumbar muscles, and head/trunk accelerations were recorded. Two-way ANOVA (pain×fatigue) was used for statistical analysis. CNP group showed larger body sway during quiet standing but not during perturbed standing compared with asymptomatic adults. In both groups, neck flexor fatigue resulted in greater body sway during the quiet standing but smaller body sway during perturbed standing, increased neck muscle activations and decreased lumbar muscle activations, as well as increased time to maximal head acceleration. Disturbed balance control was observed in CNP patients during the quiet standing. However, a rigid strategy was used to minimize the postural sway and to protect the head against backward perturbations in both CNP and asymptomatic young adults after neck flexor fatigue. The results facilitate the understanding of how the subjects with chronic neck pain and with neck muscle fatigue deal with the challenging condition. Further studies are needed to verify if such phenomenon could be changed after the intervention of specific flexor muscle retraining and balance control exercises. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Associations of passive muscle stiffness, muscle stretch tolerance, and muscle slack angle with range of motion: individual and sex differences.

    Science.gov (United States)

    Miyamoto, Naokazu; Hirata, Kosuke; Miyamoto-Mikami, Eri; Yasuda, Osamu; Kanehisa, Hiroaki

    2018-05-29

    Joint range of motion (ROM) is an important parameter for athletic performance and muscular injury risk. Nonetheless, a complete description of muscular factors influencing ROM among individuals and between men and women is lacking. We examined whether passive muscle stiffness (evaluated by angle-specific muscle shear modulus), tolerance to muscle stretch (evaluated by muscle shear modulus at end-ROM), and muscle slack angle of the triceps surae are associated with the individual variability and sex difference in dorsiflexion ROM, using ultrasound shear wave elastography. For men, ROM was negatively correlated to passive muscle stiffness of the medial and lateral gastrocnemius in a tensioned state and positively to tolerance to muscle stretch in the medial gastrocnemius. For women, ROM was only positively correlated to tolerance to muscle stretch in all muscles but not correlated to passive muscle stiffness. Muscle slack angle was not correlated to ROM in men and women. Significant sex differences were observed only for dorsiflexion ROM and passive muscle stiffness in a tensioned state. These findings suggest that muscular factors associated with ROM are different between men and women. Furthermore, the sex difference in dorsiflexion ROM might be attributed partly to that in passive muscle stiffness of plantar flexors.

  5. Characteristics of acute groin injuries in the hip flexor muscles - a detailed MRI study in athletes

    DEFF Research Database (Denmark)

    Serner, A; Weir, A; Tol, J L

    2018-01-01

    acute hip flexor muscle injury were included. A total of 156 athletes presented with acute groin pain of which 33 athletes were included, median age 26 years (range 18-35). There were 16 rectus femoris, 12 iliacus, 7 psoas major, 4 sartorius, and 1 tensor fascia latae injury. Rectus femoris injuries...

  6. The influence of training status on the drop in muscle strength after acute exercise

    DEFF Research Database (Denmark)

    Pingel, Jessica; Moerch, L; Kjaer, M

    2009-01-01

    to running exercise immediately after immobilization, the muscle strength of the triceps-surae muscles dropped even further, but just in the immobilized leg (41%; P importance of determining the muscle endurance when evaluating the effect of immobilization on muscle......Skeletal muscles fatigue after exercise, and reductions in maximal force appear. A difference in training status between the legs was introduced by unilateral immobilization of the calf muscles for 2 weeks in young men, who were randomly assigned to two groups, either a RUN group (n = 8......) that was exposed to prolonged exercise (1-h running: individual pace) or a REST group (n = 12) that did no exercise after immobilization. Cross-sectional area (CSA) of the triceps-surae muscles was calculated by magnetic resonance imaging (MRI), and maximal voluntary contraction (MVC) force of the plantar flexors...

  7. Assessment of eccentric exercise-induced muscle damage of the elbow flexors by tensiomyography.

    Science.gov (United States)

    Hunter, Angus M; Galloway, Stuart D R; Smith, Iain J; Tallent, Jamie; Ditroilo, Massimiliano; Fairweather, Malcolm M; Howatson, Glyn

    2012-06-01

    Exercise induced muscle damage (EIMD) impairs maximal torque production which can cause a decline in athletic performance and/or mobility. EIMD is commonly assessed by using maximal voluntary contraction (MVC), creatine kinase (CK) and muscle soreness. We propose as an additional technique, tensiomyography (TMG), recently introduced to measure mechanical and muscle contractile characteristics. The purpose of this study was to determine the validity of TMG in detecting changes in maximal torque following EIMD. Nineteen participants performed eccentric elbow flexions to achieve EIMD on the non- dominant arm and used the dominant elbow flexor as a control. TMG parameters, MVC and rate of torque development (RTD) were measured prior to EIMD and repeated for another six consecutive days. Creatine kinase, muscle soreness and limb girth were also measured during this period. Twenty four hours after inducing EIMD, MVC torque, RTD and TMG maximal displacement had significantly (pTMG recovered to 12%, 24% and 17% of respective pre-EIMD values. In conclusion, as hypothesised TMG maximal displacement significantly followed other standard EIMD responses. This could therefore be useful in detecting muscle damage from impaired muscle function and its recovery following EIMD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Influence of a 12.8-km military load carriage activity on lower limb gait mechanics and muscle activity.

    Science.gov (United States)

    Rice, Hannah; Fallowfield, Joanne; Allsopp, Adrian; Dixon, Sharon

    2017-05-01

    The high stress fracture occurrence in military populations has been associated with frequent load carriage activities. This study aimed to assess the influence of load carriage and of completing a load carriage training activity on gait characteristics. Thirty-two Royal Marine recruits completed a 12.8-km load carriage activity as part of their military training. Data were collected during walking in military boots, pre and post-activity, with and without the additional load (35.5 kg). Ground contact time, lower limb sagittal plane kinematics and kinetics, and electromyographic variables were obtained for each condition. When carrying load, there was increased ground contact time, increased joint flexion and joint moments, and increased plantar flexor and knee extensor muscle activity. Post-activity, there were no changes to kinematic variables, knee extensor moments were reduced, and there was evidence of plantar flexor muscle fatigue. The observed gait changes may be associated with stress fracture development. Practitioner Summary: This study identified gait changes due to load carriage and after a military load carriage training activity. Such activities are associated with lower limb stress fractures. A pre-post study design was used. Gait mechanics changed to a greater extent when carrying load, than after completion of the activity when assessed without load.

  9. Comparative proteomic profiling of soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscles from the mdx mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Carberry, Steven; Brinkmeier, Heinrich; Zhang, Yaxin; Winkler, Claudia K; Ohlendieck, Kay

    2013-09-01

    Duchenne muscular dystrophy is due to genetic abnormalities in the dystrophin gene and represents one of the most frequent genetic childhood diseases. In the X-linked muscular dystrophy (mdx) mouse model of dystrophinopathy, different subtypes of skeletal muscles are affected to a varying degree albeit the same single base substitution within exon 23 of the dystrophin gene. Thus, to determine potential muscle subtype-specific differences in secondary alterations due to a deficiency in dystrophin, in this study, we carried out a comparative histological and proteomic survey of mdx muscles. We intentionally included the skeletal muscles that are often used for studying the pathomechanism of muscular dystrophy. Histological examinations revealed a significantly higher degree of central nucleation in the soleus and extensor digitorum longus muscles compared with the flexor digitorum brevis and interosseus muscles. Muscular hypertrophy of 20-25% was likewise only observed in the soleus and extensor digitorum longus muscles from mdx mice, but not in the flexor digitorum brevis and interosseus muscles. For proteomic analysis, muscle protein extracts were separated by fluorescence two-dimensional (2D) gel electrophoresis. Proteins with a significant change in their expression were identified by mass spectrometry. Proteomic profiling established an altered abundance of 24, 17, 19 and 5 protein species in the dystrophin-deficient soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscle, respectively. The key proteomic findings were verified by immunoblot analysis. The identified proteins are involved in the contraction-relaxation cycle, metabolite transport, muscle metabolism and the cellular stress response. Thus, histological and proteomic profiling of muscle subtypes from mdx mice indicated that distinct skeletal muscles are differentially affected by the loss of the membrane cytoskeletal protein, dystrophin. Varying degrees of perturbed protein

  10. Evaluation of the equine digital flexor tendon sheath using diagnostic ultrasound and contrast radiography

    International Nuclear Information System (INIS)

    Redding, W.R.

    1994-01-01

    This study was designed to evaluate the normal anatomy of the digital flexor tendon sheath using contrast radiography and diagnostic ultrasound. Iodinated contrast medium was injected into eight cadaver limbs and the limbs immediately frozen. Lateromedial and dorsopalmar/plantar radiographs were made. These limps were then cut transversely and proximal to distal radiographs of each slab were made. This cross sectional contrast methodology allowed the visualization of the relative size and shape of the superficial and deep digital flexor tendons as well as the potential space taken by effusions of the digital flexor tendon sheath. The second part of the study used twelve live animals with normal digital flexor tendon sheaths. Ultrasonographic measurement of the structures of the digital flexor tendon sheath at each level were compiled. This documented the ability of diagnostic ultrasound to image: 1) the superficial and deep digital flexor tendons, 2) the proximal and distal ring of the manica flexoria, 3) the straight and oblique sesamoidean ligaments, and 4) the mesotendinous attachments to the superficial and deep flexor tendons. Iodinated contrast medium was then injected into the digital flexor tendon sheath and the ultrasonography repeated. These images were compared with those obtained from contrast radiography and prosections of twenty normal limbs. The iodinated contrast medium enhanced sonographic imaging of the structures of the digital tendon sheath, particularly the abaxial borders of the superficial digital flexor tendon branches and the mesotendinous attachments to the superficial and deep digital flexor tendons

  11. The effect of medial arch support over the plantar pressure and triceps surae muscle strength after prolonged standing

    OpenAIRE

    Hindun Saadah; Deswaty Furqonita; Angela Tulaar

    2015-01-01

    Background: The activity with prolonged standing position is one of the causes of abnormalities in the lower leg and foot. The aim of this study is to discover the effect of medial arch support over the distribution of plantar pressure when standing and walking.Methods: This was an experimental study with pre- and post-design the strength of triceps surae muscle after prolonged standing, was also evaluated in an experimental study with pre- and post-design. Variables of plantar pressure measu...

  12. Lower extremity muscle functions during full squats.

    Science.gov (United States)

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

    2008-11-01

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

  13. A Biomechanical Simulation of the Effect of the Extrinsic Flexor Muscles on Finger Joint Flexion

    Science.gov (United States)

    2001-10-25

    vol. 44, pp. 493-504, 1997. [8] A.B. Leger and T.E. Milner, “The effect of eccentric exercise on intrinsic and reflex stiffness in the human hand...line of action of the tendons and the effective moment arms. After a certain point, the FDP tendon became slack, while the FDS tendon remained...link chain with three revolute joints and four links was created to model the index finger. The tendons from the extrinsic flexor muscles were

  14. Plantar fibromatosis and Dupuytren’s contracture in an adolescent

    Directory of Open Access Journals (Sweden)

    Nikolić Jelena

    2011-01-01

    Full Text Available Background. Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren` s disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose`s disease or plantar fibromatosis is plantar equivalent of Dupuyten`s disease most often affecting middle- aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Case report. We presented a 19-year old adolescent that turned to a plastic surgeon complaining to his small finger contracture. He noticed palmar thickening with nodule over the metacarpophalangeal joint of small finger of his right hand when he was 16 years old. A year later a finger started to band. During physical checkup we noticed plantar nodule that also had his father and grandmother. Magnetic resonance and tumor biopsy confirmed a suspicion on plantar fibromatosis - Ledderhose`s disease. Clinical exam of the hand clearly led to a conclusion that the patient had Dupuytren`s contracture with pretendinous cord over the small finger flexor tendons and lack of extension of proximal interphalangeal (PIP joint. On the extensor side of the PIP joints there were Garrod`s nodes. The patient refused surgical treatment of plantar tumor, but agreed to surgical correction of finger contracture. Conclusion. Despite the fact that Dupuytren`s disease and plantar fibromatosis are diseases of adults, the possibility of conjoint appearance of these forms of fibromatosis in adolescent period of life should be kept in mind especially in patients with strong genetic predisposition.

  15. Case report: accessory head of the deep forearm flexors

    Science.gov (United States)

    JONES, M.; ABRAHAMS, P. H.; SAÑUDO, J. R.

    1997-01-01

    In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name (Wood, 1868; Macalister, 1875) and these have subsequently been reported with variable attachments (Wood, 1868; Macalister, 1875; Turner, 1879; Schäfer & Thane, 1894; Le Double, 1897; Dykes & Anson, 1944; Mangini, 1960; Malhotra et al. 1982; Kida, 1988; Tountas & Bergman, 1993). The accessory heads of the deep flexors of the forearm (Gantzer's muscles) have been described as 2 different small bellies which insert either into FPL or FDP. There are no previous reports which have mentioned the existence of an accessory muscle which inserts into both of the 2 deep flexors of the forearm as in the case presented here. PMID:9306208

  16. Corticospinal excitability of the ankle extensor muscles is enhanced in ballet dancers.

    Science.gov (United States)

    Saito, Sakiko; Obata, Hiroki; Endoh, Takashi; Kuno-Mizumura, Mayumi; Nakazawa, Kimitaka

    2014-09-01

    We tested the corticospinal excitability of the soleus muscle in ballet dancers to clarify whether the presumed long-term repetition of the specific plantarflexion results in changes of excitability in this neural pathway. We compared motor evoked potentials of the soleus muscle at rest and during isometric contraction of the plantar flexors in dancers and non-dancers. The amplitudes of motor evoked potentials elicited by transcranial magnetic stimulation during contraction were examined against the background electromyographic activity. A regression line was calculated for each subject. Results showed that the slope of the regression line is significantly greater in the dancer group than in the control group, suggesting that the corticospinal tract of ballet dancers has adapted to long-term repetition of plantarflexion in daily ballet training.

  17. The effect of medial arch support over the plantar pressure and triceps surae muscle strength after prolonged standing

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    Hindun Saadah

    2015-11-01

    Full Text Available Background: The activity with prolonged standing position is one of the causes of abnormalities in the lower leg and foot. The aim of this study is to discover the effect of medial arch support over the distribution of plantar pressure when standing and walking.Methods: This was an experimental study with pre- and post-design the strength of triceps surae muscle after prolonged standing, was also evaluated in an experimental study with pre- and post-design. Variables of plantar pressure measurement are the contact area and pressure peak were measured by using the Mat-scan tool. The measurement of the triceps surae muscle strength was done with a hand-held dynamometer, before and after using the medial arch support. Measurement was performed before and after working with prolonged standing position which took place about seven hours using the medial arch support inserted in the shoes. Data was analyzed using paired T-test.Results: There was a significant difference of peak pressure between standing (p = 0.041 and walking (p = 0.001. Whereas the contact area showed a significant decrease in the width of the contact area when standing (104.12 ± 12.42 vs 99.08 ± 10.21 p = 0.023. Whereas, the triceps surae muscle strength pre- and post-standing prolonged did not indicate a significant difference.Conclusion: There was decrease in peak pressure when standing and walking and decrease in contact area when standing on plantar after used of the medial arch support after prolonged standing.

  18. Sex differences in muscle morphology of the knee flexors and knee extensors.

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    Fearghal P Behan

    Full Text Available Females experience higher risk of anterior cruciate ligament (ACL injuries; males experience higher risk of hamstring strain injuries. Differences in injury may be partially due to sex differences in knee flexor (KF to knee extensor (KE muscle size ratio and the proportional size of constituent muscles.To compare the absolute and proportional size, and mass distribution, of individual KE and KF muscles, as well as overall size and balance (size ratio of these muscle groups between the sexes.T1-weighted axial plane MR images (1.5T of healthy untrained young males and females (32 vs 34 were acquired to determine thigh muscle anatomical cross-sectional area (ACSA. Maximal ACSA (ACSAmax of constituent muscles, summated for KF and KE muscle groups, and the KF:KE ratio were calculated.Females had 25.3% smaller KE ACSAmax (70.9±12.1 vs 93.6±10.3 cm2; P<0.001 and 29.6% smaller KF ACSAmax than males (38.8±7.3cm2 vs 55.1±7.3cm2; P<0.001. Consequently, females had lower KF:KE ACSA ratio (P = 0.031. There were sex differences in the proportional size of 2/4 KE and 5/6 KF. In females, vastus lateralis (VL, biceps femoris long-head (BFlh and semimembranosus (SM were a greater proportion and sartorius (SA, gracilis (GR and biceps femoris short-head (BFsh a smaller proportion of their respective muscle groups compared to males (All P<0.05.Sex differences in KF:KE ACSAmax ratio may contribute to increased risk of ACL injury in females. Sex discrepancies in absolute and proportional size of SA, GR, VL and BFlh may contribute further anatomical explanations for sex differences in injury incidence.

  19. Correlation of single-breath count test and neck flexor muscle strength with spirometry in myasthenia gravis.

    Science.gov (United States)

    Elsheikh, Bakri; Arnold, W David; Gharibshahi, Shahram; Reynolds, Jerold; Freimer, Miriam; Kissel, John T

    2016-01-01

    Although formal spirometry is the gold standard for monitoring respiratory function in patients with myasthenia gravis (MG), such testing is often delayed or unavailable. There is a need for a simple bedside test that can accurately measure respiratory function. We conducted a prospective, cross-sectional, single-blind study in adults with acetylcholine receptor antibody positive MG. Participants performed the single breath count test (SBCT) and underwent manual muscle strength testing, and a respiratory therapist performed spirometry blinded to SBCT and strength results. Thirty-one patients, aged 57 ± 19 years participated. SBCT showed significant correlations with forced vital capacity (FVC), negative inspiratory force, and neck flexor strength (P strength (P = 0.02) but no correlation with shoulder abductor strength. These data suggest that the SBCT and neck flexor strength testing are valuable tools for bedside assessment of respiratory function in MG patients. © 2015 Wiley Periodicals, Inc.

  20. Increased central common drive to ankle plantar flexor and dorsiflexor muscles during visually guided gait

    DEFF Research Database (Denmark)

    Jensen, Peter; Jensen, Nicole Jacqueline; Terkildsen, Cecilie Ulbæk

    2018-01-01

    When we walk in a challenging environment, we use visual information to modify our gait and place our feet carefully on the ground. Here, we explored how central common drive to ankle muscles changes in relation to visually guided foot placement. Sixteen healthy adults aged 23 ± 5 years participa......When we walk in a challenging environment, we use visual information to modify our gait and place our feet carefully on the ground. Here, we explored how central common drive to ankle muscles changes in relation to visually guided foot placement. Sixteen healthy adults aged 23 ± 5 years...

  1. TRAINING-INDUCED CHANGES IN THE TOPOGRAPHY OF MUSCLE TORQUES AND MAXIMAL MUSCLE TORQUES IN BASKETBALL PLAYERS

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    Krzysztof Buśko

    2012-01-01

    Full Text Available The aim of the study was to detect changes in the maximal muscle torques in male basketball players during a two-year training cycle. We verified the hypothesis that different workloads applied during the preparation and competition periods would result in changes in the maximal muscle torques of the athletes (increase during the former and decrease or no change during the latter period accompanied by no alteration of the percent muscle topography of all the muscle groups tested. The examinations were conducted on nine senior male basketball players from the Polish national team. Estimations of the muscle torques in static conditions were performed at the end of the preparation (measurements I and III and competition (measurements II and IV periods of a two-year training cycle. Eleven muscle groups were studied including flexors and extensors of the trunk and flexors and extensors of the shoulder, the elbow, the hip, the knee, and the ankle. Muscle torques of the shoulder and the elbow insignificantly decreased except for the muscle torque of the flexors of the shoulder. Muscle torques of the flexors and extensors of the trunk as well as of the flexors and extensors of the hip, the knee, and the ankle increased between measurements I and III and between measurements I and IV with the only exception being the muscle torque of the flexors of the knee (which significantly decreased by 7.4% In the case of the flexors and extensors of the trunk and the flexors and extensors of the hip, the changes appeared to be significant. The sum of the muscle torques of the upper limbs markedly decreased between the preparation (measurement I and competition (measurement IV periods. The sum of the muscle torques of the trunk and the lower limbs and the sum of the muscle torques of the eleven muscle groups significantly increased between measurements I and IV. Percent muscle topography significantly decreased for the flexors and extensors of the shoulder and the

  2. Non-neural Muscle Weakness Has Limited Influence on Complexity of Motor Control during Gait

    Directory of Open Access Journals (Sweden)

    Marije Goudriaan

    2018-01-01

    Full Text Available Cerebral palsy (CP and Duchenne muscular dystrophy (DMD are neuromuscular disorders characterized by muscle weakness. Weakness in CP has neural and non-neural components, whereas in DMD, weakness can be considered as a predominantly non-neural problem. Despite the different underlying causes, weakness is a constraint for the central nervous system when controlling gait. CP demonstrates decreased complexity of motor control during gait from muscle synergy analysis, which is reflected by a higher total variance accounted for by one synergy (tVAF1. However, it remains unclear if weakness directly contributes to higher tVAF1 in CP, or whether altered tVAF1 reflects mainly neural impairments. If muscle weakness directly contributes to higher tVAF1, then tVAF1 should also be increased in DMD. To examine the etiology of increased tVAF1, muscle activity data of gluteus medius, rectus femoris, medial hamstrings, medial gastrocnemius, and tibialis anterior were measured at self-selected walking speed, and strength data from knee extensors, knee flexors, dorsiflexors and plantar flexors, were analyzed in 15 children with CP [median (IQR age: 8.9 (2.2], 15 boys with DMD [8.7 (3.1], and 15 typical developing (TD children [8.6 (2.7]. We computed tVAF1 from 10 concatenated steps with non-negative matrix factorization, and compared tVAF1 between the three groups with a Mann-Whiney U-test. Spearman's rank correlation coefficients were used to determine if weakness in specific muscle groups contributed to altered tVAF1. No significant differences in tVAF1 were found between DMD [tVAF1: 0.60 (0.07] and TD children [0.65 (0.07], while tVAF1 was significantly higher in CP [(0.74 (0.09] than in the other groups (both p < 0.005. In CP, weakness in the plantar flexors was related to higher tVAF1 (r = −0.72. In DMD, knee extensor weakness related to increased tVAF1 (r = −0.50. These results suggest that the non-neural weakness in DMD had limited influence on

  3. Young, healthy subjects can reduce the activity of calf muscles when provided with EMG biofeedback in upright stance

    Directory of Open Access Journals (Sweden)

    Taian M. Vieira

    2016-04-01

    Full Text Available Recent evidence suggests the minimisation of muscular effort rather than of the size of bodily sway may be the primary, nervous system goal when regulating the human, standing posture. Different programs have been proposed for balance training; none however has been focused on the activation of postural muscles during standing. In this study we investigated the possibility of minimising the activation of the calf muscles during standing through biofeedback. By providing subjects with an audio signal that varied in amplitude and frequency with the amplitude of surface electromyograms (EMG recorded from different regions of the gastrocnemius and soleus muscles, we expected them to be able to minimise the level of muscle activation during standing without increasing the excursion of the centre of pressure (CoP. CoP data and surface EMG from gastrocnemii, soleus and tibialis anterior muscles were obtained from ten healthy participants while standing at ease and while standing with EMG biofeedback. Four sensitivities were used to test subjects’ responsiveness to the EMG biofeedback. Compared with standing at ease, the two most sensitive feedback conditions induced a decrease in plantar flexor activity (~15%; P<0.05 and an increase in tibialis anterior EMG (~10%; P<0.05. Furthermore, CoP mean position significantly shifted backward (~30 mm. In contrast, the use of less sensitive EMG biofeedback resulted in a significant decrease in EMG activity of ankle plantar flexors with a marginal increase in TA activity compared with standing at ease. These changes were not accompanied by greater CoP displacements or significant changes in mean CoP position. Key results revealed subjects were able to keep standing stability while reducing the activity of gastrocnemius and soleus without loading their tibialis anterior muscle when standing with EMG biofeedback. These results may therefore posit the basis for the development of training protocols aimed at

  4. Ankle and toe muscle strength characteristics in runners with a history of medial tibial stress syndrome.

    Science.gov (United States)

    Saeki, Junya; Nakamura, Masatoshi; Nakao, Sayaka; Fujita, Kosuke; Yanase, Ko; Morishita, Katsuyuki; Ichihashi, Noriaki

    2017-01-01

    A high proportion of flexor digitorum longus attachment is found at the posteromedial border of the tibia, which is the most common location of medial tibial stress syndrome (MTSS). Therefore, plantar flexion strength of the lesser toes could be related to MTSS; however, the relationship between MTSS and muscle strength of the hallux and lesser toes is not yet evaluated due to the lack of quantitative methods. This study investigated the muscle strength characteristics in runners with a history of MTSS by using a newly developed device to measure the muscle strength of the hallux, lesser toes, and ankle. This study comprised 27 collegiate male runner participants (20.0 ± 1.6 years, 172.1 ± 5.1 cm, 57.5 ± 4.0 kg). Maximal voluntary isometric contraction (MVIC) torque of the plantar flexion, dorsiflexion, inversion, and eversion of the ankle were measured by using an electric dynamometer. MVIC torque of the 1st metatarsophalangeal joint (MTPJ) and 2nd-5th MTPJ were measured by using a custom-made torque-measuring device. MVIC torques were compared between runners with and without a history of MTSS. MVIC torque of the 1st MTPJ plantar flexion was significantly higher in runners with a history of MTSS than in those without it. In contrast, there were no significant differences in the MVIC torque values of the 2nd-5th MTPJ plantar flexion and each MVIC torque of the ankle between runners with and without a history of MTSS. A history of MTSS increased the isometric FHL strength.

  5. Balance and muscle power of children with Charcot-Marie-Tooth.

    Science.gov (United States)

    Silva, Tais R; Testa, Amanda; Baptista, Cyntia R J A; Marques, Wilson; Mattiello-Sverzut, Ana C

    2014-01-01

    In certain diseases, functional constraints establish a greater relationship with muscle power than muscle strength. However, in hereditary peripheral polyneuropathies, no such relationship was found in the literature. In children with Charcot-Marie-Tooth (CMT), to identify the impact of muscle strength and range of movement on the static/dynamic balance and standing long jump based on quantitative and functional variables. The study analyzed 19 participants aged between 6 and 16 years, of both genders and with clinical diagnoses of CMT of different subtypes. Anthropometric data, muscle strength of the lower limbs (hand-held dynamometer), ankle and knee range of movement, balance (Pediatric Balance Scale) and standing long jump distance were obtained by standardized procedures. For the statistical analysis, Pearson and Spearman correlation coefficients were used. There was a strong positive correlation between balance and the muscle strength of the right plantar flexors (r=0.61) and dorsiflexors (r=0.59) and a moderate correlation between balance and the muscle strength of inversion (r=0.41) and eversion of the right foot (r=0.44). For the long jump and range of movement, there was a weak positive correlation with right and left plantar flexion (r=0.20 and r=0.12, respectively) and left popliteal angle (r=0.25), and a poor negative correlation with left dorsiflexion (r=-0.15). The data on the patients analyzed suggests that the maintenance of distal muscle strength favors performance during balance tasks, while limitations in the range of movement of the legs seem not to be enough to influence the performance of the horizontal long jump.

  6. Efeitos da crioterapia e facilitação neuromuscular proprioceptiva sobre a força muscular nas musculaturas flexora e extensora de joelho Effects of cryotherapy and proprioceptive neuromuscular facilitation on muscle strength at the flexor and extensor muscles of the knee

    Directory of Open Access Journals (Sweden)

    Daiana Moreira Mortari

    2009-12-01

    Full Text Available As musculaturas flexora e extensora do joelho são freqüentemente lesionadas devido a um desequilíbrio entre esses grupos. Recursos térmicos, como a crioterapia, e técnicas de alongamento, como a técnica mantém-relaxa da facilitação neuromuscular proprioceptiva (FNP, influenciam a flexibilidade e força muscular, proporcionando maior homogeneidade entre essas musculaturas e diminuindo a incidência de lesões. Este estudo objetivou verificar os efeitos da crioterapia e da FNP sobre a força das musculaturas flexora e extensora de joelho. A amostra foi composta por 18 mulheres com idade entre 18 e 24 anos, não-praticantes de atividade física regular, divididas em dois grupos: um submetido a crioterapia e o outro à técnica mantém-relaxa da FNP. Antes e após uma sessão de aplicação das técnicas foi feita avaliação isocinética. A aplicação da técnica mantém-relaxa provocou aumento da força em ambas as musculaturas em ambos os membros, atingindo nível de significância nos flexores do membro inferior direito (p=0,04. A crioterapia diminuiu a força dos extensores e exerceu efeito contrário sobre os flexores, tendo gerado aumento significativo nos flexores do membro inferior direito (p=0,035. Quando comparadas as técnicas, a técnica mantém-relaxa gerou maiores valores de pico de torque, principalmente nos extensores do membro inferior esquerdo (p=0,042. Conclui-se que a técnica mantém-relaxa da FNP gerou maiores valores no pico de torque em relação à crioterapia.Knee extensor and flexor muscles are often injured due to an imbalance between these groups, which may lead to a deficit in muscle performance. Thermal resources, such as cryotherapy, and stretching techniques, such as the "hold-relax" of proprioceptive neuromuscular facilitation (PNF, influence flexibility and muscle strength and may reduce the chances of muscle tendon injuries. The aim of the study was to verify the effects of cryotherapy and of the PNF

  7. Mechanical Information of Plantar Fascia during Normal Gait

    Science.gov (United States)

    Gu, Yaodong; Li, Zhiyong

    The plantar fascia is an important foot tissue in stabilizing the longitudinal arch of human foot. Direct measurement to monitor the mechanical situation of plantar fascia at human locomotion is difficult. The purpose of this study was to construct a three-dimensional finite element model of the foot to calculate the internal stress/strain value of plantar fascia during different stage of gait. The simulated stress distribution of plantar fascia was the lowest at heel-strike, which concentrated on the medial side of calcaneal tubercle. The peak stress of plantar fascia was appeared at push-off, and the value is more than 5 times of the heel-strike position. Current FE model was able to explore the plantar fascia tension trend at the main sub-phases of foot. More detailed fascia model and intrinsic muscle forces could be developed in the further study.

  8. Reliability of ultrasound for measurement of selected foot structures.

    Science.gov (United States)

    Crofts, G; Angin, S; Mickle, K J; Hill, S; Nester, C J

    2014-01-01

    Understanding the relationship between the lower leg muscles, foot structures and function is essential to explain how disease or injury may relate to changes in foot function and clinical pathology. The aim of this study was to investigate the inter-operator reliability of an ultrasound protocol to quantify features of: rear, mid and forefoot sections of the plantar fascia (PF); flexor hallucis brevis (FHB); flexor digitorum brevis (FDB); abductor hallucis (AbH); flexor digitorum longus (FDL); flexor hallucis longus (FHL); tibialis anterior (TA); and peroneus longus and brevis (PER). A sample of 6 females and 4 males (mean age 29.1 ± 7.2 years, mean BMI 25.5 ± 4.8) was recruited from a university student and staff population. Scans were obtained using a portable Venue 40 musculoskeletal ultrasound system (GE Healthcare UK) with a 5-13 MHz wideband linear array probe with a 12.7 mm × 47.1mm footprint by two operators in the same scanning session. Intraclass Correlation Coefficients (ICC) values for muscle thickness (ICC range 0.90-0.97), plantar fascia thickness (ICC range 0.94-0.98) and cross sectional muscle measurements (ICC range 0.91-0.98) revealed excellent inter-operator reliability. The limits of agreement, relative to structure size, ranged from 9.0% to 17.5% for muscle thickness, 11.0-18.0% for plantar fascia, and 11.0-26.0% for cross sectional area measurements. The ultrasound protocol implemented in this work has been shown to be reliable. It therefore offers the opportunity to quantify the structures concerned and better understand their contributions to foot function. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  9. Poststroke Muscle Architectural Parameters of the Tibialis Anterior and the Potential Implications for Rehabilitation of Foot Drop

    Directory of Open Access Journals (Sweden)

    John W. Ramsay

    2014-01-01

    Full Text Available Poststroke dorsiflexor weakness and paretic limb foot drop increase the risk of stumbling and falling and decrease overall functional mobility. It is of interest whether dorsiflexor muscle weakness is primarily neurological in origin or whether morphological differences also contribute to the impairment. Ten poststroke hemiparetic individuals were imaged bilaterally using noninvasive medical imaging techniques. Magnetic resonance imaging was used to identify changes in tibialis anterior muscle volume and muscle belly length. Ultrasonography was used to measure fascicle length and pennation angle in a neutral position. We found no clinically meaningful bilateral differences in any architectural parameter across all subjects, which indicates that these subjects have the muscular capacity to dorsiflex their foot. Therefore, poststroke dorsiflexor weakness is primarily neural in origin and likely due to muscle activation failure or increased spasticity of the plantar flexors. The current finding suggests that electrical stimulation methods or additional neuromuscular retraining may be more beneficial than targeting muscle strength (i.e., increasing muscle mass.

  10. Mechanisms underlying chronic whiplash: contributions from an incomplete spinal cord injury?

    Science.gov (United States)

    Elliott, James M; Dewald, Julius P A; Hornby, T George; Walton, David M; Parrish, Todd B

    2014-11-01

    To explore the association between findings on advanced, but available, magnetic resonance imaging (MRI) sequences of the cervical spinal cord and muscular system, in tandem with biomechanical measures of maximum volitional plantar flexion torques as a proxy for a mild incomplete spinal cord injury. Observational case series. University research laboratory. Three patients with chronic whiplash and one patient with history of whiplash injury but no current symptoms. We measured lower extremity muscle fat, morphological changes in descending spinal cord pathways with advanced MRI applications and maximal activation of the plantar flexors. Larger magnitudes of lower extremity muscle fat corresponded to altered spinal cord anatomy and reductions in the ability to maximally activate plantar flexor torques in the three subjects with chronic whiplash. Such findings were not present in the recovered participant. The potential value of MRI to quantify neuromuscular degeneration in chronic whiplash is recognized. Larger scaled prospective studies are warranted before stronger conclusions can be drawn. Wiley Periodicals, Inc.

  11. Egyptian Journal of Medical Human Genetics - Vol 16, No 3 (2015)

    African Journals Online (AJOL)

    Sarcopenic obesity and dyslipidemia response to selective exercise program after liver ... Shock wave therapy for spastic plantar flexor muscles in hemiplegic cerebral palsy children · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... skeletal anomalies, and hypoplasia of pectoralis major muscle in an Egyptian child ...

  12. Neglected ruptured flexor carpi ulnaris tendon mimics a soft tissue tumor in the wrist.

    Science.gov (United States)

    Rau, Chi-Lun; Yen, Tze-Hsun; Wu, Lien-Chen; Huang, Yi-You; Jaw, Fu-Shan; Liou, Tsan-Hon

    2014-04-01

    A wrist mass is rarely caused by a ruptured tendon in the forearm. The common pathologies are ganglia, tendon tenosynovitis, and giant cell tumors of tendon sheaths. Less common causes are nerve sheath tumors, vascular lesions, or an accessory muscle belly. The authors investigated a case of neglected ruptured flexor carpi ulnaris tendon that mimics a mass in the wrist. To the authors' knowledge, this is the first case report in relevant literature. During investigation, the high-resolution musculoskeletal ultrasound suggested a soft tissue tumor or a ruptured flexor carpi ulnaris tendon. The magnetic resonance imaging scan indicated an accessory flexor carpi ulnaris muscle belly. The diagnosis of ruptured flexor carpi ulnaris tendon was confirmed by surgical exploration. This case indicates that ultrasound may be better suited than magnetic resonance imaging in evaluating a wrist mass for its accuracy, availability, and portability.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Nomenclatural review of long digital forelimb flexors in carnivores.

    Science.gov (United States)

    Spoor, C F; Badoux, D M

    1986-12-01

    A hitherto-unknown atavistic muscle in the dog initiated a review of the literature on the homologies and nomenclature of the forelimb flexors in carnivores and man. A consequence is that we recommend a revision of the nomenclature in the Nomina Anatomica Veterinaria (Ithaca, New York, 1983) so that it is in agreement with the Nomina Anatomica (Wilkins, Baltimore, 1983). This revision mainly consists of the incorporation of the terms M. palmaris longus and Mm. flexores breves manus.

  15. Analysis of isokinetic muscle function and postural control in individuals with intermittent claudication

    Directory of Open Access Journals (Sweden)

    Morgan Lanzarin

    2016-02-01

    Full Text Available BACKGROUND: Intermittent claudication (IC is a debilitating condition that mostly affects elderly people. IC is manifested by a decrease in ambulatory function. Individuals with IC present with motor and sensory nerve dysfunction in the lower extremities, which may lead to deficits in balance. OBJECTIVE: This study aimed to measure postural control and isokinetic muscle function in individuals with intermittent claudication. METHOD: The study included 32 participants of both genders, 16 IC participants (mean age: 64 years, SD=6 and 16 healthy controls (mean age: 67 years, SD=5, which were allocated into two groups: intermittent claudication group (ICG and control group (CG. Postural control was assessed using the displacement and velocity of the center of pressure (COP during the sensory organization test (SOT and the motor control test (MCT. Muscle function of the flexor and extensor muscles of the knee and ankle was measured by an isokinetic dynamometer. Independent t tests were used to calculate the between-group differences. RESULTS: The ICG presented greater displacement (p =0.027 and speed (p =0.033 of the COP in the anteroposterior direction (COPap during the MCT, as well as longer latency (p =0.004. There were no between-group differences during the SOT. The ICG showed decreased muscle strength and power in the plantar flexors compared to the CG. CONCLUSION: Subjects with IC have lower values of strength and muscle power of plantiflexores, as well as changes in postural control in dynamic conditions. These individuals may be more vulnerable to falls than healthy subjects.

  16. Flexor tendon lacerations in zone V.

    Science.gov (United States)

    Stefanich, R J; Putnam, M D; Peimer, C A; Sherwin, F S

    1992-03-01

    Twenty-three patients with zone V flexor tendon lacerations rehabilitated by the Kleinert protocol were studied at an average of 46 months after trauma. Hand function was subjectively normal in only eight. Of fourteen patients who were employed at the time of injury, eight returned to their original occupations. Eight others were working at other jobs, and we considered six more capable of employment. Only one had a poor functional result that precluded occupational use of the hand. Pinch/grip strengths recovered to 85%/79% of the uninvolved side. Independent flexor digitorum superficialis/flexor digitorum profundus action was present in only seven patients. Sixteen regained full digital flexion. Extension loss averaged 25% at the wrist and 10% in each digit. As assessed by static two-point discrimination, sensibility was poor after associated median and ulnar nerve transections; this did not preclude good objective functional results. Complications included two tendon ruptures, proximal interphalangeal hyperextension in the presence of an unrepaired flexor digitorum superficialis, and limited motion in two patients after poor compliance in therapy. Tenolysis was needed in 4 of the 23. We now use a modified Duran technique for noncompliant patients and in those who are unable to extend their PIP joints because of weak intrinsic muscles.

  17. Magnetic resonance imaging of plantar aponeurosis lesions

    International Nuclear Information System (INIS)

    Roger, B.; Christel, P.; Poux, D.

    1987-01-01

    Exploration of sporting injuries to plantar aponeurosis (PA) has up to now been based mainly on clinical examination, from which the diagnosis was established. Imaging technics such as standard radiography and ultrasound scanning have limitations allowing diagnosis to be made usually only by elimination, the lesion being very rarely visualized directly. Ten patients with hyperalgic lesion of plantar arch and functional impotence were explored by MR imaging, and in all cases this examination provided superior data confirmed at operation. The examination is painless and little invasive and can be carried out during the acute phase. The plantar aponeurosis is visualized directly between the muscle mass of the plantar arch and the fatty cushion. All three spatial planes can be investigated, most interesting data being obtained from the sagittal (in the PA axis) and frontal (comparative) planes [fr

  18. An evaluation of the somatosensory profile of hemiparetic individuals

    Directory of Open Access Journals (Sweden)

    R.S. Mota

    2010-01-01

    Full Text Available The purpose of this study was to evaluate the somatosensory profile of 18 hemiparetic spastic victims of stroke with and without blocking vision. Maximal isometric contraction test was used for flexor and extensor muscles of the hip and knee, and flexor plantar muscles. The number of cycles per minute on stationary bike was also measured with eyes opened and closed. Significant differences were found suggesting the existence of miscommunication between sensory-motor neural mechanisms responsible for voluntary motor actions in these individuals.

  19. The Effect of Fatigue in Proxmal and Distal Muscles of Lower Extremity on Postural Control

    Directory of Open Access Journals (Sweden)

    Mozhgan Moghadam

    2003-07-01

    Full Text Available Objective: Several studies have shown the effects of muscular fatigue on proprioception and neuromuscular control. However all available researches have studied just the effect of local fatigue in ankle joint muscles on postural control, and no study have found about the effect of fatigue in proximal muscles of the lower extremity on postural control. To compare changes in postural control parameters after isokinetic fatigue of proximal and distal muscles of lower extremity. Materials & Methods: Subjects were twenty healthy men (age: 22.6±2.4 years, height: 173.7± 3.6 cm, weight: 63.3±7.9kg. There were 4 test sessions, with a randomized order according to site and plane of fatigue. During each session one of these muscle groups was fatigued using a Biodex isokinetic dynamometer: ankle plantar / dorsi flexors, ankle evertor / inventors, hip flexor / extensors and hip abductor/adductors. The biodex stability system was used to perform dynamic balance test before and after muscle fatigue in each session. Overall, anterior / posterior, and medial/lateral stability indices were recorded. The higher the stability indices, the lower the balancing skill. Results: Analysis of pre-and post fatigue balance results of all sessions, demonstrated significant increase (P<0.05 in all stability indices. Repeated measures ANOVA performed on the rate of changes in stability indices during each session revealed that hip muscle fatigue caused much more increase in stability indices than ankle muscle fatigue (P<0.05. Conclusion: Isokinetic fatigue of both ankle and hip muscles significantly decreases postural control ability in healthy young men. In addition, our findings suggest that the hip joint musculature plays a more prominent role in postural control.

  20. The effect of the gastrocnemius on the plantar fascia.

    Science.gov (United States)

    Pascual Huerta, Javier

    2014-12-01

    Although anatomic and functional relationship has been established between the gastrocnemius muscle, via the Achilles tendon, and the plantar fascia, the exact role of gastrocnemius tightness in foot and plantar fascia problems is not completely understood. This article summarizes past and current literature linking these 2 structures and gives a mechanical explanation based on functional models of the relationship between gastrocnemius tightness and plantar fascia. The effect of gastrocnemius tightness on the sagittal behavior of the foot is also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Biomechanical consequences of plantar fascial release or rupture during gait. Part II: alterations in forefoot loading.

    Science.gov (United States)

    Sharkey, N A; Donahue, S W; Ferris, L

    1999-02-01

    With a model using feet from cadavers, we tested the hypothesis that plantar fascial release or rupture alters the loading environment of the forefoot during the latter half of the stance phase of gait. The model simulated the position and loading environment of the foot at two instants: early in terminal stance immediately after heel-off and late in terminal stance just preceding contralateral heel strike. Eight feet were loaded at both positions by simulated plantar flexor contraction, and the distribution of plantar pressure was measured before and after progressive release of the plantar fascia. Strain in the diaphysis of the second metatarsal was also measured, from which the bending moments and axial force imposed on the metatarsal were calculated. Cutting the medial half of the central plantar fascial band significantly increased peak pressure under the metatarsal heads but had little effect on pressures in other regions of the forefoot or on second metatarsal strain and loading. Dividing the entire central band or completely releasing the plantar fascia from the calcaneus had a much greater effect and caused significant shifts in plantar pressure and force from the toes to beneath the metatarsal heads. These shifts were accompanied by significantly increased strain and bending in the second metatarsal. Complete fasciotomy increased the magnitude of strain in the dorsal aspect of the second metatarsal by more than 80%, suggesting that plantar fascial release or rupture accelerates the accumulation of fatigue damage in these bones. Altered forefoot loading may be a potential complication of plantar fasciotomy.

  2. Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy

    DEFF Research Database (Denmark)

    Frisk, Rasmus F.; Jensen, Peter; Kirk, Henrik

    2017-01-01

    applied unload perturbations at the ankle, thereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were...... feedback to ongoing soleus muscle activation during push-off than uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminishn sensory feedback during gait, and/or sensory feedback is less integrated with central motor commands in the activation of spinal motor neurons...

  3. Browse Title Index

    African Journals Online (AJOL)

    Items 401 - 450 of 452 ... Vol 16, No 3 (2015), Shock wave therapy for spastic plantar flexor muscles ... of Acute Promyelocytic Leukemia (AML-M3) Using Karyotyping, ... gene polymorphisms in a sample of Egyptian autistic children, Abstract PDF.

  4. Acute effects of maximal isometric muscle action of the elbow extensors on contralateral dynamic task of the elbow flexors: a pilot study

    Directory of Open Access Journals (Sweden)

    Cauê V La Scala Teixeira

    2017-12-01

    Full Text Available ABSTRACT Aim the aim was to investigate the influence of a maximal isometric muscle action of the elbow extensors on the contralateral dynamic task of the elbow flexors. Methods Seventeen recreationally trained men (23.3 ± 4.9 yrs, BMI: 24.8 ± 2.2 Kg/m² underwent two randomized different testing sessions separated by one week. In the control session (CON all subjects performed a maximum number of repetitions test (RMs at 75%1RM using the right elbow flexors. The experimental session (EXP was similar to the CON; however, all subjects were instructed to perform RMs at 75%1RM by using the right elbow flexors and maintaining the maximal voluntary contraction of the left elbow extensors during the test. RMs, rating of perceived exertion (RPE, and training volume (TV were measured and compared between sessions. Results The EXP showed a significant 10.4% increase on the RMs (13.8 vs. 12.5, p < 0.001, d = 0.44 and 12.1% increase in TV (238.0 vs. 212.4 kg, p < 0.001, d = 0.43 than CON. No differences were observed for RPE between sessions. Conclusion The maximum voluntary contraction of the left elbow extensors increased the RMs of the contralateral elbow flexors, reflecting a higher TV, and no differences in the RPE. Our results suggest that the investigated method may be a viable and practical alternative to increase the acute strength performance of elbow flexors when using submaximal loads.

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

    Science.gov (United States)

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

    2017-01-01

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

  6. The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain.

    Science.gov (United States)

    Falla, Deborah; O'Leary, Shaun; Farina, Dario; Jull, Gwendolen

    2012-09-01

    Altered activation of the deep cervical flexors (longus colli and longus capitis) has been found in individuals with neck pain disorders but the response to training has been variable. Therefore, this study investigated the relationship between change in deep cervical flexor muscle activity and symptoms in response to specific training. Fourteen women with chronic neck pain undertook a 6-week program of specific training that consisted of a craniocervical flexion exercise performed twice per day (10 to 20 min) for the duration of the trial. The exercise targets the deep flexor muscles of the upper cervical region. At baseline and follow-up, measures were taken of neck pain intensity (visual analogue scale, 0 to 10), perceived disability (Neck Disability Index, 0 to 50) and electromyography (EMG) of the deep cervical flexors (by a nasopharyngeal electrode suctioned over the posterior oropharyngeal wall) during performance of craniocervical flexion. After training, the activation of the deep cervical flexors increased (Pcervical flexor EMG amplitude at baseline (R(2)=0.68; Ppain intensity, change in pain level with training, and change in EMG amplitude for the deep cervical flexors during craniocervical flexion (R(2)=0.34; Pcervical flexor muscles in women with chronic neck pain reduces pain and improves the activation of these muscles, especially in those with the least activation of their deep cervical flexors before training. This finding suggests that the selection of exercise based on a precise assessment of the patients' neuromuscular control and targeted exercise interventions based on this assessment are likely to be the most beneficial to patients with neck pain.

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

    Science.gov (United States)

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

    2013-01-01

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

  8. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogéria Nobre Rodrigues

    2015-12-01

    Full Text Available Abstract Objective: To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods: Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV and those who had been operated on for nerve decompression were excluded. Results: A female prevalence (78.8% was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

  9. Computed tomographical findings of skeletal muscles in rimmed vacuole type distal myopathy

    International Nuclear Information System (INIS)

    Kunimoto, Masanari; Kawai, Mitsuru; Goto, Jun; Nakano, Imaharu

    1987-01-01

    Skeletal muscle CT scans of three patients with biopsy-proven rimmed vacuole type distal myopathy(RVDM) from two unrelated families showed unique involvement pattern of the lower extremities. Parents of the patients in both families are first cousins. T.Y. is a 36-year-old woman who noticed mild difficulty in walking at 34 years of age. Now she shows waddling but still indpendent gait. Manual muscle test (MMT) revealed the following results: fair (3+/5) for hip flexion, 3 for hip extension, 3 for knee flexion, normal (5/5) for knee extension, poor (2/5) for ankle dorsi-flexion, good (4/5) for ankle plantar flexion. T.M., a 34-year-old younger sister of T.Y., started dragging her feet on gait at age 27. She could walk neither on toes nor heels. At present, she can walk only with support. MMT showed the following: 3- and trace (1/5) for hip flexion and extension, 3- and 4 for knee flexion and extension, 1 for ankle plantar- and dorsiflexion. K.W., a 33-year-old woman, began to drag her foot tips in walk and became unable to walk on toes at age 21. The leg weakness progressed into the wheelchair-ridden state at age 30. MMT gave the following results: 1 for hip flexion and extension, 2 and 4 for knee flexion and extension, zero for plantar- and dorsi-flexion. The most impressive CT findings common to these three patients are prominent contrast between the quadriceps muscles and the adductor- and hamstring-group: the former is markedly well preserved even in the most advanced patient (K.W.) while the latter are diffusely and severely affected even in the least affected patient (T.Y.). This finding well coincides with the results of MMT: the knee extensor (quadriceps muscles) fairly well keeps its strength even in the most advanced patient but the knee flexors (adductors and hamstrings) are definitely affected in the early stage of the condition. (J.P.N.)

  10. Computed tomographical findings of skeletal muscles in rimmed vacuole type distal myopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kunimoto, Masanari; Kawai, Mitsuru; Goto, Jun; Nakano, Imaharu

    1987-03-01

    Skeletal muscle CT scans of three patients with biopsy-proven rimmed vacuole type distal myopathy(RVDM) from two unrelated families showed unique involvement pattern of the lower extremities. Parents of the patients in both families are first cousins. T.Y. is a 36-year-old woman who noticed mild difficulty in walking at 34 years of age. Now she shows waddling but still indpendent gait. Manual muscle test (MMT) revealed the following results: fair (3+/5) for hip flexion, 3 for hip extension, 3 for knee flexion, normal (5/5) for knee extension, poor (2/5) for ankle dorsi-flexion, good (4/5) for ankle plantar flexion. T.M., a 34-year-old younger sister of T.Y., started dragging her feet on gait at age 27. She could walk neither on toes nor heels. At present, she can walk only with support. MMT showed the following: 3- and trace (1/5) for hip flexion and extension, 3- and 4 for knee flexion and extension, 1 for ankle plantar- and dorsiflexion. K.W., a 33-year-old woman, began to drag her foot tips in walk and became unable to walk on toes at age 21. The leg weakness progressed into the wheelchair-ridden state at age 30. MMT gave the following results: 1 for hip flexion and extension, 2 and 4 for knee flexion and extension, zero for plantar- and dorsi-flexion. The most impressive CT findings common to these three patients are prominent contrast between the quadriceps muscles and the adductor- and hamstring-group: the former is markedly well preserved even in the most advanced patient (K.W.) while the latter are diffusely and severely affected even in the least affected patient (T.Y.). This finding well coincides with the results of MMT: the knee extensor (quadriceps muscles) fairly well keeps its strength even in the most advanced patient but the knee flexors (adductors and hamstrings) are definitely affected in the early stage of the condition. (J.P.N.).

  11. Passive stiffness of monoarticular lower leg muscles is influenced by knee joint angle.

    Science.gov (United States)

    Ateş, Filiz; Andrade, Ricardo J; Freitas, Sandro R; Hug, François; Lacourpaille, Lilian; Gross, Raphael; Yucesoy, Can A; Nordez, Antoine

    2018-03-01

    While several studies demonstrated the occurrence of intermuscular mechanical interactions, the physiological significance of these interactions remains a matter of debate. The purpose of this study was to quantify the localized changes in the shear modulus of the gastrocnemius lateralis (GL), monoarticular dorsi- and plantar-flexor muscles induced by a change in knee angle. Participants underwent slow passive ankle rotations at the following two knee positions: knee flexed at 90° and knee fully extended. Ultrasound shear wave elastography was used to assess the muscle shear modulus of the GL, soleus [both proximally (SOL-proximal) and distally (SOL distal)], peroneus longus (PERL), and tibialis anterior (TA). This was performed during two experimental sessions (experiment I: n = 11; experiment II: n = 10). The shear modulus of each muscle was compared between the two knee positions. The shear modulus was significantly higher when the knee was fully extended than when the knee was flexed (P passive muscle force, these results provide evidence of a non-negligible intermuscular mechanical interaction between the human lower leg muscles during passive ankle rotations. The role of these interactions in the production of coordinated movements requires further investigation.

  12. Plantar pressure and EMG activity of simulated and actual ski jumping take-off.

    Science.gov (United States)

    Virmavirta, M; Komi, P V

    2001-10-01

    Plantar pressures and activation of the four muscles (VL - vastus lateralis, GL - gluteus, TA - tibialis anterior and GA - lat. gastrocnemius) were measured from ten ski jumpers under simulated laboratory conditions with training shoes (Lab TS) and with jumping boots (Lab JB) as well as in actual hill jumping conditions (Hill). The most significant differences between measured conditions were found in muscle activation patterns and plantar pressures prior to take-off. The centrifugal force due to the curvature of the inrun under actual hill jumping conditions caused extra pressure under the fore and rear parts of the feet (Pknee and hip extensor muscles.

  13. A pneumatically powered knee-ankle-foot orthosis (KAFO with myoelectric activation and inhibition

    Directory of Open Access Journals (Sweden)

    Ferris Daniel P

    2009-06-01

    Full Text Available Abstract Background The goal of this study was to test the mechanical performance of a prototype knee-ankle-foot orthosis (KAFO powered by artificial pneumatic muscles during human walking. We had previously built a powered ankle-foot orthosis (AFO and used it effectively in studies on human motor adaptation, locomotion energetics, and gait rehabilitation. Extending the previous AFO to a KAFO presented additional challenges related to the force-length properties of the artificial pneumatic muscles and the presence of multiple antagonistic artificial pneumatic muscle pairs. Methods Three healthy males were fitted with custom KAFOs equipped with artificial pneumatic muscles to power ankle plantar flexion/dorsiflexion and knee extension/flexion. Subjects walked over ground at 1.25 m/s under four conditions without extensive practice: 1 without wearing the orthosis, 2 wearing the orthosis with artificial muscles turned off, 3 wearing the orthosis activated under direct proportional myoelectric control, and 4 wearing the orthosis activated under proportional myoelectric control with flexor inhibition produced by leg extensor muscle activation. We collected joint kinematics, ground reaction forces, electromyography, and orthosis kinetics. Results The KAFO produced ~22%–33% of the peak knee flexor moment, ~15%–33% of the peak extensor moment, ~42%–46% of the peak plantar flexor moment, and ~83%–129% of the peak dorsiflexor moment during normal walking. With flexor inhibition produced by leg extensor muscle activation, ankle (Pearson r-value = 0.74 ± 0.04 and knee ( r = 0.95 ± 0.04 joint kinematic profiles were more similar to the without orthosis condition compared to when there was no flexor inhibition (r = 0.49 ± 0.13 for ankle, p = 0.05, and r = 0.90 ± 0.03 for knee, p = 0.17. Conclusion The proportional myoelectric control with flexor inhibition allowed for a more normal gait than direct proportional myoelectric control. The current

  14. A pneumatically powered knee-ankle-foot orthosis (KAFO) with myoelectric activation and inhibition

    Science.gov (United States)

    Sawicki, Gregory S; Ferris, Daniel P

    2009-01-01

    Background The goal of this study was to test the mechanical performance of a prototype knee-ankle-foot orthosis (KAFO) powered by artificial pneumatic muscles during human walking. We had previously built a powered ankle-foot orthosis (AFO) and used it effectively in studies on human motor adaptation, locomotion energetics, and gait rehabilitation. Extending the previous AFO to a KAFO presented additional challenges related to the force-length properties of the artificial pneumatic muscles and the presence of multiple antagonistic artificial pneumatic muscle pairs. Methods Three healthy males were fitted with custom KAFOs equipped with artificial pneumatic muscles to power ankle plantar flexion/dorsiflexion and knee extension/flexion. Subjects walked over ground at 1.25 m/s under four conditions without extensive practice: 1) without wearing the orthosis, 2) wearing the orthosis with artificial muscles turned off, 3) wearing the orthosis activated under direct proportional myoelectric control, and 4) wearing the orthosis activated under proportional myoelectric control with flexor inhibition produced by leg extensor muscle activation. We collected joint kinematics, ground reaction forces, electromyography, and orthosis kinetics. Results The KAFO produced ~22%–33% of the peak knee flexor moment, ~15%–33% of the peak extensor moment, ~42%–46% of the peak plantar flexor moment, and ~83%–129% of the peak dorsiflexor moment during normal walking. With flexor inhibition produced by leg extensor muscle activation, ankle (Pearson r-value = 0.74 ± 0.04) and knee ( r = 0.95 ± 0.04) joint kinematic profiles were more similar to the without orthosis condition compared to when there was no flexor inhibition (r = 0.49 ± 0.13 for ankle, p = 0.05, and r = 0.90 ± 0.03 for knee, p = 0.17). Conclusion The proportional myoelectric control with flexor inhibition allowed for a more normal gait than direct proportional myoelectric control. The current orthosis design

  15. Predicting muscle forces of individuals with hemiparesis following stroke

    Directory of Open Access Journals (Sweden)

    Maladen Ryan

    2008-02-01

    Full Text Available Abstract Background Functional electrical stimulation (FES has been used to improve function in individuals with hemiparesis following stroke. An ideal functional electrical stimulation (FES system needs an accurate mathematical model capable of designing subject and task-specific stimulation patterns. Such a model was previously developed in our laboratory and shown to predict the isometric forces produced by the quadriceps femoris muscles of able-bodied individuals and individuals with spinal cord injury in response to a wide range of clinically relevant stimulation frequencies and patterns. The aim of this study was to test our isometric muscle force model on the quadriceps femoris, ankle dorsiflexor, and ankle plantar-flexor muscles of individuals with post-stroke hemiparesis. Methods Subjects were seated on a force dynamometer and isometric forces were measured in response to a range of stimulation frequencies (10 to 80-Hz and 3 different patterns. Subject-specific model parameter values were obtained by fitting the measured force responses from 2 stimulation trains. The model parameters thus obtained were then used to obtain predicted forces for a range of frequencies and patterns. Predicted and measured forces were compared using intra-class correlation coefficients, r2 values, and model error relative to the physiological error (variability of measured forces. Results Results showed excellent agreement between measured and predicted force-time responses (r2 >0.80, peak forces (ICCs>0.84, and force-time integrals (ICCs>0.82 for the quadriceps, dorsiflexor, and plantar-fexor muscles. The model error was within or below the +95% confidence interval of the physiological error for >88% comparisons between measured and predicted forces. Conclusion Our results show that the model has potential to be incorporated as a feed-forward controller for predicting subject-specific stimulation patterns during FES.

  16. Comparative Triceps Surae Morphology in Primates: A Review

    Directory of Open Access Journals (Sweden)

    Jandy B. Hanna

    2011-01-01

    Full Text Available Primate locomotor evolution, particularly the evolution of bipedalism, is often examined through morphological studies. Many of these studies have examined the uniqueness of the primate forelimb, and others have examined the primate hip and thigh. Few data exist, however, regarding the myology and function of the leg muscles, even though the ankle plantar flexors are highly important during human bipedalism. In this paper, we draw together data on the fiber type and muscle mass variation in the ankle plantar flexors of primates and make comparisons to other mammals. The data suggest that great apes, atelines, and lorisines exhibit similarity in the mass distribution of the triceps surae. We conclude that variation in triceps surae may be related to the shared locomotor mode exhibited by these groups and that triceps surae morphology, which approaches that of humans, may be related to frequent use of semiplantigrade locomotion and vertical climbing.

  17. Metabolic cost and mechanics of walking in women with fibromyalgia syndrome

    OpenAIRE

    MacPhee, Ren?e S; McFall, Kristen; Perry, Stephen D; Tiidus, Peter M

    2013-01-01

    Background Fibromyalgia syndrome (FS) is characterized by the presence of widespread pain, fatigue, muscle weakness and reduced work capacity. Previous research has demonstrated that women with fibromyalgia have altered walking (gait) patterns, which may be a consequence of muscular pain. This altered gait is characterized by greater reliance on hip flexors rather than ankle plantar flexors and resembles gait patterns seen in normal individuals walking at higher speeds, suggesting that gait o...

  18. Gymnasts and non-athletes muscle activation and torque production at the ankle joint

    Directory of Open Access Journals (Sweden)

    Natália Batista Albuquerque Goulart

    2014-07-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2014v16n5p555  Artistic Gymnasts (AG execute specific movements that require substantial movement control and force production at the ankle joint. This high demand might change the neuromechanical properties of the ankle joint muscles in these athletes compared to non-athlete girls (NAG. The aim of this study was to compare muscle activation and torque production at the ankle joint between AG and NAG. Ten AG (11.70 ± 1.06 years of age and 10 NAG (11.70 ± 1.49 years of age participated in the study. Electromyographic  (EMG signals of medial gastrocnemius (MG, soleus (SO and tibialis anterior (TA were obtained simultaneously to the maximal isometric plantarflexion (PFT and dorsiflexion (DFT torques of the dominant limb during a maximal voluntary isometric contraction (MVIC at five different joint angles (20°, 10°, 0°, -10° e -20°. Neuromuscular efficiency was also calculated by the Torque/EMG ratio. AG presented higher PFT (p0.05. In addition, AG showed higher values for plantar flexion neuromuscular efficiency and smaller values of dorsiflexion neuromuscular efficiency compared to the NAG (p<0.01. Higher sports demands of AG determined higher PFT, higher plantar flexor efficiency, smaller DFT but similar activation of MG, SO and TA compared to NAG.

  19. Relative sensitivity of depth discrimination for ankle inversion and plantar flexion movements.

    Science.gov (United States)

    Black, Georgia; Waddington, Gordon; Adams, Roger

    2014-02-01

    25 participants (20 women, 5 men) were tested for sensitivity in discrimination between sets of six movements centered on 8 degrees, 11 degrees, and 14 degrees, and separated by 0.3 degrees. Both inversion and plantar flexion movements were tested. Discrimination of the extent of inversion movement was observed to decline linearly with increasing depth; however, for plantar flexion, the discrimination function for movement extent was found to be non-linear. The relatively better discrimination of plantar flexion movements than inversion movements at around 11 degrees from horizontal is interpreted as an effect arising from differential amounts of practice through use, because this position is associated with the plantar flexion movement made in normal walking. The fact that plantar flexion movements are discriminated better than inversion at one region but not others argues against accounts of superior proprioceptive sensitivity for plantar flexion compared to inversion that are based on general properties of plantar flexion such as the number of muscle fibres on stretch.

  20. Cervical flexor muscle training reduces pain, anxiety, and depression levels in patients with chronic neck pain by a clinically important amount: A prospective cohort study.

    Science.gov (United States)

    Nazari, Goris; Bobos, Pavlos; Billis, Evdokia; MacDermid, Joy C

    2018-03-14

    Neck pain is the fourth leading cause of disability in the United States and exerts an important socio-economic burden around the world. The aims of this study were to determine the effectiveness of deep and superficial flexor muscle training in addition to home-based exercises in reducing chronic neck pain and anxiety/depression levels. This was a prospective cohort study. Patients between 18 and 65 years old with chronic neck pain were eligible to participate if they had disability levels at least 5 out of 50 on the Neck Disability Index. Patients were divided into three groups: Group A received deep neck flexor and home-based exercises; Group B received superficial muscle and home-based exercises; and Group C received home-based exercises only. The Numeric Pain Rating Scale (NPRS), Neck Disability Index, and Hospital Anxiety and Depression Scale were administered at baseline and 7 weeks later. The highest improvements in pain intensity levels were observed in Group A with 4.75 (1.74) NPRS points, and the lowest were in Group C with 1.00 (1.10). The highest reductions in anxiety and depression levels were noted in Group A (2.80) and Group B (1.65), respectively. The highest improvements in pain intensity levels were observed among Groups A versus C with 2.80 (0.52) NPRS. The highest reductions in anxiety and depression levels were noted among Groups A versus C with 1.75 (1.10) points and Groups B versus C with 1.60 (0.90) points, respectively. Deep and superficial flexor muscle training along with home-based exercises is likely to reduce chronic neck pain and anxiety/depression levels by a clinically relevant amount. Future larger scaled randomized controlled trials are warranted to further support these findings. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Measurement of Resistive Plantar Flexion Torque of the Ankle during Passive Stretch in Healthy Subjects and Patients with Poststroke Hemiplegia.

    Science.gov (United States)

    Mizuno, Shiho; Sonoda, Shigeru; Takeda, Kotaro; Maeshima, Shinichiro

    2016-04-01

    Quantification of increased muscle tone for patients with spasticity has been performed to date using various devices to replace the manual scales, such as the modified Ashworth scale or the Tardieu scale. We developed a device that could measure resistive plantar flexion (PF) torque of the ankle during passive dorsiflexion (DF) as an indicator of muscle tone of ankle plantar flexors. The primary objective was to explore the test-retest intrarater reliability of a custom-built device. Participants were 11 healthy subjects (7 men, 4 women; mean age 47.0 years) and 22 patients with poststroke hemiplegia (11 hemorrhagic, 11 ischemic; 14 men, 8 women; mean age 57.2 years). The device was affixed to the ankle. Subjects were seated with knees either flexed or extended. The ankle was passively dorsiflexed from 20° of PF to more than 10° of DF at 5°/second (slow stretch) or 90°/second (fast stretch). Angle and torque were measured twice during the stretches. The intraclass correlation coefficients (ICCs) of torque at 10° of DF (T10) in the 4 conditions-slow and fast stretches with knee flexed or extended-were calculated. The T10 ICCs of the 4 conditions were .95-.99 in both groups. The healthy subjects showed significantly higher T10 of knee extension than of knee flexion during slow and fast stretches. The patients showed increased velocity-dependent torque during fast stretches. Excellent reliability was observed. The device is suitable for measuring resistive PF torque during passive stretch in a flexed knee condition. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. The short-term effects of plantar vibration on balance disorder after stroke

    Directory of Open Access Journals (Sweden)

    Soofia Naghdi

    2013-05-01

    Full Text Available Background: Balance disorders are common in patients following stroke. There are a number of physiotherapy modalities to treat balance impairments, one of which is vibration. The effects of vibration on balance disorders after stroke have not been investigated. This case report demonstrates the short-term effects of plantar vibration on the balance impairment of a patient with stroke. Case presentation: A 72-years-old man with right hemiplegia resulted from stroke was admitted for vibration therapy after not responding to standard rehabilitation interventions. He complained of balance problems despite walking independently. Main studied outcomes were timed up and go test and posturography. Foot sensation, ankle plantar flexor spasticity, and the passive range of ankle dorsiflexion were assessed, as well. Vibration with a frequency of 100 Hz was introduced to the sole of the affected foot for 5 minutes. After intervention, all tests were improved compared to the baselines. Conclusion: This case showed that the vibration was effective for improving balance disorder after stroke.

  3. Overload protection: avoidance response to heavy plantar surface loading.

    Science.gov (United States)

    Robbins, S E; Hanna, A M; Gouw, G J

    1988-02-01

    Current footwear which are designed for use in running are examples of intentional biomechanical model integration into device design. The inadequacy of this footwear in protecting against injury is postulated to be due to fixation on inadequate models of locomotory biomechanics that do not provide for feedback control; in particular, an hypothesized plantar surface sensory-mediated feedback control system, which imparts overload protection during locomotion. A heuristic approach was used to identify the hypothesized system. A random series of loads (0 to 164 kg) was applied to the knee flexed at 90 degrees. In this testing system, plantar surface avoidance behavior was the difference between the sum of the leg weight and the load applied to the knee, and the load measured at the plantar surface; this was produced by activation of hip flexors. Significant avoidance behavior was found in all of the subjects (P less than 0.001). On all surfaces tested, including modern athletic footwear (P less than 0.001), its magnitude increased directly in relation to the load applied to the knee (P less than 0.001). There were significant differences in avoidance behavior in relation to the weight-bearing surfaces tested (P less than 0.05). With the identification of a feedback control system which would serve to moderate loading during locomotion, an explanation is provided as to why current athletic footwear do not protect and may be injurious; thus allowing the design of footwear which may be truly protective.

  4. Comparison of the effect of selected muscle groups fatigue on ...

    African Journals Online (AJOL)

    During each session, postural control was assessed during two 30-s trials of bipedal stance with eyes close before and after the fatigue protocol. Fatigue protocols were performed by 60% of their unfatigued Maximum Voluntary Contraction of unilateral ankle plantar flexors, bilateral lumbar extensors and bilateral neck ...

  5. Measurement of Gender Differences of Gastrocnemius Muscle and Tendon Using Sonomyography during Calf Raises: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Guang-Quan Zhou

    2017-01-01

    Full Text Available Skeletal muscles are essential to the gender-specific characteristics of human movements. Sonomyography, a new signal for quantifying muscle activation, is of great benefit to understand muscle function through monitoring the real-time muscle architectural changes. The purpose of this pilot study was to investigate gender differences in the architectural changes of gastronomies muscle and tendon by using sonomyography during performing two-legged calf raising exercises. A motion analysis system was developed to extract sonomyography from ultrasound images together with kinematic and kinetic measurements. Tiny fascicle length changes among seven male subjects were observed at the initial part of calf raising, whereas the fascicle of seven female subjects shortened immediately. This result suggested that men would generate higher mechanical power output of plantar flexors to regulate their heavier body mass. In addition, the larger regression coefficient between the fascicle length and muscle force for the male subjects implied that higher muscle stiffness for the men was required in demand of maintaining their heavier body economically. The findings from the current study suggested that the body mass might play a factor in the gender difference in structural changes of muscle and tendon during motion. The sonomyography may provide valuable information in the understanding of the gender difference in human movements.

  6. The effect of ankle foot orthosis stiffness on the energy cost of walking : A simulation study

    NARCIS (Netherlands)

    Bregman, D.J.J.; Van der Krogt, M.M.; De Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot

  7. The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study.

    NARCIS (Netherlands)

    Bregman, D.J.J.; van der Krogt, M.M.; de Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background: In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot

  8. Plantar fascia softening in plantar fasciitis with normal B-mode sonography.

    Science.gov (United States)

    Wu, Chueh-Hung; Chen, Wen-Shiang; Wang, Tyng-Guey

    2015-11-01

    To investigate plantar fascia elasticity in patients with typical clinical manifestations of plantar fasciitis but normal plantar fascia morphology on B-mode sonography. Twenty patients with plantar fasciitis (10 unilateral and 10 bilateral) and 30 healthy volunteers, all with normal plantar fascia morphology on B-mode sonography, were included in the study. Plantar fascia elasticity was evaluated by sonoelastographic examination. All sonoelastograms were quantitatively analyzed, and less red pixel intensity was representative of softer tissue. Pixel intensity was compared among unilateral plantar fasciitis patients, bilateral plantar fasciitis patients, and healthy volunteers by one-way ANOVA. A post hoc Scheffé's test was used to identify where the differences occurred. Compared to healthy participants (red pixel intensity: 146.9 ± 9.1), there was significantly less red pixel intensity in the asymptomatic sides of unilateral plantar fasciitis (140.4 ± 7.3, p = 0.01), symptomatic sides of unilateral plantar fasciitis (127.1 ± 7.4, p plantar fasciitis (129.4 ± 7.5, p plantar fascia thickness or green or blue pixel intensity among these groups. Sonoelastography revealed that the plantar fascia is softer in patients with typical clinical manifestations of plantar fasciitis, even if they exhibit no abnormalities on B-mode sonography.

  9. Intra-rater reliability of hallux flexor strength measures using the Nintendo Wii Balance Board.

    Science.gov (United States)

    Quek, June; Treleaven, Julia; Brauer, Sandra G; O'Leary, Shaun; Clark, Ross A

    2015-01-01

    The purpose of this study was to investigate the intra-rater reliability of a new method in combination with the Nintendo Wii Balance Board (NWBB) to measure the strength of hallux flexor muscle. Thirty healthy individuals (age: 34.9 ± 12.9 years, height: 170.4 ± 10.5 cm, weight: 69.3 ± 15.3 kg, female = 15) participated. Repeated testing was completed within 7 days. Participants performed strength testing in sitting using a wooden platform in combination with the NWBB. This new method was set up to selectively recruit an intrinsic muscle of the foot, specifically the flexor hallucis brevis muscle. Statistical analysis was performed using intra-class coefficients and ordinary least product analysis. To estimate measurement error, standard error of measurement (SEM), minimal detectable change (MDC) and percentage error were calculated. Results indicate excellent intra-rater reliability (ICC = 0.982, CI = 0.96-0.99) with an absence of systematic bias. SEM, MDC and percentage error value were 0.5, 1.4 and 12 % respectively. This study demonstrates that a new method in combination with the NWBB application is reliable to measure hallux flexor strength and has potential to be used for future research and clinical application.

  10. Bilateral congenital absence of flexor pollicis longus with thumb hypoplasia and thenar atrophy

    International Nuclear Information System (INIS)

    Chaudhary, Vikas; Sehgal, Harsha; Bano, Shahina; Parmar, Pranjali R; Kumar, Sanjay

    2014-01-01

    Congenital absence of flexor pollicis longus with or without associated anomalies of thenar muscles and thumb is of rare occurrence. Inability to flex the interphalangeal joint of the thumb and absent dorsal wrinkles and flexion creases of the thumb are important clues to the diagnosis. Routine radiography and cross-sectional imaging help to confirm and document the condition. This article presents an extremely rare case of bilateral congenital absence of flexor pollicis longus tendon with thumb hypoplasia and thenar atrophy

  11. Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

    Science.gov (United States)

    Ciuffolo, Fabio; Ferritto, Anna L; Muratore, Filippo; Tecco, Simona; Testa, Mauro; D'Attilio, Michele; Festa, Felice

    2006-01-01

    This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

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

    DEFF Research Database (Denmark)

    Rose, Martin Høyer; Løkkegaard, Annemette; Sonne-Holm, Stig

    2013-01-01

    The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight...... healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3km/h) were measured before, at the mid-point, and after training. Increasing BW support...... decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without...

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

    Science.gov (United States)

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

    2013-12-01

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

  14. Comparison of isokinetic muscle strength and muscle power by types of warm-up.

    Science.gov (United States)

    Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

    2015-05-01

    [Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.

  15. Neck muscle function in violinists/violists with and without neck pain.

    Science.gov (United States)

    Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

    2016-04-01

    Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

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

    Science.gov (United States)

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

    2015-01-01

    We examined the temporal changes of isokinetic strength performance of knee flexor (KF) and extensor (KE) strength after a football match. Players were randomly assigned to a control (N = 14, participated only in measurements and practices) or an experimental group (N = 20, participated also in a football match). Participants trained daily during the two days after the match. Match and training overload was monitored with GPS devices. Venous blood was sampled and muscle damage was assessed pre-match, post-match and at 12h, 36h and 60h post-match. Isometric strength as well as eccentric and concentric peak torque of knee flexors and extensors in both limbs (dominant and non-dominant) were measured on an isokinetic dynamometer at baseline and at 12h, 36h and 60h after the match. Functional (KFecc/KEcon) and conventional (KFcon/KEcon) ratios were then calculated. Only eccentric peak torque of knee flexors declined at 60h after the match in the control group. In the experimental group: a) isometric strength of knee extensors and knee flexors declined (Pfootball-specific conditioning. Our data suggest that recovery kinetics of knee flexor and extensor strength after a football match demonstrate strength, limb and velocity specificity and may depend on match physical overload and players' physical conditioning level. PMID:26043222

  17. Plantar fasciitis

    Science.gov (United States)

    ... activities in moderation can also help. Images Plantar fascia Plantar fasciitis References Abu-Laban RB, Rose NGW. Ankle ... Elsevier; 2016:970. Kadakia AR. Heel pain and plantar fasciitis In: Miller MD, ... of tendons and fascia and adolescent and adult pes planus. In: Canale ...

  18. Degree of thoracic kyphosis and peak torque of trunk flexors and extensors among healthy women.

    Science.gov (United States)

    Granito, Renata Neves; Aveiro, Mariana Chaves; Rennó, Ana Claudia Muniz; Oishi, Jorge; Driusso, Patricia

    2014-01-01

    The aim of this study was to analyze the effects of aging on the degree of thoracic kyphosis and peak torque of the trunk flexor and extensor muscles among women without a densitometric diagnosis of osteoporosis. Thirty women were selected to make up three groups: young women (n = 10; 24.60 ± 2.27 years of age); adults (n = 10; 43.50 ± 2.88); and elderly women (n = 10; 62.40 ± 2.67). Bone mineral density (BMD), degree of thoracic kyphosis and peak torque of the trunk flexors and extensors were evaluated. Differences between the groups were evaluated using the Kruskal-Wallis ANOVA and Mann-Whitney U tests. Pearson's correlation coefficient was used to assess correlations between the variables. The significance level was taken to be 5% (p ≤ 0.05). The elderly group presented a greater degree of thoracic kyphosis (p = 0.009) and lower peak torque of the trunk flexors and extensors than the young group. The adult group presented lower peak torque of the trunk than the young group. A negative correlation was observed between age and peak torque of the trunk flexors and extensors (p ≤ 0.001), and a positive correlation between age and the degree of thoracic kyphosis (r = 0.58; p ≤ 0.001). The elderly group presented higher values for the eccentric/concentric ratio of the peak torque for flexors (p = 0.03) and extensors (p = 0.02). This study suggests that physiological aging may be associated with a greater degree of thoracic kyphosis and lower muscle strength of the trunk flexors and extensors. Moreover, the elderly women showed a relative capacity for preservation of eccentric strength.

  19. Degree of thoracic kyphosis and peak torque of trunk flexors and extensors among healthy women,

    Directory of Open Access Journals (Sweden)

    Renata Neves Granito

    2014-06-01

    Full Text Available OBJECTIVE: The aim of this study was to analyze the effects of aging on the degree of thoracic kyphosis and peak torque of the trunk flexor and extensor muscles among women without a densitometric diagnosis of osteoporosis.METHODS: Thirty women were selected to make up three groups: young women (n = 10; 24.60 ± 2.27 years of age; adults (n = 10; 43.50 ± 2.88; and elderly women (n= 10; 62.40 ± 2.67. Bone mineral density (BMD, degree of thoracic kyphosis and peak torque of the trunk flexors and extensors were evaluated. Differences between the groups were evaluated using the Kruskal-Wallis ANOVA and Mann-Whitney U tests. Pearson's correlation coefficient was used to assess correlations between the variables. The significance level was taken to be 5% (p < 0.05.RESULTS: The elderly group presented a greater degree of thoracic kyphosis (p = 0.009 and lower peak torque of the trunk flexors and extensors than the young group. The adult group presented lower peak torque of the trunk than the young group. A negative correlation was observed between age and peak torque of the trunk flexors and extensors (p < 0.001, and a positive correlation between age and the degree of thoracic kyphosis (r = 0.58; p < 0.001. The elderly group presented higher values for the eccentric/concentric ratio of the peak torque for flexors (p = 0.03 and extensors (p = 0.02.CONCLUSION: This study suggests that physiological aging may be associated with a greater degree of thoracic kyphosis and lower muscle strength of the trunk flexors and extensors. Moreover, the elderly women showed a relative capacity for preservation of eccentric strength.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-03-29

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

  2. Effects of plyometric and isometric training on muscle and tendon stiffness in vivo.

    Science.gov (United States)

    Kubo, Keitaro; Ishigaki, Tomonobu; Ikebukuro, Toshihiro

    2017-08-01

    The purpose of this study was to compare the effects of plyometric and isometric training on tendon properties during ramp and ballistic contractions and muscle stiffness under passive and active conditions. Eleven subjects completed 12 weeks (3 days/week) of a unilateral training program for the plantar flexors. They performed plyometric training on one side (PLY) and isometric training on the other side (ISO). Active muscle stiffness in the medial gastrocnemius muscle was calculated according to changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Passive muscle stiffness was also calculated from estimated passive muscle force and fascicle length during slow passive stretching. Stiffness and hysteresis of tendon structures were measured using ultrasonography during ramp and ballistic contractions. Passive muscle stiffness and tendon hysteresis did not change for PLY or ISO Active muscle stiffness significantly increased for PLY, but not for ISO Tendon stiffness during ramp and ballistic contractions increased significantly for ISO, but not for PLY In addition, tendon elongation values at force production levels beyond 100 N during ballistic contractions increased for PLY These results suggest that plyometric training (but not isometric training) enhances the extensibility of tendon structures during ballistic contractions and active muscle stiffness during fast stretching, and these changes may be related to improved performances during stretch-shortening cycle exercises. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  3. Age and sex differences in steadiness of elbow flexor muscles with imposed cognitive demand

    Science.gov (United States)

    Pereira, Hugo M.; Spears, Vincent C.; Schlinder-Delap, Bonnie; Yoon, Tejin; Nielson, Kristy A.; Hunter, Sandra K.

    2015-01-01

    Purpose These studies determined (1) age and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and, (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2). Methods 36 young adults (18–25 years; 18 women) and 30 older adults (60–82 years; 17 women) performed isometric contractions at 5%, 30% and 40% of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session (no mental math). Study 2 (older adults only) involved a low-cognitive demand session (subtracting by 1s). Results Older individuals exhibited greater increases in force fluctuations (coefficient of variation of force, CV) with high cognitive demand than young adults, with the largest age difference at 5% MVC (P = 0.01). Older adults had greater agonist EMG activity with high-cognitive demand and women had greater coactivation than men (Pdemand for the older women but not for the older men (P = 0.03). Conclusion Older adults had reduced steadiness and increased muscle activation when high cognitive demand was imposed while low cognitive demand induced increased force fluctuations in older women but not older men. These findings have implications for daily and work-related tasks that involve cognitive demand performed simultaneously during submaximal isometric contractions in an aging workforce. PMID:25633070

  4. The Fate of the Iliopsoas Muscle in Long-term Follow-up After Open Reduction With a Medial Approach in Developmental Dysplasia of the Hip. Part 2: Isokinetic Muscle Strength Evaluation.

    Science.gov (United States)

    Yilmaz, Serdar; Aksahin, Ertugrul; Ersoz, Murat; Bicimoglu, Ali

    2017-09-01

    The impact on long-term weakness of hip flexion of complete iliopsoas tenotomy during open reduction of developmental hip dysplasia with a medial approach has not yet been fully clarified. The purpose of this study was to investigate the isokinetic muscle strength (IMS) of hip flexor and extensor muscles in these patients and also to analyze the effect of spontaneous reattachment of the iliopsoas muscle on IMS measurements. The study included 20 patients. Earlier magnetic resonance imaging examination of all the patients revealed spontaneous reattachment of the iliopsoas in 18 (90%) patients. IMS measurements were performed at 60 and 150 degrees/s. The peak torque, total work (TW), average power (AP), work fatigue, and agonist to antagonist muscle ratio of the operated and nonoperated hips were recorded separately for flexors and extensors. The effect of iliopsoas reattachment on IMS was also evaluated. The mean follow-up period was 16.65±2.16 (13 to 20) years. Total work (P=0.013) and average power (P=0.009) of the flexor muscles and work fatigue of the extensor muscles (P=0.030) of the operated hip were significantly decreased when compared with the nonoperated hips at 150 degrees/s. There was no significant difference between the flexor muscles of the operated and nonoperated hips (Phips. Flexor muscle strength was decreased in the operated hip against low resistance in long-term follow-up after iliopsoas tenotomy. This may reflect that hip muscle strength was decreased after prolonged activities such as sports. However, in forceful activities flexor muscle strength was retained due to iliopsoas reattachment. On the basis of this study we thought that spontaneous reattachment of the iliopsoas tendon substantially preserves muscle strength. Nonetheless possible efforts should be made to surgically reattach the psoas tendon to preserve strength of the muscle. Therapeutic level IV.

  5. Seasonal variation in isokinetic strength of knee flexors and extensors in soccer players

    Directory of Open Access Journals (Sweden)

    Michal Lehnert

    2015-06-01

    Full Text Available BACKGROUND: Muscle strength is an important factor in soccer from the performance and health perspective. There is a lack of knowledge about changes in muscle strength of the knee flexors and extensors and their ratios during annual training cycle. OBJECTIVES: The aim of this study was to evaluate the seasonal variability of the observed parameters of isokinetic strength of the knee flexors and extensors in soccer players, U19, from the performance and health perspective. METHODS: The strength of the knee flexors and extensors was measured in players U19 category (n = 9; the average age 18.5 ±0.4 years on the isokinetic dynamometer IsoMed 2000 in angular velocity 60° × s-1. Measurement was performed in concentric/concentric and excentric/excentric mode of muscle action at the beginning of the winter preparatory period, at the end of the preparatory period and at the end of the spring competitive period. Monitored parameters were absolute peak torque (PT, conventional H/Q ratio (H/QCON, functional H/Q ratio (H/QFUN and functional H/Q ratio in range 10-30° of knee flexion (H/QFUN_10-30. RESULTS: Significant change in PT (p < .05 was noted only in cases of the knee extensors of the nondominant leg in the concentric mode. The evaluation of imbalance of the knee flexors and extensors by H/QCON and H/QFUN ratios did not show any significant changes, but there was found a significant decrease of the H/QFUN_10-30 ratio in the dominant leg between measurements at the beginning and at the end of the winter preparatory period. CONCLUSIONS: The results of the current study indicate that throughout the monitored periods of the annual training cycle desirable changes in knee flexors and extensors strength did not occur. The values suggest the disruption of the dynamic stabilization of the knee joint and increase in injury risk. Different dynamics of the three observed ratios confirmed that they provide different information about the physical fitness of

  6. Endoscopic Plantar Fascia Debridement for Chronic Plantar Fasciitis.

    Science.gov (United States)

    Cottom, James M; Baker, Joseph S

    2016-10-01

    When conservative therapy fails for chronic plantar fasciitis, surgical intervention may be an option. Surgical techniques that maintain the integrity of the plantar fascia will have less risk of destabilizing the foot and will retain foot function. Endoscopic debridement of the plantar fascia can be performed reproducibly to reduce pain and maintain function of the foot. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Influence of sex on performance fatigability of the plantar flexors following repeated maximal dynamic shortening contractions.

    Science.gov (United States)

    Lanning, Amelia C; Power, Geoffrey A; Christie, Anita D; Dalton, Brian H

    2017-10-01

    The purpose was to determine sex differences in fatigability during maximal, unconstrained velocity, shortening plantar flexions. The role of time-dependent measures (i.e., rate of torque development, rate of velocity development, and rate of neuromuscular activation) in such sex-related differences was also examined. By task termination, females exhibited smaller reductions in power and similar changes in rate of neuromuscular activation than males, indicating females were less fatigable than males.

  8. Association between isometric muscle strength and gait joint kinetics in adolescents and young adults with cerebral palsy.

    Science.gov (United States)

    Dallmeijer, A J; Baker, R; Dodd, K J; Taylor, N F

    2011-03-01

    The purpose of this study was to determine the association between isometric muscle strength of the lower limbs and gait joint kinetics in adolescents and young adults with cerebral palsy (CP). Twenty-five participants (11 males) with bilateral spastic CP, aged 14-22 years (mean: 18.9, sd: 2.0 yr) and Gross Motor Function Classification System (GMFCS) level II (n=19) and III (n=6) were tested. Hand held dynamometry was used to measure isometric strength (expressed in Nm/kg) of the hip, knee, and ankle muscles using standardized testing positions and procedures. 3D gait analysis was performed with a VICON system to calculate joint kinetics in the hip, knee and ankle during gait. Ankle peak moments exceeded by far the levels of isometric strength of the plantar flexors, while the knee and hip peak moments were just at or below maximal isometric strength of knee and hip muscles. Isometric muscle strength showed weak to moderate correlations with peak ankle and hip extension moment and power during walking. Despite considerable muscle weakness, joint moment curves were similar to norm values. Results suggest that passive stretch of the muscle-tendon complex of the triceps surae contributes to the ankle moment during walking and that muscle strength assessment may provide additional information to gait kinetics. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Overexpression of IGF-1 attenuates skeletal muscle damage and accelerates muscle regeneration and functional recovery after disuse

    Science.gov (United States)

    Ye, Fan; Mathur, Sunita; Liu, Min; Borst, Stephen E.; Walter, Glenn A.; Sweeney, H. Lee; Vandenborne, Krista

    2014-01-01

    Skeletal muscle is a highly dynamic tissue that responds to endogenous and external stimuli, including alterations in mechanical loading and growth factors. In particular, the antigravity soleus muscle experiences significant muscle atrophy during disuse and extensive muscle damage upon reloading. Since insulin-like growth factor-1 (IGF-1) has been implicated as a central regulator of muscle repair and modulation of muscle size, we examined the effect of viral mediated overexpression of IGF-1 on the soleus muscle following hindlimb cast immobilization and upon reloading. Recombinant IGF-1 cDNA virus was injected into one of the posterior hindlimbs of the mice, while the contralateral limb was injected with saline (control). At 20 weeks of age, both hindlimbs were immobilized for two weeks to induce muscle atrophy in the soleus and ankle plantar flexor muscle group. Subsequently, the mice were allowed to reambulate and muscle damage and recovery was monitored over a period of 2 to 21 days. The primary finding of this study was that IGF-1 overexpression attenuated reloading-induced muscle damage in the soleus muscle, and accelerated muscle regeneration and force recovery. Muscle T2 assessed by MRI, a nonspecific marker of muscle damage, was significantly lower in IGF-1 injected, compared to contralateral soleus muscles at 2 and 5 days reambulation (P<0.05). The reduced prevalence of muscle damage in IGF-1 injected soleus muscles was confirmed on histology, with a lower fraction area of abnormal muscle tissue in IGF-I injected muscles at 2 days reambulation (33.2±3.3%vs 54.1±3.6%, P<0.05). Evidence of the effect of IGF-1 on muscle regeneration included timely increases in the number of central nuclei (21% at 5 days reambulation), paired-box transcription factor 7 (36% at 5 days), embryonic myosin (37% at 10 days), and elevated MyoD mRNA (7-fold at 2 days) in IGF-1 injected limbs (P<0.05). These findings demonstrate a potential role of IGF-1 in protecting unloaded

  11. Plantar vein thrombosis: a rare cause of plantar foot pain

    International Nuclear Information System (INIS)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G.; Challies, Tracy

    2008-01-01

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  12. Plantar vein thrombosis: a rare cause of plantar foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Challies, Tracy [Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA (United States)

    2008-03-15

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  13. Flexor zone 5 cut injuries: emergency management and outcome

    International Nuclear Information System (INIS)

    Raza, M.S.

    2014-01-01

    To determine the outcome and devise a protocol for emergency management of cut injuries in Flexor Zone 5 of hands. Study Design: Descriptive study. Place and Duration of Study: Department of Plastic Surgery and Burn Unit, Mayo Hospital, KEMU, Lahore, Pakistan, from January 2009 to March 2013. Methodology: All patients above 12 years of age with single sharp cut injuries in Flexor Zone 5, with no skeletal injuries, presenting within 12 hours in emergency were included with follow-up of 6 months, with active range of motion evaluated by Strickland's adjusted formula. Power of opponens pollicis and adductor muscles was evaluated from P0-4. Nerve repair results were evaluated serially by advancing Tinnel's sign, electrophysiological studies and sensory perception scored from S0-4 compared to the normal opposite upper limb. Results: The study group comprised of 31 patients (M : F = 2.4 : 1). Average age was 27 years ranging from 17 - 53 years. In 25 (80%) cases, injury was accidental, in 3 (10%) homicidal and in 3 (10%) injury was suicidal. Four most commonly involved structures included Flexor carpi ulnaris, ulnar artery, ulnar nerve and Flexor digitorum superficialis. Median nerve and radial artery were involved in 10 cases each, while ulnar artery and ulnar nerve were involved in 14 cases each. Longtendons were involved in most cases with greater involvement of medial tendons. None of the patients required re-exploration for ischaemia of distal limb while doppler showed 22 out of 24 vascular anastomosis remained patent. Recovery of long-tendons was good and recovery after nerve repair was comparable in both median and ulnar nerves. Conclusion: Early and technically proper evaluation, exploration and repair of Zone 5 Flexor tendon injuries results in good functional and technical outcome. (author)

  14. Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity.

    Science.gov (United States)

    Kwon, O Y; Tuttle, L J; Johnson, J E; Mueller, M J

    2009-10-01

    Multiple factors may contribute to hammer toe deformity at the metatarsophalangeal joint. The purposes of this study were to (1) compare the ratio of toe extensor/flexor muscle strength in toes 2-4 among groups with and without hammer toe deformity, (2) to determine correlations between the ratio of toe extensor/flexor muscle strength in toes 2-4, and metatarsophalangeal joint deformity (3) to determine if other clinical measures differ between groups and if these measures are correlated with metatarsophalangeal joint angle. Twenty-seven feet with visible hammer toe deformity and 31 age matched feet without hammer toe deformity were tested. Toe muscle strength was measured using a dynamometer and the ratio of toe extensor muscle strength to flexor muscle strength was calculated. Metatarsophalangeal joint angle was measured from a computerized tomography image. Ankle and subtalar joint range of motion, and tibial torsion were measured using goniometry. Extensor/flexor toe muscle strength ratio was 2.3-3.0 times higher in the hammer toe group compared to the non-hammer toe group, in toes 2-4. The ratios of extensor/flexor toe muscle strength for toes 2-4 and metatarsophalangeal joint angle were highly correlated (r=0.69-0.80). Ankle dorsiflexion and metatarsophalangeal joint angle were negatively correlated for toes 2-4 (r=-0.38 to -0.56) as were eversion and metatarsophalangeal joint angle. These results provide insight into potential risk factors for the development of hammer toe deformity. Additional research is needed to determine the causal relationship between hammer toe deformity and the ratio of toe extensor/flexor muscle strength in toes 2-4.

  15. The effects of extracorporeal shock wave therapy on stroke patients with plantar fasciitis

    Science.gov (United States)

    Kim, Tae Gon; Bae, Sea Hyun; Kim, Gye Yeop; Kim, Kyung Yoon

    2015-01-01

    [Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30 min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients. PMID:25729207

  16. Effects of Muscle Strength and Balance Control on Sit-to-Walk and Turn Durations in the Timed Up and Go Test.

    Science.gov (United States)

    Chen, Tzurei; Chou, Li-Shan

    2017-12-01

    To examine the association of muscle strength and balance control with the amount of time taken to perform sit-to-walk (STW) or turning components of the Timed Up and Go (TUG) test in older adults. Correlations; multiple regression models. General community. Older adults (N=60) age >70 years recruited from the community. Not applicable. Muscle strength, balance control, and TUG test performance time. Muscle strength was quantified by peak joint moments during the isometric maximal voluntary contraction test for bilateral hip abductors, knee extensors, and ankle plantar flexors. Balance control was assessed with the Berg Balance Scale, Fullerton Advanced Balance Scale, and center of mass and ankle inclination angle derived during the TUG test performance. We found that balance control measures were significantly associated with both STW and turning durations even after controlling for muscle strength and other confounders (STW duration: Pbalance control is an important factor that contributes to longer STW and turning durations on the TUG test. Furthermore, strength has a higher association with STW than turning duration. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Selective plantar fascia release for nonhealing diabetic plantar ulcerations.

    Science.gov (United States)

    Kim, J Young; Hwang, Seungkeun; Lee, Yoonjung

    2012-07-18

    Achilles tendon lengthening can decrease plantar pressures, leading to resolution of forefoot ulceration in patients with diabetes mellitus. However, this procedure has been reported to have a complication rate of 10% to 30% and can require a long period of postoperative immobilization. We have developed a new technique, selective plantar fascia release, as an alternative to Achilles tendon lengthening for managing these forefoot ulcers. We evaluated sixty patients with diabetes for a mean of 23.5 months after selective plantar fascia release for the treatment of nonhealing diabetic neuropathic ulcers in the forefoot. Preoperative and postoperative dorsiflexion range of motion of the affected metatarsophalangeal joint and wound-healing data were used to evaluate the effectiveness of the procedure and to determine the relationship between plantar fascia release and ulcer healing. Complications were recorded. Thirty-six (56%) of the ulcers healed within six weeks, including twenty-nine (60%) of the plantar toe ulcers and seven (44%) of the metatarsophalangeal joint ulcers. The mean range of motion of the affected metatarsophalangeal joint increased from 15.3° ± 7.8° to 30.6° ± 14.1° postoperatively (p plantar fascia release. Our results suggest that selective plantar fascia release can lead to healing of neuropathic plantar forefoot ulcers in diabetic patients. Ulcers in patients in whom the preoperative dorsiflexion angle of the affected metatarsophalangeal joint is between 5° and 30° and in whom the increase in range of motion is ≥13° postoperatively have the greatest chance of being cured. Therapeutic level IV. See Instructions for Authors for a complete description of the levels of evidence.

  18. Higher plantar pressure on the medial side in four soccer-related movements.

    Science.gov (United States)

    Wong, Pui-lam; Chamari, Karim; Mao, De Wei; Wisløff, Ulrik; Hong, Youlian

    2007-02-01

    To measure the plantar pressure in four soccer-related movements in 15 male soccer players (mean (SD) age 20.9 (1.3) years, height 173 (4) cm, weight 61.7 (3.6) kg). To record plantar pressure distribution, the players wore soccer boots with 12 circular studs and with an insole pressure recorder device equipped with 99 sensors. Plantar pressure was recorded in five successful trials in each of the four soccer-related movements: running, sideward cutting, 45 degrees cutting and landing from a vertical jump. Each footprint was divided into 10 recorded areas for analysis. Compared with running at 3.3 m/s, maximal speed sideward cutting and 45 degrees cutting induced higher peak pressure (pplantar surface as compared with the lateral side. These data suggest that the medial side of the plantar surface may be more prone to injuries, and that foot orthosis adoption, improved soccer boot design and specific muscle training could be considered to reduce pressure and the subsequent risk of injury.

  19. Isometric torque-angle relationship and movement-related activity of human elbow flexors: implications for the equilibrium-point hypothesis.

    Science.gov (United States)

    Hasan, Z; Enoka, R M

    1985-01-01

    Since the moment arms for the elbow-flexor muscles are longest at intermediate positions of the elbow and shorter at the extremes of the range of motion, it was expected that the elbow torque would also show a peak at an intermediate angle provided the activity of the flexor muscles remained constant. We measured the isometric elbow torque at different elbow angles while the subject attempted to keep constant the electromyographic activity (EMG) of the brachioradialis muscle. The torque-angle relationship thus obtained exhibited a peak, as expected, but the shape of the relationship varied widely among subjects. This was due in part to differences in the variation of the biceps brachii EMG with elbow angle among the different subjects. The implications of these observations for the equilibrium-point hypothesis of movement were investigated as follows. The subject performed elbow movements in the presence of an external torque (which tended to extend the elbow joint) provided by a weight-and-pulley arrangement. We found in the case of flexion movements that invariably there was a transient increase in flexor EMG, as would seem necessary for initiating the movement. However, the steady-state EMG after the movement could be greater or less than the pre-movement EMG. Specifically, the least flexor EMG was required for equilibrium in the intermediate range of elbow angles, compared to the extremes of the range of motion. The EMG-angle relationship, however, varied with the muscle and the subject. The observation that the directions of change in the transient and the steady-state EMG are independent of each other militates against the generality of the equilibrium-point hypothesis. However, a form of the hypothesis which includes the effects of the stretch reflex is not contradicted by this observation.

  20. Degree of thoracic kyphosis and peak torque of trunk flexors and extensors among healthy women☆☆☆

    Science.gov (United States)

    Granito, Renata Neves; Aveiro, Mariana Chaves; Rennó, Ana Claudia Muniz; Oishi, Jorge; Driusso, Patricia

    2014-01-01

    Objective The aim of this study was to analyze the effects of aging on the degree of thoracic kyphosis and peak torque of the trunk flexor and extensor muscles among women without a densitometric diagnosis of osteoporosis. Methods Thirty women were selected to make up three groups: young women (n = 10; 24.60 ± 2.27 years of age); adults (n = 10; 43.50 ± 2.88); and elderly women (n = 10; 62.40 ± 2.67). Bone mineral density (BMD), degree of thoracic kyphosis and peak torque of the trunk flexors and extensors were evaluated. Differences between the groups were evaluated using the Kruskal–Wallis ANOVA and Mann–Whitney U tests. Pearson's correlation coefficient was used to assess correlations between the variables. The significance level was taken to be 5% (p ≤ 0.05). Results The elderly group presented a greater degree of thoracic kyphosis (p = 0.009) and lower peak torque of the trunk flexors and extensors than the young group. The adult group presented lower peak torque of the trunk than the young group. A negative correlation was observed between age and peak torque of the trunk flexors and extensors (p ≤ 0.001), and a positive correlation between age and the degree of thoracic kyphosis (r = 0.58; p ≤ 0.001). The elderly group presented higher values for the eccentric/concentric ratio of the peak torque for flexors (p = 0.03) and extensors (p = 0.02). Conclusion This study suggests that physiological aging may be associated with a greater degree of thoracic kyphosis and lower muscle strength of the trunk flexors and extensors. Moreover, the elderly women showed a relative capacity for preservation of eccentric strength. PMID:26229814

  1. The correlation between plantar fascia thickness and symptoms of plantar fasciitis.

    Science.gov (United States)

    Mahowald, Sarah; Legge, Bradford S; Grady, John F

    2011-01-01

    The purpose of this study was to determine whether changes in plantar fascia thickness are a reliable gauge of efficacy of treatment protocols for plantar fasciitis. Thirty-nine feet (30 patients) with plantar fasciitis received an ultrasound examination to measure the thickness of the medial band of the plantar fascia. Each patient assessed his or her pain using the visual analogue scale. Following various treatments, a second ultrasound examination was performed and the thickness of the plantar fascia was again measured and subjective pain level assessed. Twenty-nine feet (74.4%) showed a decrease in plantar fascia thickness and a decrease in pain. One foot (2.6%) experienced an increase in fascia thickness and reported an increase in pain. Four feet (10.3%) had an increase in thickness of the plantar fascia and reported no change in pain level. Three feet had minor increases in fascia thickness but reported a decrease in pain (7.7%). One foot (2.6%) had no change in fascia thickness but a decrease in pain and one foot (2.6%) had a decrease in the plantar fascia but no change in pain level. The average reduction in fascia thickness was 0.82 mm ± 1.04 mm, correlating with an average improvement in pain of 3.64 ± 2.7 (P plantar fascia is a valid objective measurement to assess effectiveness of new or existing treatment protocols.

  2. A Rare Case of Deep Digital Flexor Tendinopathy following Centesis of the Navicular Bursa

    Directory of Open Access Journals (Sweden)

    Tim J. Froydenlund

    2017-10-01

    Full Text Available Navicular bursa (NB centesis is a common diagnostic and therapeutic procedure in equine practice. This case report documents the clinical, diagnostic imaging and histological findings in a horse with a suspected iatrogenic deep digital flexor tendon (DDFT injury following centesis of the NB via a modified distal plantar approach (placement of two needles in a weight bearing position. Although it cannot be proven with absolute certainty, the authors believe that this is the first reported case where NB centesis is the likely cause of a DDFT lesion, and with magnetic resonance imaging performed both pre- and post-centesis. With this potential, though rare, complication of the procedure, alternative tendon sparing injection techniques should be considered prior to NB centesis in certain cases.

  3. Flexion synergy overshadows flexor spasticity during reaching in chronic moderate to severe hemiparetic stroke.

    Science.gov (United States)

    Ellis, Michael D; Schut, Ingrid; Dewald, Julius P A

    2017-07-01

    Pharmaceutical intervention targets arm flexor spasticity with an often-unsuccessful goal of improving function. Flexion synergy is a related motor impairment that may be inadvertently neglected. Here, flexor spasticity and flexion synergy are disentangled to determine their contributions to reaching dysfunction. Twenty-six individuals participated. A robotic device systematically modulated shoulder abduction loading during ballistic reaching. Elbow muscle electromyography data were partitioned into windows delineated by elbow joint velocity allowing for the separation of synergy- and spasticity-related activation. Reaching velocity decreased with abduction loading (psynergy increased with abduction loading (psynergy is the predominant contributor to reaching dysfunction while flexor spasticity appears only relevant during unnaturally occurring passively supported movement. Interventions targeting flexion synergy should be leveraged in future stroke recovery trials. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  4. Quantitative muscle ultrasonography in amyotrophic lateral sclerosis.

    NARCIS (Netherlands)

    Arts, I.M.P.; Rooij, F.G. van; Overeem, S.; Pillen, S.; Janssen, H.M.; Schelhaas, H.J.; Zwarts, M.J.

    2008-01-01

    In this study, we examined whether quantitative muscle ultrasonography can detect structural muscle changes in early-stage amyotrophic lateral sclerosis (ALS). Bilateral transverse scans were made of five muscles or muscle groups (sternocleidomastoid, biceps brachii/brachialis, forearm flexor group,

  5. Effects of muscle activation on shear between human soleus and gastrocnemius muscles.

    Science.gov (United States)

    Finni, T; Cronin, N J; Mayfield, D; Lichtwark, G A; Cresswell, A G

    2017-01-01

    Lateral connections between muscles provide pathways for myofascial force transmission. To elucidate whether these pathways have functional roles in vivo, we examined whether activation could alter the shear between the soleus (SOL) and lateral gastrocnemius (LG) muscles. We hypothesized that selective activation of LG would decrease the stretch-induced shear between LG and SOL. Eleven volunteers underwent a series of knee joint manipulations where plantar flexion force, LG, and SOL muscle fascicle lengths and relative displacement of aponeuroses between the muscles were obtained. Data during a passive full range of motion were recorded, followed by 20° knee extension stretches in both passive conditions and with selective electrical stimulation of LG. During active stretch, plantar flexion force was 22% greater (P stronger (stiffer) connectivity between the two muscles, at least at flexed knee joint angles, which may serve to facilitate myofascial force transmission. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Using of Tendinous Plasty in Treatment of Patients with Flexor Tendons of 2–5 Fingers Injury in “Critical” Zone

    Directory of Open Access Journals (Sweden)

    S.I. Kireev

    2009-06-01

    Full Text Available Injury of both superficial and deep tendons of fingers flexors needs to carry out tendinous plasty with excision of distal part of superficial flexor muscle tendon. Use of length measuring method for tendinous transplant allows us to avoid the flexion contracture in future and appearance of functional insufficiency of flexion during postoperative period and rehabilitation of patient.

  7. The relationship between passive stiffness and evoked twitch properties: the influence of muscle CSA normalization

    International Nuclear Information System (INIS)

    Ryan, E D; Thompson, B J; Sobolewski, E J; Herda, T J; Costa, P B; Walter, A A; Cramer, J T

    2011-01-01

    Passive stiffness measurements are often used as a clinical tool to examine a muscle's passive lengthening characteristics. The purpose of this study was to examine the relationship between passive stiffness and evoked twitch properties prior to and following normalization of passive stiffness to muscle cross-sectional area (CSA). Ten healthy volunteers (mean ± SD age = 23 ± 3 year) performed passive range of motion, evoked twitch, and muscle CSA assessments of the plantar flexor muscles. Passive stiffness was determined from the slope of the final 5° of the angle–torque curve. Peak twitch torque (PTT) and rate of torque development (RTD) were determined via transcutaneous electrical stimulation, and muscle CSA was assessed using a peripheral quantitative computed tomography scanner. Pearson product moment correlation coefficients (r) were used to assess the relationships between passive stiffness and PTT and RTD and normalized passive stiffness (passive stiffness . muscle CSA −1 ) and PTT and RTD. Significant positive relationships were observed between passive stiffness and PTT (P = 0.003, r = 0.828) and RTD (P = 0.003, r = 0.825). There were no significant relationships between normalized passive stiffness and PTT (P = 0.290, r = 0.372) or RTD (P = 0.353, r = 0.329) demonstrating that stiffness did not account for a significant portion of the variance in twitch properties. Passive stiffness was largely influenced by the amount of muscle tissue in this study. Future studies that examine muscle stiffness and its relationship with performance measures, among different populations, and following various interventions may consider normalizing stiffness measurements to muscle CSA

  8. Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Walther, Markus; Yilmaz, Tayfun

    2017-01-01

    of life. 17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution......Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality...... correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak...

  9. Plantar fibromatosis. Ultrasound assessment; La fibromatosi plantare: risultati ecografici

    Energy Technology Data Exchange (ETDEWEB)

    Solivetti, F.R.; Luzi, F.; Bucher, S.; Thorel, M.F.; Muscardin, L. [Rome Ospedale Santa Maria e San Gallicano, Rome (Italy)

    1999-05-01

    In 1998-99, six patients with plantar fibromatosis were submitted to US (ultrasound) with plantar fibromatosis were submitted to US with 13 MHz linear array and 20 MHz mechanical annular array probes. All patients were examined in prone recumbency with the probe positioned on the sole of the foot. Only some of them were subsequently submitted to surgery. Plantar fibromatosis exhibited an almost pathognomonic pattern and US proved to be a quick, noninvasive and cost-effective technique to confirm clinical diagnosis. The nodule is typically single and iso echoic, with maximum diameter of about 1 cm, inhomogeneous internal structure and few thin hyperechoic septa. The nodular fibrous proliferation adheres with the major axis along the plantar fascia; it exhibits clear-cut margins and US beam transmission is good. No calcifications or fluid collections are seen within the nodule. Color and power Doppler show no flow inside. It is demonstrated that US is an adequate tool for the study of plantar fibromatosis. [Italian] Negli anni 1998-99 sono stati osservati ben sei casi di fibromatosi plantare, solo in parte trattati chirurgicamente. Tutti sono stati studiati con ecografia, con apparecchiatura in tempo reale e sonde lineari da 13 MHz e anulari da 20 MHz. Si puo' descrivere un quadro tipico della malattia diagnosticabile con l'ecografia, specie in associazione con sintomi clinici caratteristici.

  10. Muscle imbalance between ankle dorsiflexors and plantarflexors after conservative and accelerated treatment of Achilles tendon rupture

    OpenAIRE

    Mayer, Alexandre; Frasson, Viviane Bortoluzzi; Ott, Rafael; Fortuna, Rafael de Oliveira; Vaz, Marco Aurelio

    2010-01-01

    A ruptura do tendão calcâneo (TC) reduz a sobrecarga mecânica dos flexores plantares (FP) do tornozelo. Essa alteração muda o equilíbrio natural entre os FP e flexores dorsais (FD) do tornozelo. O objetivo do estudo foi avaliar as razões isocinéticas concêntricas convencionais de torque de pacientes submetidos a tratamento cirúrgico de ruptura aguda do TC após dois protocolos diferentes de reabilitação. Após procedimento cirúrgico para reconstrução do TC, a amostra foi dividida de forma inten...

  11. Plantar flaps based on perforators of the plantar metatarsal/common digital arteries.

    Science.gov (United States)

    Valentin, Georgescu Alexandru; Rodica, Matei Ileana; Manuel, Llusa

    2014-09-01

    Because of the unique characteristics of its integument, the affirmation "replacing like with like" becomes more than evident in the reconstruction of defects of the ultraspecialized plantar skin. But, the paucity of local resources, and especially in the forefoot, transforms this attempt in a very challenging problem. Many techniques, including skin grafts and various types of flaps were used in the management of defects in the forefoot. We present a new useful flap in the reconstruction of skin defects in the forefoot, based on small perforator vessels originating either from the plantar metatarsal arteries or plantar common digital arteries. Starting with June 2011, this flap was performed, as plantar transposition perforator flap, plantar propeller flap, or plantar propeller perforator plus flap, in seven patients with ulcers over the plantar forefoot. During a follow-up of 7 to 17 months (mean, 9.8 months), the local evolution regarding flap integration, pain, relapse, sensitive recovery, donor site, and footwear quality was analyzed. We registered a 100% survival rate of the flaps, with delayed healing in only one case. The gait resumption was possible after 6 weeks in all cases. This new flap, based on small perforator vessels from the plantar metatarsal or common digital arteries, and which provides a good, stable, and sensory recovery, seems to be a promising method in the reconstruction of plantar skin defects over the metatarsal heads. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Effect of a step-training program on muscle strength in older women

    Directory of Open Access Journals (Sweden)

    Daniela Coelho Zazá

    2010-04-01

    Full Text Available Step-training is associated with strength improvement of the lower limbs. Muscle strength is a critical component for the maintenance of functional capacity. The objective of the present study was to determine the effect of 6 weeks of step-training on work and power of the lower limbs in older women. Thirteen healthy and active women volunteered to participate in the study. All subjects underwent step-training classes three times per week for 60 min. Strength variables of the knee extensor and flexor muscles were measured with a Biodex System 3 Pro isokinetic dynamometer. Muscle work and power were assessed at an angular velocity of 60 and 180°/s. A significant difference (p<0.05 in knee flexor muscle work was observed between pre- and post-test at 60 and 180°/s. There was a significant difference (p<0.05 in knee extensor muscle work between pre- and post-test at 60°/s. Significant differences were observed between pre- and post-test values of knee flexor muscle power at 60°/s (p<0.05 and knee extensor muscle power at 60 and 180°/s (p<0.05. In conclusion, step-training can be recommended as an alternative physical activity to increase strength performance (work and power of the knee extensor and flexor muscles in older subjects.

  13. Effect of Achilles tendon loading on plantar fascia tension in the standing foot.

    Science.gov (United States)

    Cheung, Jason Tak-Man; Zhang, Ming; An, Kai-Nan

    2006-02-01

    The plantar fascia, which is one of the major arch-supporting structures of the human foot, sustains high tensions during weight-bearing. A positive correlation between Achilles tendon loading and plantar fascia tension has been reported. Excessive stretching and tightness of the Achilles tendon are thought to be the risk factors of plantar fasciitis but their biomechanical effects on the plantar fascia have not been fully addressed. A three-dimensional finite element model of the human foot and ankle, incorporating geometrical and material nonlinearity, was employed to investigate the loading response of the plantar fascia in the standing foot with different magnitudes of Achilles tendon loading. With the total ground reaction forces of one foot maintained at 350 N to represent half body weight, an increase in Achilles tendon load from (0-700 N) resulted in a general increase in total force and peak plantar pressure at the forefoot of up to about 250%. There was a lateral and anterior shift of the centre of pressure and a reduction in the arch height with an increasing Achilles tendon load as a result of the plantar flexion moment on the calcaneus. From the finite element predictions of simulated balanced standing, Achilles tendon forces of 75% of the total weight on the foot (350 N) were found to provide the closest match of the measured centre of pressure of the subject during balanced standing. Both the weight on the foot and Achilles tendon loading resulted in an increase in tension of the plantar fascia with the latter showing a two-times larger straining effect. Increasing tension on the Achilles tendon is coupled with an increasing strain on the plantar fascia. Overstretching of the Achilles tendon resulting from intense muscle contraction and passive stretching of tight Achilles tendon are plausible mechanical factors for overstraining of the plantar fascia.

  14. Comparison of the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy young women.

    Science.gov (United States)

    Shirazi, Zahra Rojhani; Jahromi, Fatemeh Nikhalat

    2013-09-01

    The maintenance of balance is an essential requirement for the performance of daily tasks and sporting activities and muscular fatigue is a factor to impair postural control, so this study was done to compare the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy subjects. Fifteen healthy female students (24.3 ± 2.6 years) completed three testing session with a break period of at least 2 days. During each session, postural control was assessed during two 30-s trials of bipedal stance with eyes close before and after the fatigue protocol. Fatigue protocols were performed by 60% of their unfatigued Maximum Voluntary Contraction of unilateral ankle plantar flexors, bilateral lumbar extensors and bilateral neck extensors. One of the three fatigue protocols was performed on each session. The result showed that fatigue had a significant effect on COP velocity and it increase COP velocity but there was not found any difference in postural sway between muscle groups. Localized muscle fatigue caused deficits in postural control regardless of the location of fatigue. Authors suggest the possibility of the contributions of central mechanisms to postural deficits due to fatigue and it seems that difference was not between muscle groups due to central fatigue.

  15. MR imaging of flexor digitorum accessorius longus

    International Nuclear Information System (INIS)

    Cheung, Y.Y.; Rosenberg, Z.S.; Colon, E.; Jahss, M.

    1999-01-01

    Objective The flexor digitorum accessorius longus muscle (FDAL), an anomalous muscle about the ankle, has recently been implicated in tarsal tunnel syndrome. The purpose of this study is to document the prevalence of the FDAL, its MR appearance and its relation to the neurovascular bundle in the tarsal tunnel. Design and patients The prevalence of the FDAL was determined from 100 ankle MR examinations in asymptomatic individuals. The appearance of the FDAL was summarized from 20 examples of FDAL: six gathered from the asymptomatic group and 14 acquired from a group of randomly collected cases of patients with ankle complaints. Results The prevalence of the FDAL was 6%, calculated from the group of 100 asymptomatic individuals. Possessing a dominant fleshy component in the tarsal tunnel, the FDAL accompanies the posterior neurovascular bundle as it descends the ankle. Conclusion The FDAL is encountered in 6% of asymptomatic individuals. Its prominent fleshy component in the tarsal tunnel and its close proximity to the posterior tibial neurovascular bundle readily differentiate the FDAL from other medial anomalous muscles on MR imaging. (orig.)

  16. The functional significance of hamstrings composition: is it really a "fast" muscle group?

    Science.gov (United States)

    Evangelidis, Pavlos E; Massey, Garry J; Ferguson, Richard A; Wheeler, Patrick C; Pain, Matthew T G; Folland, Jonathan P

    2017-11-01

    Hamstrings muscle fiber composition may be predominantly fast-twitch and could explain the high incidence of hamstrings strain injuries. However, hamstrings muscle composition in vivo, and its influence on knee flexor muscle function, remains unknown. We investigated biceps femoris long head (BFlh) myosin heavy chain (MHC) composition from biopsy samples, and the association of hamstrings composition and hamstrings muscle volume (using MRI) with knee flexor maximal and explosive strength. Thirty-one young men performed maximal (concentric, eccentric, isometric) and explosive (isometric) contractions. BFlh exhibited a balanced MHC distribution [mean ± SD (min-max); 47.1 ± 9.1% (32.6-71.0%) MHC-I, 35.5 ± 8.5% (21.5-60.0%) MHC-IIA, 17.4 ± 9.1% (0.0-30.9%) MHC-IIX]. Muscle volume was correlated with knee flexor maximal strength at all velocities and contraction modes (r = 0.62-0.76, P hamstrings strain injury. Hamstrings muscle volume explained 38-58% of the inter-individual differences in knee flexor maximum strength at a range of velocities and contraction modes, while BFlh muscle composition was not associated with maximal or explosive strength. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Higher plantar pressure on the medial side in four soccer‐related movements

    Science.gov (United States)

    Wong, Pui‐lam; Chamari, Karim; De Wei Mao; Wisløff, Ulrik; Hong, Youlian

    2007-01-01

    Objective To measure the plantar pressure in four soccer‐related movements in 15 male soccer players (mean (SD) age 20.9 (1.3) years, height 173 (4) cm, weight 61.7 (3.6) kg). Design To record plantar pressure distribution, the players wore soccer boots with 12 circular studs and with an insole pressure recorder device equipped with 99 sensors. Plantar pressure was recorded in five successful trials in each of the four soccer‐related movements: running, sideward cutting, 45° cutting and landing from a vertical jump. Each footprint was divided into 10 recorded areas for analysis. Results Compared with running at 3.3 m/s, maximal speed sideward cutting and 45° cutting induced higher peak pressure (pplantar surface as compared with the lateral side. Conclusions These data suggest that the medial side of the plantar surface may be more prone to injuries, and that foot orthosis adoption, improved soccer boot design and specific muscle training could be considered to reduce pressure and the subsequent risk of injury. PMID:17178776

  18. Strength deficit of knee flexors is dependent on hip position in adults with chronic hemiparesis.

    Science.gov (United States)

    Michaelsen, Stella M; Ovando, Angélica C; Bortolotti, Adriano; Bandini, Bruno

    2013-01-01

    The extent to which muscle length affects force production in paretic lower limb muscles after stroke in comparison to controls has not been established. To investigate knee flexor strength deficits dependent on hip joint position in adults with hemiparesis and compare with healthy controls. a cross-sectional study with ten subjects with chronic (63±40 months) hemiparesis with mild to moderate lower limb paresis (Fugl-Meyer score 26±3) and 10 neurologically healthy controls. Isometric knee flexion strength with the hip positioned at 90° and 0° of flexion was assessed randomly on the paretic and non-paretic side of hemiparetic subjects and healthy controls. Subjects were asked to perform a maximal isometric contraction sustained for four seconds and measured by a dynamometer. The ratio of knee flexor strength between these two hip positions was calculated: Hip 0°/Hip 90°. Also, locomotor capacity was evaluated by the timed up and go test and by walking velocity over 10 meters. In subjects with hemiparesis, absolute knee flexion torque decreased (phemiparesis when compared to controls. More attention should be given to lower limb muscle strengthening exercises in individuals with stroke, with emphasis on the strengthening exercises in positions in which the muscle is shortened.

  19. Efficacy of Low Level Laser Therapy After Hand Flexor Tendon Repair

    Science.gov (United States)

    Ayad, K. E.; El Gohary, H. M.; Abd Elrahman, M.; Abd El Mejeed, S. F.; Bekheet, A. B.

    2009-09-01

    Flexor tendon injury is a common problem requiring suturing repair followed by early postoperative mobilization. Muscle atrophy, joint stiffness, osteoarthritis, infection, skin necrosis, ulceration of joint cartilage and tendocutaneous adhesion are familiar complications produced by prolonged immobilization of surgically repaired tendon ruptures. The purpose of this study was to clarify the importance of low level laser therapy after hand flexor tendon repair in zone II. Thirty patients aging between 20 and 40 years were divided into two groups. Patients in group A (n = 15) received a conventional therapeutic exercise program while patients in group B (n = 15) received low level laser therapy combined with the same therapeutic exercise program. The results showed a statistically significant increase in total active motion of the proximal and distal interphalangeal joints as well as maximum hand grip strength at three weeks and three months postoperative, but improvement was more significant in group B. It was concluded that the combination of low level laser therapy and early therapeutic exercises was more effective than therapeutic exercises alone in improving total active motion of proximal and distal interphalangeal joints and hand grip strength after hand flexor tendon repair.

  20. Voluntary muscle activation and evoked volitional-wave responses as a function of torque.

    Science.gov (United States)

    Hight, Robert E; Quarshie, Alwyn T; Black, Christopher D

    2018-08-01

    This study employed a unique stimulation paradigm which allowed for the simultaneous assessment of voluntary activation levels (VA) via twitch-interpolation, and the evoked V-wave responses of the plantar flexors during submaximal and maximal contractions. Test-retest reliability was also examined. Fourteen participants repeated a stimulation protocol over four visits to assess VA and evoked V-wave amplitude across torque levels ranging from 20% to 100% MVC. MVC torque and EMG amplitude were also measured. VA increased nonlinearly with torque production and plateaued by 80% MVC. V-wave amplitude increased linearly from 20% to 100% MVC. There were no differences in any dependent variable across visits (p > 0.05). VA demonstrated moderate to substantial reliability across all torque levels (ICC = 0.76-0.91) while V-wave amplitude exhibited fair to moderate reliability from 40% to 100% (ICC = 0.48-0.74). We were able to reliably collect VA and the V-wave simultaneously in the plantar flexors. Collection of VA and V-wave during the same contraction provides distinct information regarding the contribution of motor-unit recruitment and descending cortico-spinal drive/excitability to force production. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Distribution of skeletal muscle involvement in autosomal recessive distal muscular dystrophy

    International Nuclear Information System (INIS)

    Mizusawa, Hidehiro; Nakanishi, Takao; Kobayashi, Fumie.

    1987-01-01

    Distribution of skeletal muscle involvement in 5 cases with autosomal recessive distal muscular dystrophy was studied clinically and by computed tomography (CT). Manual muscle test showed muscle involvement with a predilection for flexors in the lower leg and adductors in the thigh. Flexion and extension of the thigh and the lower leg was impaired to similar degree. In progressed cases, neck flexors and trunk muscles were also affected mildly. CT disclosed more clearly the preferential involvement of flexors in the lower leg, and involvement of both hamstrings · adductors group and extensors group of the thigh to similar degree. However, m. popliteus was curiously well preserved. In addition, there was a stage showing high density and hypertrophy of m. sartorius, m. gracilis, m. adductor, m. biceps femoris, m. semimenbranosus, m. semitendinosus or m. rectus femoris, which in thought to be compensatory hypertrophy. M. gluteus minimus in the pelvic girdle and m. dorsi proprii in the trunk were also liable to be affected. The CT findings are regarded as characteristic features noted clearly before muscle weakness and atrophy become apparent clinically. CT is very useful for distinguishing distal muscular dystrophy from rimmed vacuolar distal myopathy in which m. quadriceps femoris and flexors of the lower leg are usually well preserved without compensatory hypertrophy on CT. (author)

  2. Salvage Flexor Hallucis Longus Transfer for a Failed Achilles Repair: Endoscopic Technique.

    Science.gov (United States)

    Gonçalves, Sérgio; Caetano, Rubén; Corte-Real, Nuno

    2015-10-01

    Flexor hallucis longus (FHL) transfer is a well-established treatment option in failed Achilles tendon (AT) repair and has been routinely performed as an open procedure. We detail the surgical steps needed to perform an arthroscopic transfer of the FHL for a chronic AT rupture. The FHL tendon is harvested as it enters in its tunnel beneath the sustentaculum tali; a tunnel is then drilled in the calcaneus as near to the AT footprint as possible. By use of a suture-passing device, the free end of the FHL is advanced to the plantar aspect of the foot. After adequate tension is applied to the construct, the tendon is fixed in place with an interference screw in an inside-out fashion. This minimally invasive approach is a safe and valid alternative to classic open procedures with the obvious advantages of preserving the soft-tissue envelope and using a biologically intact tendon.

  3. Explanations pertaining to the Hip Joint Flexor Moment During the Stance Phase of Human Walking

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild

    2012-01-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different...... positions: normal, inclined and reclined. Net joint moments were calculated about the hip, knee and ankle joint. The peak hip joint flexor moment during late stance was significantly lower during inclined walking than in the two other conditions. During normal walking the iliacus muscle showed no or very...... weak activity and first at the transition from stance to swing. When walking reclined, a clear but rather low activity level of the iliacus muscle was seen in the first half of the stance phase, which could contribute to the hip moment. In the inclined condition the iliacus showed much increased...

  4. Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients.

    Science.gov (United States)

    Ustun, N; Erol, O; Ozcakar, L; Ceceli, E; Ciner, O Akar; Yorgancioglu, Z R

    2013-01-01

    Sensitive muscle strength tests are needed to measure muscle strength in the diagnosis and management of sciatica patients. The aim of this study was to assess the isokinetic muscle strength in sciatica patients' and control subjects' ankles that exhibited normal ankle muscle strength when measured clinically. Forty-six patients with L5 and/or S1 nerve compression, and whose age, sex, weight, and height matched 36 healthy volunteers, were recruited to the study. Heel-walking, toe-walking, and manual muscle testing were used to perform ankle dorsiflexion and plantar flexion strengths in clinical examination. Patients with normal ankle dorsiflexion and plantar flexion strengths assessed by manual muscle testing and heel-and toe-walking tests were included in the study. Bilateral isokinetic (concentric/concentric) ankle plantar-flexion-dorsiflexion measurements of the patients and controls were performed within the protocol of 30°/sec (5 repetitions). Peak torque and peak torque/body weight were obtained for each ankle motion of the involved limb at 30°/s speed. L5 and/or S1 nerve compression was evident in 46 patients (76 injured limbs). Mean disease duration was two years. The plantar flexion muscle strength of the patients was found to be lower than that of the controls (p=0.036). The dorsiflexion muscle strength of the patients was found to be the same as that of the controls (p=0.211). Isokinetic testing is superior to clinical muscle testing when evaluating ankle plantar flexion torque in sciatica patients. Therefore, isokinetic muscle testing may be helpful when deciding whether to place a patient into a focused rehabilitation program.

  5. Functional Capacity in Adults With Cerebral Palsy: Lower Limb Muscle Strength Matters.

    Science.gov (United States)

    Gillett, Jarred G; Lichtwark, Glen A; Boyd, Roslyn N; Barber, Lee A

    2018-05-01

    To investigate the relation between lower limb muscle strength, passive muscle properties, and functional capacity outcomes in adults with cerebral palsy (CP). Cross-sectional study. Tertiary institution biomechanics laboratory. Adults with spastic-type CP (N=33; mean age, 25y; range, 15-51y; mean body mass, 70.15±21.35kg) who were either Gross Motor Function Classification System (GMFCS) level I (n=20) or level II (n=13). Not applicable. Six-minute walk test (6MWT) distance (m), lateral step-up (LSU) test performance (total repetitions), timed up-stairs (TUS) performance (s), maximum voluntary isometric strength of plantar flexors (PF) and dorsiflexors (DF) (Nm.kg -1 ), and passive ankle joint and muscle stiffness. Maximum isometric PF strength independently explained 61% of variance in 6MWT performance, 57% of variance in LSU test performance, and 50% of variance in TUS test performance. GMFCS level was significantly and independently related to all 3 functional capacity outcomes, and age was retained as a significant independent predictor of LSU and TUS test performance. Passive medial gastrocnemius muscle fascicle stiffness and ankle joint stiffness were not significantly related to functional capacity measures in any of the multiple regression models. Low isometric PF strength was the most important independent variable related to distance walked on the 6MWT, fewer repetitions on the LSU test, and slower TUS test performance. These findings suggest lower isometric muscle strength contributes to the decline in functional capacity in adults with CP. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effectiveness of water-based Liuzijue exercise on respiratory muscle strength and peripheral skeletal muscle function in patients with COPD

    Directory of Open Access Journals (Sweden)

    Wu W

    2018-05-01

    Full Text Available Weibing Wu,1,* Xiaodan Liu,2,* Jingxin Liu,1 Peijun Li,1 Zhenwei Wang3 1Department of Sports Medicine, Shanghai University of Sport, 2School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, 3Department of Respiratory Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Objects: The purpose of this study was to quantitatively assess the effects of water-based Liuzijue exercise on patients with COPD and compare it with land-based Liuzijue exercise.Materials and methods: Participants were randomly allocated to one of three groups: the water-based Liuzijue exercise group (WG, the land-based Liuzijue exercise group (LG, and the control group (CG. CG participants accepted no exercise intervention, while training groups performed Liuzijue exercise according to Health Qigong Liuzijue (People’s Republic of China in different environments for 60-min sessions twice a week for 3 months.Results: Of the 50 patients enrolled, 45 (90% completed the 3-month intervention. The CG showed decreased expiratory muscle strength, extensor and flexor endurance ratio (ER of the elbow joints and flexor peak torque (PT, total work (TW, and ER of the knee joints (p<0.05. Both training groups showed improved respiratory muscle strength, which differed from the CG (p<0.001. In addition, extensor and flexor TW of the elbow joints in the training groups were increased (p<0.01, and the WG differed from the CG in extensor TW and ER and flexor TW (p<0.01, while the LG differed from the CG in flexor TW and extensor ER (p<0.05. PT, PT/body weight (BW, and TW in the knee joint extensor in the training groups were increased as well (PT and PT/BW: p<0.05, TW: p<0.01, and the WG differed from the CG in terms of knee joints outcomes, while the LG differed from the CG in flexor TW only (p<0.05.Conclusion: Water-based Liuzijue exercise has

  7. Periodic modulation of motor-unit activity in extrinsic hand muscles during multidigit grasping.

    Science.gov (United States)

    Johnston, Jamie A; Winges, Sara A; Santello, Marco

    2005-07-01

    We recently examined the extent to which motor units of digit flexor muscles receive common input during multidigit grasping. This task elicited moderate to strong motor-unit synchrony (common input strength, CIS) across muscles (flexor digitorum profundus, FDP, and flexor pollicis longus, FPL) and across FDP muscle compartments, although the strength of this common input was not uniform across digit pairs. To further characterize the neural mechanisms underlying the control of multidigit grasping, we analyzed the relationship between firing of single motor units from these hand muscles in the frequency domain by computing coherence. We report three primary findings. First, in contrast to what has been reported in intrinsic hand muscles, motor units belonging to different muscles and muscle compartments of extrinsic digit flexors exhibited significant coherence in the 0- to 5- and 5- to 10-Hz frequency ranges and much weaker coherence in the higher 10-20 Hz range (maximum 0.0025 and 0.0008, respectively, pooled across all FDP compartment pairs). Second, the strength and incidence of coherence differed considerably across digit pairs. Third, contrary to what has been reported in the literature, across-muscle coherence can be stronger and more prevalent than within-muscle coherence, as FPL-FDP2 (thumb-index digit pair) exhibited the strongest and most prevalent coherence in our data (0.010 and 43% at 3 Hz, respectively). The heterogeneous organization of common input to these muscles and muscle compartments is discussed in relation to the functional role of individual digit pairs in the coordination of multiple digit forces in grasping.

  8. Influence of pressure changes on recruitment pattern and neck muscle activities during Cranio-Cervical Flexion Tests (CCFTs).

    Science.gov (United States)

    Park, Junhyung; Hur, Jingang; Ko, Taesung

    2015-01-01

    The muscle activity of the deep cervical flexors is emphasized more than that of the superficial cervical flexors, and it has been reported that functional disorders of the longuscolli are found in patients who experience neck pain. The objective of this study was to analyze the recruitment patterns and muscle activities of the cervical flexors during Cranio-Cervical Flexion Tests (CCFTs) through real-time ultrasonography and surface electromyography with a view to presenting appropriate pressure levels for deep cervical flexor exercise protocols based on the results of the analysis. The twenty subjects without neck pain were trained until they became accustomed to CCFTs, and the pressure level was increased gradually from 20 mmHg to 40 mmHg by increasing the pressure level 5 mmHg at a time. Real-time ultrasonography images of the longuscolli and the sternocleidomastoid were taken to measure the amounts of changes in the thicknesses of these muscles, and surface electromyography was implemented to observe the muscle activity of the sternocleidomastoid. The measured value is RMS. According to the results of the ultrasonography, the muscle thicknesses of both the longuscolli and the sternocleidomastoid showed significant increases, as the pressure increased up to 40 mmHg (p< 0.05). The differences in the muscle thicknesses at all individual pressure levels showed significant increases (p< 0.05). According to the results of the electromyography, the muscle activity of the sternocleidomastoid gradually increased as the pressure increased up to 40 mmHg, the increases were significant between 20 mmHg and 25 mmHg, between 30 mmHg and 35 mmHg (p< 0.05). The pressure levels of exercise methods at which the muscle activity of the deep cervical flexors is maximally increased and the muscle activity of the superficial cervical flexors is minimally increased are 25 mmHg-30 mmHg.

  9. Range of motion, neuromechanical and architectural daptations to plantar flexor stretch training in humans

    DEFF Research Database (Denmark)

    Blazevich, Anthony John; Cannavan, Dale; Waugh, Charlie M

    2014-01-01

    angles, but not with the ankle dorsiflexed. Muscle and fascicle strain increased (12 vs. 23%) along with a decrease in muscle stiffness (-18%) during stretch to a constant target joint angle. Muscle length at end ROM increased (13%) without a change in fascicle length, fascicle rotation, tendon...

  10. Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry.

    Science.gov (United States)

    Guilhem, Gaël; Giroux, Caroline; Couturier, Antoine; Maffiuletti, Nicola A

    2014-12-01

    This study aimed to evaluate the validity and test-retest reliability of trunk muscle strength testing performed with a latest-generation isokinetic dynamometer. Eccentric, isometric, and concentric peak torque of the trunk flexor and extensor muscles was measured in 15 healthy subjects. Muscle cross sectional area (CSA) and surface electromyographic (EMG) activity were respectively correlated to peak torque and submaximal isometric torque for erector spinae and rectus abdominis muscles. Reliability of peak torque measurements was determined during test and retest sessions. Significant correlations were consistently observed between muscle CSA and peak torque for all contraction types (r=0.74-0.85; Ptorque (r ⩾ 0.99; Ptorque between test and retest ranged from -3.7% to 3.7% with no significant mean directional bias. Overall, our findings establish the validity of torque measurements using the tested trunk module. Also considering the excellent test-retest reliability of peak torque measurements, we conclude that this latest-generation isokinetic dynamometer could be used with confidence to evaluate trunk muscle function for clinical or athletic purposes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Agonist contraction during intermittent theta burst stimulation enhances motor cortical plasticity of the wrist flexors.

    Science.gov (United States)

    Mirdamadi, J L; Suzuki, L Y; Meehan, S K

    2015-03-30

    Differences in cortical control across the different muscles of the upper limb may mitigate the efficacy of TMS interventions targeting a specific muscle. The current study sought to determine whether weak concurrent contraction during TMS could enhance the efficacy of intermittent theta burst stimulation (iTBS) in the forearm flexors. Motor evoked potentials (MEP) were elicited from the flexor (FCR) and extensor carpi radialis (ECR) motor cortical hotspots before and after iTBS over the FCR cortical hotspot. During iTBS the FCR was either relaxed (iTBS-Relax) or tonically contracted to 10% of maximum voluntary force (iTBS-Contract). iTBS-Relax failed to produce consistent potentiation of MEPFCR amplitude. Individuals with a relatively lower RMTFCR compared RMTECR demonstrated MEPFCR facilitation post-iTBS-Relax. Individuals with relatively higher RMTFCR demonstrated less facilitation and even suppression of MEPFCR amplitude. iTBS-Contract facilitated MEPFCR amplitude but only for MEPFCR evoked from the ECR hotspot. Interactions between overlapping cortical representations determine the efficacy of iTBS. Tonic contraction increases the efficacy of iTBS by enhancing the volume of the cortical representation. However, metaplastic effects may attenuate the enhancement of MEP gain at the motor cortical hotspot. The use of TMS as an adjunct to physical therapy should account for inter-muscle interactions when targeting muscles of the forearm. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Digital flexor musculotendinous contracture in two Devon Rex cats.

    Science.gov (United States)

    Thom, Leonie K; Pool, Roy R; Malik, Richard

    2017-03-01

    Clinical summary: A 13-year-old, spayed Devon Rex with unilateral digital flexor musculotendinous contracture of the forelimb was treated by surgical tenotomy. The condition improved transiently, but recurred rapidly and became bilateral. Histopathologic analysis of necropsy tissues resulted in a morphologic diagnosis of fibromyositis of the antebrachial muscles causing contracture and flexural deformity of the carpi and phalanges of both thoracic limbs. A search for similar cases yielded the clinical notes of a second cat, a 10-year-old, spayed Devon Rex, also with bilateral disease. This second case responded well to surgical tenotomy but tissue biopsies were not obtained to permit microscopic assessment of the underlying pathologic process. Relevance and novel information: Acquired and permanent contracture of the digital flexor muscles and/or tendons of the forelimbs is a rare and poorly described condition of cats. The very limited number of documented cases describing disease affecting one or more digits (but not the carpus) infers a causal link with onychectomy, but reported histopathologic changes have been limited to the tendons. The two cases described in this report suffered contracture of the carpus and all digits bilaterally, one without previous onychectomy and the other 9 years after onychectomy. There were novel histopathologic findings in the muscles of the one case for which biopsy material was available. Information gained from these two cases provides a new perspective for the investigation and treatment of future cases. Specifically, consideration should be given to an underlying immune-mediated myopathic process and a possible genetic predisposition in the Devon Rex breed. Currently, the poorly understood etiopathogenesis hinders our ability to definitively recommend treatment options, which might include corticosteroids and other forms of immunosuppressive therapy.

  13. Pressure pain and isometric strength of neck flexors are related in chronic tension-type headache.

    Science.gov (United States)

    Castien, Rene; Blankenstein, Annette; De Hertogh, Willem

    2015-01-01

    In patients with chronic tension-type headache (CTTH) changes in pressure pain in the cervical region are associated with peripheral or central sensitization. It is hypothesized that an increase of isometric strength of neck flexors would lead to a decrease of pressure pain in CTTH, as an expression of reduced peripheral or central sensitization In this study we aimed to analyze the correlation between change in isometric strength of the neck flexors and change in pressure pain scores (PPS) in patients with CTTH. Comparative analysis of data from previous study. Primary healthcare center. Data from 145 patients with CTTH who underwent a manual therapy program including isometric strength training of the neck flexors were analyzed at 8 and 26 weeks post-treatment. PPS were measured as a total of pain scores on a numeric rating scale (score 0 to 10) on application of a pressure stimulus of 3kg/cm at 8 cervical- and suboccipital muscles. Isometric strength of the neck flexors was measured in seconds. Correlations were computed between changes in PPS and isometric neck flexor strength. Isometric strength of neck flexors scored significantly different compared to baseline measurement (mean 30.0 seconds, sd:25.2), and increased with a mean difference of 17.33 seconds (95%CI: 20.61 to 14.05) at 8 weeks and 19.18 seconds (95%CI: 23.48 to 14.87) at 26 weeks. Similarly, compared to PPS baseline measurement (31.6 points, sd:18.6), mean difference in PPS was significantly decreased at 8 and 26 weeks: -11.3 points (95%CI: -8.77 to -13.83) and -11.15 points (95%CI: -8.31 to -13.99). There is a negative correlation between changes in PPS and changes in isometric strength of neck flexors which is weak at 8 weeks (r = -0.243, P = 0.004) and moderate at 26 weeks (r = -0.318, P isometric strength of neck flexors in patients with CTTH in short- and long-term.

  14. Bilateral assessment of knee muscle relationships in healthy adults

    Directory of Open Access Journals (Sweden)

    Gislaine Regina Santos dos Santos

    2014-09-01

    Full Text Available Asymmetric performance of flexor and extensor muscles of the knee may be a risk factor for knee injuries, especially the anterior cruciate ligament. Additionally, asymmetries in power and work may have correlations with fatigue and performance during functional tasks. Among untrained individuals, such asymmetries may be of potential interest for training prescription. Here, we investigated the bilateral performance of knee flexors and extensors muscle groups of untrained individuals. We quantified the torque-angle and torque-velocity relationships, as well as work, power and asymmetry indexes in 20 untrained male (25 ± 4 years old; height 1.74 ± 0.05 m; body mass 76 ± 9 kg. No significant asymmetry was observed for torque-angle and torque-velocity relationships, work and power output for knee flexor and extensor muscle groups (p < .05. Our results suggest that untrained male present symmetry in the knee flexion and extension bilateral performance. Changes in this behavior due to physical training must be monitored.

  15. Palmaris Longus Muscle in the South Indian Population – A Cadaveric Study

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    Lydia S. Quadros

    2017-07-01

    Full Text Available Introduction: Palmaris longus, one of the superficial flexor muscles of the anterior compartment of the forearm is the most variable muscle of the upper limb. Purpose: To note the variations of palmaris longus for tendon grafts. Methods: Forty formalin-fixed upper limb specimens of South Indian population were dissected to note the variations of Palmaris longus muscle. Results: Out of the forty upper limb specimens, two variants of the palmaris longus were noted. In one specimen, a reversed palmaris longus was noted. It had a long tendinous origin with a muscle belly and a short flat tendon at insertion. The tendon inserted partly into the flexor retinaculum and partly into palmar aponeurosis. In another specimen, apart from the normal palmaris longus muscle, an additional smaller muscle was noted. It was the Palmaris profundus. This muscle took origin in the form of a tendon from the middle of the shaft of the radius, continued as a muscle belly and then terminated as a tendon which later inserted into the flexor retinaculum, close to the tendon of palmaris longus muscle. At its insertion, the superficial palmar branch of radial artery hooked it. The anterior interosseous nerve supplied the Palmaris profundus. Conclusion: These variations are worthy to be noted for tendon grafts.

  16. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon.

    Science.gov (United States)

    Stecco, Carla; Corradin, Marco; Macchi, Veronica; Morra, Aldo; Porzionato, Andrea; Biz, Carlo; De Caro, Raffaele

    2013-12-01

    Although the plantar fascia (PF) has been studied quite well from a biomechanical viewpoint, its microscopic properties have been overlooked: nothing is known about its content of elastic fibers, the features of the extracellular matrix or the extent of innervation. From a functional and clinical standpoint, the PF is often correlated with the triceps surae muscle, but the anatomical grounds for this link are not clear. The aim of this work was to focus on the PF macroscopic and microscopic properties and study how Achilles tendon diseases might affect it. Twelve feet from unembalmed human cadavers were dissected to isolate the PF. Specimens from each PF were tested with various histological and immunohistochemical stains. In a second stage, 52 magnetic resonance images (MRI) obtained from patients complaining of aspecific ankle or foot pain were analyzed, dividing the cases into two groups based on the presence or absence of signs of degeneration and/or inflammation of the Achilles tendon. The thickness of PF and paratenon was assessed in the two groups and statistical analyses were conducted. The PF is a tissue firmly joined to plantar muscles and skin. Analyzing its possible connections to the sural structures showed that this fascia is more closely connected to the paratenon of Achilles tendon than to the Achilles tendon, through the periosteum of the heel. The PF extended medially and laterally, continuing into the deep fasciae enveloping the abductor hallucis and abductor digiti minimi muscles, respectively. The PF was rich in hyaluronan, probably produced by fibroblastic-like cells described as 'fasciacytes'. Nerve endings and Pacini and Ruffini corpuscles were present, particularly in the medial and lateral portions, and on the surface of the muscles, suggesting a role for the PF in the proprioception of foot. In the radiological study, 27 of the 52 MRI showed signs of Achilles tendon inflammation and/or degeneration, and the PF was 3.43 ± 0.48 mm thick

  17. Unloaded shortening velocity of voluntarily and electrically activated human dorsiflexor muscles in vivo.

    Directory of Open Access Journals (Sweden)

    Kazushige Sasaki

    Full Text Available We have previously shown that unloaded shortening velocity (V(0 of human plantar flexors can be determined in vivo, by applying the "slack test" to submaximal voluntary contractions (J Physiol 567:1047-1056, 2005. In the present study, to investigate the effect of motor unit recruitment pattern on V(0 of human muscle, we modified the slack test and applied this method to both voluntary and electrically elicited contractions of dorsiflexors. A series of quick releases (i.e., rapid ankle joint rotation driven by an electrical dynamometer was applied to voluntarily activated dorsiflexor muscles at three different contraction intensities (15, 50, and 85% of maximal voluntary contraction; MVC. The quick-release trials were also performed on electrically activated dorsiflexor muscles, in which three stimulus conditions were used: submaximal (equal to 15%MVC 50-Hz stimulation, supramaximal 50-Hz stimulation, and supramaximal 20-Hz stimulation. Modification of the slack test in vivo resulted in good reproducibility of V(0, with an intraclass correlation coefficient of 0.87 (95% confidence interval: 0.68-0.95. Regression analysis showed that V(0 of voluntarily activated dorsiflexor muscles significantly increased with increasing contraction intensity (R(2 = 0.52, P<0.001. By contrast, V(0 of electrically activated dorsiflexor muscles remained unchanged (R(2<0.001, P = 0.98 among three different stimulus conditions showing a large variation of tetanic torque. These results suggest that the recruitment pattern of motor units, which is quite different between voluntary and electrically elicited contractions, plays an important role in determining shortening velocity of human skeletal muscle in vivo.

  18. Endoscopic Plantar Fasciotomy Through Two Medial Portals for the Treatment of Recalcitrant Plantar Fasciopathy.

    Science.gov (United States)

    Al-Ashhab, Mohamed Ebrahim; Elbegawy, Hossam El-Dein A; Hasan, Hala Ali Abed

    Plantar fasciopathy is a common cause of heel pain. Endoscopic plantar fasciotomy has the advantage of less surgical trauma and rapid recovery. The aim of the present prospective study was to delineate the results of endoscopic plantar fascia release through 2 medial portals. The present study included 2 groups. The first group included 27 feet in 25 patients that had undergone endoscopic plantar fascia release followed up for 19.7 (range 12 to 33) months. The second group, the control group, included 20 feet in 16 patients treated conservatively and followed up for 16.4 (range 12 to 24) months. The results of endoscopic plantar fascia release were superior to the conservative methods. The surgically treated group experienced significantly less pain, activity limitations, and gait abnormality. The presence of a calcaneal spur had no effect on the final postoperative score. In conclusion, endoscopic plantar fascia release through 2 medial portals is an effective procedure for treatment of resistant plantar fasciopathy that fails to respond to conservative management options. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. THE RELATIONSHIP BETWEEN TRUNK MUSCLES ENDURANCE AND NORMAL BMI AMONG UNIVERSITY STUDENTS WITH SEDENTARY LIFESTYLE

    Directory of Open Access Journals (Sweden)

    Karthikeyan Selvaganapathy

    2017-12-01

    Full Text Available Background: The most important trunk stabilizers are the trunk flexors and extensors. The isometric endurance of the trunk muscles is an essential element for mechanical support of the spine in all positions. The study objectives were to find out the trunk flexors and extensors endurance, its relationship with normal BMI and to find out the ratio of trunk flexors to extensors endurance. Methods: In this correlation study, 50 subjects were selected by convenience sampling method on the basis of inclusion and exclusion criteria from Asia metropolitan university, Malaysia. The trunk flexors and extensors endurance were assessed by Kraus- Weber and Sorenson test respectively. Paired 't' test and Spearman correlation test were used for data analysis. Results: There was a significant difference (p 0.01 and TEE, rs (50 = -0.162, p >0.01 but there was a significant strong positive relationship between TFE and TEE, rs (50 = 0.68, p < 0.01. The ratio of trunk flexors to extensors was 0.61. Conclusion: The trunk extensors endurance is higher than trunk flexors endurance and BMI has no relationship with trunk flexors and extensors muscle endurance. The ratio of trunk flexors to extensors endurance value is low

  20. Gastrocnemius recession leads to medial shift of gait line, impairment of muscle strength and improved dorsal extension in forefoot overload syndrome

    DEFF Research Database (Denmark)

    Schmal, Hagen; Walther, Markus; Hirschmüller, Anja

    2018-01-01

    . A strength power analysis of plantar flexors and a pedobarography was performed. Clinical outcome was measured by Foot Function Index (FFI). RESULTS: Plantarflexors are impaired about 40% six weeks and around 10% 24 weeks following GR compared to the contralateral side. Patients experienced a pain relief...... and an improvement of ankle dorsiflexion from 2° to 15°. An increased contact time of the heel (15%) and a shift of metatarsal plantar pressure from lateral to medial could be demonstrated. CONCLUSIONS: This study suggests that GR leads to pain reduction by an increase in heel contact time and a shift of gait line...

  1. Plantar fascia coronal length: a new parameter for plantar fascia assessment.

    Science.gov (United States)

    Sari, Ahmet Sinan; Demircay, Emre; Cakmak, Gokhan; Sahin, M Sukru; Tuncay, I Cengiz; Altun, Suleyman

    2015-01-01

    The effects of gender and various anthropometric variables were previously reported as significant predictors of plantar fascia thickness. Although a strong correlation between either the body weight or body mass index (BMI) and plantar fascia thickness were not demonstrated, a moderate relation was stated. We retrospectively investigated the role of gender, height, weight, and body mass index on plantar fascia thickness at the calcaneal origin (PFCO) and 1 cm distal from the calcaneal origin (PF1cm) and the coronal length of the plantar fascia at the calcaneal origin (CLPF) in healthy subjects. The PFCO, PF1cm, and CLPF were retrospectively measured from magnetic resonance images of 100 healthy subjects. The gender, height, weight, and body mass index of the participants were also noted. Gender was a predictive factor for the length of the CLPF. The subjects with a BMI >25 kg/m(2) had a significantly greater PFCO, PF1cm, and CLPF. Height was mildly and BMI and weight were moderately related to the PFCO. However the CLPF showed a better correlation with height, BMI, and weight than that of plantar fascia thickness. CLPF better reflected the role of weight, BMI, and height than its thickness. It is a new parameter that could be valuable in the evaluation of plantar fascia disorders. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Pyogenic Flexor Tenosynovitis in an Infant

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    James I. Gragg

    2017-03-01

    Full Text Available Pyogenic flexor tenosynovitis is a rare, though well known infectious process of the flexor tendon sheath of the hand. This condition is generally diagnosed in adults by the observance of the four Kanavel signs. Application of the Kanavel signs to diagnosis in the pediatric population, however, is of unknown utility. We present the case of a 13-month-old male with pyogenic flexor tenosynovitis who presented with all four of the Kanavel signs.

  3. Relationship of Plantar Fascia Thickness and Preoperative Pain, Function, and Quality of Life in Recalcitrant Plantar Fasciitis.

    Science.gov (United States)

    Gamba, Carlo; Sala-Pujals, Aleix; Perez-Prieto, Daniel; Ares-Vidal, Jesus; Solano-Lopez, Alberto; Gonzalez-Lucena, Gemma; Ginés-Caspedosa, Alberto

    2018-04-01

    The measurement of plantar fascia thickness has been advocated as a diagnostic and prognostic instrument in patients with plantar fasciitis, but there are no data relative to it in recalcitrant plantar fasciitis. The aim of the study is to evaluate the correlation between plantar fascia thickness and pain, functional score, and health perception in patients with this condition. Thirty-eight feet were studied with ultrasound and magnetic resonance imaging to measure plantar fascia thickness. The visual analogue scale (VAS), American Orthopaedic Foot & Ankle Hindfoot Score (AOFAS), and SF-36 were then recorded for each patient. The relationship between the fascia and these scores was analyzed to evaluate the correlation of thickness with pain, functional level, and health perception of patients. In patients with recalcitrant plantar fasciitis, plantar fascia thickness did not correlate with pain (VAS), AOFAS, or any item of the SF-36. The thickness of the plantar fascia in patients with recalcitrant plantar fasciitis did not correlate with its clinical impact, and thus, we believe it should not be used in treatment planning. Level IV, case series.

  4. Reliability of Baropodometry on the Evaluation of Plantar Load Distribution: A Transversal Study.

    Science.gov (United States)

    Baumfeld, Daniel; Baumfeld, Tiago; da Rocha, Romário Lopes; Macedo, Benjamim; Raduan, Fernando; Zambelli, Roberto; Alves Silva, Thiago Alexandre; Nery, Caio

    2017-01-01

    Introduction . Baropodometry is used to measure the load distribution on feet during rest and walking. The aim of this study was to evaluate changes in plantar foot pressures distribution due to period of working and due to stretching exercises of the posterior muscular chain. Methods . In this transversal study, all participants were submitted to baropodometric evaluation at two different times: before and after the working period and before and after stretching the muscles of the posterior chain. Results . We analyzed a total of 54 feet of 27 participants. After the working period, there was an average increase in the forefoot pressure of 0.16 Kgf/cm 2 and an average decrease in the hindfoot pressure of 0.17 Kgf/cm 2 . After stretching the posterior muscular chain, the average increase in the forefoot pressure was 0.56 Kgf/cm 2 and the hindfoot average pressure decrease was 0.56 Kgf/cm 2 . These changes were not statistically significant. Discussion . It was reported that the strength of the Achilles tendon generates greater forefoot load transferred from the hindfoot. In our study, no significant variation in the distribution of plantar pressure was observed. It can be inferred that baropodometry was a reliable instrument to determine the plantar pressure, regardless of the tension of the posterior chain muscles.

  5. The bigger, the stronger? Insights from muscle architecture and nervous characteristics in obese adolescent girls.

    Science.gov (United States)

    Garcia-Vicencio, S; Coudeyre, E; Kluka, V; Cardenoux, C; Jegu, A-G; Fourot, A-V; Ratel, S; Martin, V

    2016-02-01

    Young obese youth are generally stronger than lean youth. This has been linked to the loading effect of excess body mass, acting as a training stimulus comparable to strength training. Whether this triggers specific adaptations of the muscle architecture (MA) and voluntary activation (VA) that could account for the higher strength of obese subjects remains unknown. MA characteristics (that is, pennation angle (PA), fascicle length (FL) and muscle thickness (MT)) and muscle size (that is, anatomical cross-sectional area (ACSA)) of the knee extensor (KE) and plantar flexor (PF) muscles were evaluated in 12 obese and 12 non-obese adolescent girls (12-15 years). Maximal isometric torque and VA of the KE and PF muscles were also assessed. Results revealed higher PA (Pmuscles in obese girls. Moreover, obese individuals produced a higher absolute torque than their lean counterparts on the KE (224.6±39.5 vs 135.7±32.7 N m, respectively; Pmuscles (73.3±16.5 vs 44.5±6.2 N m; Pmuscles (r=0.45-0.55, P<0.05-0.01). MVC was also correlated with VA (KE: r=0.44, P<0.05; PF: r=0.65, P<0.001) and segmental lean mass (KE: r=0.48, P<0.05; PF: r=0.57, P<0.01). This study highlighted favorable muscular and nervous adaptations to obesity that account for the higher strength of obese youth. The excess of body mass supported during daily activities could act as a chronic training stimulus responsible for these adaptations.

  6. Volumetric Muscle Loss: Persistent Functional Deficits Beyond Frank Loss of Tissue

    Science.gov (United States)

    2014-09-18

    and fascia covering the tibialis anterior (TA) muscle were bluntly separated from the musculature. The tissue covering all aspects of the middle...testing system.5 Peak TA muscle isometric torque was determined with the ankle at a right angle 0˚ and 20˚ of dorsi- or plantar flexion, assuming a moment...of plantar and dorsiflexion). At all joint angles, VML resulted in a significant functional deficit, although a greater torque deficit was observed

  7. Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures.

    Science.gov (United States)

    Aydogan, Umur; Roush, Evan P; Moore, Blake E; Andrews, Seth H; Lewis, Gregory S

    2017-04-01

    Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique, or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques. Six matched pairs of foot and ankle specimens were mounted on a pressure mat loading platform. Two randomly assigned surgery groups, which had received either distal oblique, or proximal dorsiflexion osteotomy of the second metatarsal, were evaluated before and after plantar fasciectomy. Specimens were loaded up to a ground reaction force of 400 N at varying Achilles tendon forces. Average pressures, peak pressures, and contact areas were analyzed. Supporting our hypothesis, average pressures under the second metatarsal during 600 N Achilles load were decreased by plantar fascia release following proximal osteotomy (p plantar fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p Plantar fasciotomy should not be added to distal metatarsal osteotomy in the treatment of metatarsalgia. If proximal dorsiflexion osteotomy would be preferred, plantar fasciotomy should be approached cautiously not to disturb the forefoot biomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:800-804, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Effects of high-intensity pulse irradiation with linear polarized near-infrared rays and stretching on muscle tone in patients with cerebrovascular disease: a randomized controlled trial.

    Science.gov (United States)

    Takeuchi, Nobuyuki; Takezako, Nobuhiro; Shimonishi, Yuko; Usuda, Shigeru

    2017-08-01

    [Purpose] The purpose of this study was to clarify the influence of high-intensity pulse irradiation with linear polarized near-infrared rays (HI-LPNR) and stretching on hypertonia in cerebrovascular disease patients. [Subjects and Methods] The subjects were 40 cerebrovascular disease patients with hypertonia of the ankle joint plantar flexor muscle. The subjects were randomly allocated to groups undergoing treatment with HI-LPNR irradiation (HI-LPNR group), stretching (stretching group), HI-LPNR irradiation followed by stretching (combination group), and control group (10 subjects each). In all groups, the passive range of motion of ankle dorsiflexion and passive resistive joint torque of ankle dorsiflexion were measured before and after the specified intervention. [Results] The changes in passive range of motion, significant increase in the stretching and combination groups compared with that in the control group. The changes in passive resistive joint torque, significant decrease in HI-LPNR, stretching, and combination groups compared with that in the control group. [Conclusion] HI-LPNR irradiation and stretching has effect of decrease muscle tone. However, combination of HI-LPNR irradiation and stretching has no multiplier effect.

  9. Bioelectrical activity of limb muscles during cold shivering of stimulation of the vestibular apparatus

    Science.gov (United States)

    Kuzmina, G. I.

    1980-01-01

    The effects of caloric and electric stimulation of the vestibular receptors on the EMG activity of limb muslces in anesthetized cats during cold induced shivering involved flexor muscles alone. Both types of stimulation suppressed bioelectrical activity more effectively in the ipsilateral muscles. The suppression of shivering activity seems to be due to the increased inhibitory effect of descending labyrinth pathways on the function of flexor motoneurons.

  10. MR imaging of accessory muscles of the ankle

    International Nuclear Information System (INIS)

    Mondello, Eduardo; Nazar, Miguel E.; Martin, Eduardo

    2001-01-01

    Purpose: The purpose of this work is to describe the normal anatomy and the characteristics in MRI of the accessory muscles of the posterior ankle: the accessory soleus, accessory flexor digitorum longus, peroneus quartus, tibiocalcaneus internus and peroneocalcaneus internus. Material and methods: There were evaluated 280 symptomatic patients between 18 and 40 years old (85 % males). MR was performed in High Field Magnetic Resonance Units (1.5 T y 1.0 T) and multiplanar sequences. Results: We found 2 peroneus quartus (0.7%), 2 accessory soleus muscles (0.7%), 3 accessory flexor digitorum longus (1.07%) and 1 peroneocalcaneus internus (0.35%). Conclusion: The knowledge of the accessory muscles of the posterior ankle allow to explain different painful pathologies with instability or tendinous tears, which are difficult to diagnose if the muscle are not adequately recognized. (author)

  11. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties.

    Science.gov (United States)

    Konrad, A; Stafilidis, S; Tilp, M

    2017-10-01

    The purpose of this study was to investigate the influence of a single static, ballistic, or proprioceptive neuromuscular facilitation (PNF) stretching exercise on the various muscle-tendon parameters of the lower leg and to detect possible differences in the effects between the methods. Volunteers (n = 122) were randomly divided into static, ballistic, and PNF stretching groups and a control group. Before and after the 4 × 30 s stretching intervention, we determined the maximum dorsiflexion range of motion (RoM) with the corresponding fascicle length and pennation angle of the gastrocnemius medialis. Passive resistive torque (PRT) and maximum voluntary contraction (MVC) were measured with a dynamometer. Observation of muscle-tendon junction (MTJ) displacement with ultrasound allowed us to determine the length changes in the tendon and muscle, respectively, and hence to calculate stiffness. Although RoM increased (static: +4.3%, ballistic: +4.5%, PNF: +3.5%), PRT (static: -11.4%, ballistic: -11.5%, PNF: -13,7%), muscle stiffness (static: -13.1%, ballistic: -20.3%, PNF: -20.2%), and muscle-tendon stiffness (static: -11.3%, ballistic: -10.5%, PNF: -13.7%) decreased significantly in all the stretching groups. Only in the PNF stretching group, the pennation angle in the stretched position (-4.2%) and plantar flexor MVC (-4.6%) decreased significantly. Multivariate analysis showed no clinically relevant difference between the stretching groups. The increase in RoM and the decrease in PRT and muscle-tendon stiffness could be explained by more compliant muscle tissue following a single static, ballistic, or PNF stretching exercise. © 2017 The Authors Scandinavian Journal of Medicine & Science In Sports Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2014-04-02

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

  13. Corticospinal excitability changes following prolonged muscle tendon vibration

    NARCIS (Netherlands)

    Steyvers, M.; Levin, O.; Baelen, M.G.M. van; Swinnen, S.P.

    2003-01-01

    The present experiment addressed the time course of corticospinal excitability changes following interventional muscle tendon vibration. Using transcranial magnetic stimulation, motor evoked potentials of the flexor carpi radialis and extensor carpi radialis brevis muscle were recorded for a period

  14. EFFECTIVENESS OF INSTUMENTAL ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE WITH STATIC STRETCHING IN SUBJECTS WITH PLANTAR FASCIITIS

    Directory of Open Access Journals (Sweden)

    Vinod Babu. K

    2014-08-01

    Full Text Available Background: Instrumental assisted soft tissue mobilization and static stretching found to be effective in plantar fasciitis, however the combined effectiveness of these techniques were unknown. The purpose of this study is to find the effect of Instrumental assisted soft tissue mobilization technique for plantar fascia combined with static stretching of triceps surae for subjects with chronic stage of Plantar Fasciitis on pain intensity, ankle dorsiflexion range of motion and functional disability. Methods: An experimental study design, selected subjects with chronic Plantar Fasciitis randomized subjects into each Study and Control group. Total of 40 subject’s data who completed study, 20 in each group, was used for analysis. Control group received conventional exercise while Study group received conventional exercises with Instrumental assisted soft tissue mobilization combined with static stretching of triceps surae muscle. Outcome measurements such as Intensity of pain using Numerical Pain Rating Scale-101 (NPRS-101, function disability using Foot Function Index Pain Subscale (FFI and ankle dorsiflexion active range of motion using Goniometer was measured before and after 2 weeks of intervention. Results: There is statistically significant improvement in means of NRS-101, ankle dorsiflexion active range of motion and Foot Function Index Pain Subscale after intervention in both groups. When the post-intervention means were compared between Study and Control group after 2 weeks of treatment there is statistically significant difference in means between the groups whereas study group showed greater percentage of improvement than control group. Conclusion: It is concluded that Instrumental assisted soft tissue mobilization technique combined with static stretching of triceps surae muscle is significantly effective than conventional exercises on reducing pain, improving ankle dorsiflexion range of motion and functional disability for subjects

  15. No functionally relevant mechanical effects of epimuscular myofascial connections between rat ankle plantar flexors

    NARCIS (Netherlands)

    Tijs, C.; van Dieen, J.H.; Maas, H.

    2015-01-01

    Triceps surae muscles are mechanically connected by the shared Achilles tendon and by epimuscular myofascial connections. We aimed to assess the effects of proximal lengthening of gastrocnemius and plantaris muscles, imposed by changes in knee angle, on the magnitude and direction of the 3D ankle

  16. Effect of repeated forearm muscle cooling on the adaptation of skeletal muscle metabolism in humans

    Science.gov (United States)

    Wakabayashi, Hitoshi; Nishimura, Takayuki; Wijayanto, Titis; Watanuki, Shigeki; Tochihara, Yutaka

    2017-07-01

    This study aimed to investigate the effect of repeated cooling of forearm muscle on adaptation in skeletal muscle metabolism. It is hypothesized that repeated decreases of muscle temperature would increase the oxygen consumption in hypothermic skeletal muscle. Sixteen healthy males participated in this study. Their right forearm muscles were locally cooled to 25 °C by cooling pads attached to the skin. This local cooling was repeated eight times on separate days for eight participants (experimental group), whereas eight controls received no cold exposure. To evaluate adaptation in skeletal muscle metabolism, a local cooling test was conducted before and after the repeated cooling period. Change in oxy-hemoglobin content in the flexor digitorum at rest and during a 25-s isometric handgrip (10% maximal voluntary construction) was measured using near-infrared spectroscopy at every 2 °C reduction in forearm muscle temperature. The arterial blood flow was occluded for 15 s by upper arm cuff inflation at rest and during the isometric handgrip. The oxygen consumption in the flexor digitorum muscle was evaluated by a slope of the oxy-hemoglobin change during the arterial occlusion. In the experimental group, resting oxygen consumption in skeletal muscle did not show any difference between pre- and post-intervention, whereas muscle oxygen consumption during the isometric handgrip was significantly higher in post-intervention than in pre-test from thermoneutral baseline to 31 °C muscle temperature ( P cooling might facilitate oxidative metabolism in the skeletal muscle. In summary, skeletal muscle metabolism during submaximal isometric handgrip was facilitated after repeated local muscle cooling.

  17. Osteomyelitis of the proximal sesamoid bone in a horse - a case report

    International Nuclear Information System (INIS)

    Kofler, J.

    1994-01-01

    Suppurative osteomyelitis of the lateral proximal sesamoid bone and chronic septic tenosynovitis of the digital flexor tendon sheath of the right hind limb was diagnosed in a 8 year old warmblood mare. Three months earlier the horse had received a puncture wound in the plantar fetlock region, penetrating the plantar annular ligament, tendon sheath and intersesamoidian ligament up to the plantaro-axial surface of the lateral sesamoid bone. The clinical, radiographic and ultrasonographic findings are described. The horse showed grade 2 / 4 right hindlimb lameness, marked thickening of the entire digital flexor tendon sheath area as well as the puncture wound in the middle of the annular ligament region. Radiographs revealed a 10 x 12 mm centro-axial, circular translucent lesion and marked bony proliferation on the abaxial and plantar margins of the lateral proximal sesamoid. Adhesions and marked anechoic areas between the plantar septum of the tendon sheath and the superficial flexor tendon, a thickening of the plantar annular ligament and structural alterations of the deep flexor tendon were demonstrated by sonography. Due to these severe findings a very poor prognosis was given and therefore surgery was not recommended. The horse was euthanized 4 months later as a result of further deterioration. Additional clinical, radiographic and sonographic findings as well as post mortem findings are mentioned. Gross pathology showed a fibrino-purulent tenosynovitis of the digital flexor tendon sheath and tendinitis of both flexor tendons, as well as a fistulous lesion of the intersesamoidian ligament over the lateral proximal sesamoid bone. The patho-histologic examination revealed focal suppurative osteomyelitis of the lateral sesamoid bone with necrotic bone tissue in the osteolytic area and accumulated neutrophils and macrophages [de

  18. Electrically induced muscle cramps induce hypertrophy of calf muscles in healthy adults.

    Science.gov (United States)

    Behringer, M; Moser, M; Montag, J; McCourt, M; Tenner, D; Mester, J

    2015-06-01

    Skeletal muscles usually cramp at short lengths, where the tension that can be exerted by muscle fibers is low. Since high tension is an important anabolic stimulus, it is questionable if cramps can induce hypertrophy and strength gains. In the present study we investigated if electrically induced cramps (EIMCs) can elicit these adaptations. 15 healthy male adults were randomly assigned to an intervention (IG; n=10) and a control group (CG; n=5). The cramp protocol (CP) applied twice a week to one leg of the IG, consisted of 3x6 EIMCs, of 5 s each. Calf muscles of the opposite leg were stimulated equally, but were hindered from cramping by fixating the ankle at 0° plantar flexion (nCP). After six weeks, the cross sectional area of the triceps surae was similarly increased in both the CP (+9.0±3.4%) and the nCP (+6.8±3.7%). By contrast, force of maximal voluntary contractions, measured at 0° and 30° plantar flexion, increased significantly only in nCP (0°: +8.5±8.8%; 30°: 11.7±13.7%). The present data indicate that muscle cramps can induce hypertrophy in calf muscles, though lacking high tension as an important anabolic stimulus.

  19. Effectiveness of using ultrasound therapy and manual therapy in the conservative treatment of calcaneal spur – pilot study

    Directory of Open Access Journals (Sweden)

    Twarowska Natalia

    2016-06-01

    Full Text Available Introduction: Calcaneal spur is a pathology of the fibrocartilage enthesis of the Achilles tendon and plantar fascia or a pathology of the mixed enthesis of the flexor digitorum brevis muscle. Ultrasound therapy is commonly applied in the conservative treatment of a calcaneal spur. Foot muscle strengthening exercises, stretching exercises and soft tissue therapy are indicated as effective methods of conservative treatment. The aim of the study was to compare and assess the effects of ultrasound therapy and selected techniques of manual therapy on pain level and functional state in patients with calcaneal spur.

  20. Progressive Muscle Atrophy and Weakness After Treatment by Mantle Field Radiotherapy in Hodgkin Lymphoma Survivors

    International Nuclear Information System (INIS)

    Leeuwen-Segarceanu, Elena M. van; Dorresteijn, Lucille D.A.; Pillen, Sigrid; Biesma, Douwe H.; Vogels, Oscar J.M.; Alfen, Nens van

    2012-01-01

    Purpose: To describe the damage to the muscles and propose a pathophysiologic mechanism for muscle atrophy and weakness after mantle field radiotherapy in Hodgkin lymphoma (HL) survivors. Methods and Materials: We examined 12 patients treated by mantle field radiotherapy between 1969 and 1998. Besides evaluation of their symptoms, the following tests were performed: dynamometry; ultrasound of the sternocleidomastoid, biceps, and antebrachial flexor muscles; and needle electromyography of the neck, deltoid, and ultrasonographically affected arm muscles. Results: Ten patients (83%) experienced neck complaints, mostly pain and muscle weakness. On clinical examination, neck flexors were more often affected than neck extensors. On ultrasound, the sternocleidomastoid was severely atrophic in 8 patients, but abnormal echo intensity was seen in only 3 patients. Electromyography of the neck muscles showed mostly myogenic changes, whereas the deltoid, biceps, and antebrachial flexor muscles seemed to have mostly neurogenic damage. Conclusions: Many patients previously treated by mantle field radiotherapy develop severe atrophy and weakness of the neck muscles. Neck muscles within the radiation field show mostly myogenic damage, and muscles outside the mantle field show mostly neurogenic damage. The discrepancy between echo intensity and atrophy suggests that muscle damage is most likely caused by an extrinsic factor such as progressive microvascular fibrosis. This is also presumed to cause damage to nerves within the radiated field, resulting in neurogenic damage of the deltoid and arm muscles.

  1. Amputation of finger by horse bite with complete avulsion of both flexor tendons.

    Science.gov (United States)

    Koren, Lior; Stahl, Shalom; Rovitsky, Alexey; Peled, Eli

    2011-08-08

    Amputation of fingers with tendon avulsion occurs through a traction injury, and most occur through a ring avulsion mechanism. Usually the flexor digitorum profundus is torn out with the amputated finger. Replantation usually is recommended only when the amputation is distal to the flexor digitorum superficialis insertion. Animal bites are relatively common, with a decreasing order of frequency of dogs, cats, and humans. Horse bites are relatively infrequent but are associated with crush injuries and tissue loss when they occur. This article describes a 23-year-old man with amputation of his middle finger at the level of the proximal phalanx after being bitten by a horse. The amputated stump was avulsed with the middle finger flexor digitorum profundus and flexor digitorum superficialis torn from the muscle-tendon junction from approximately the middle of the forearm. The patient had no other injuries, and he was able to move his other 4 fingers with only mild pain. As the amputated digit was not suitable for replantation, the wound was irrigated and debrided. The edges of the phalanx were trimmed, and the edges of the wound were sutured. Tetanus toxoid and rabies vaccine were administered, along with intravenous amoxicillin and clavulanic acid. The patient was discharged from the hospital 2 days later, with no sign of infection of the wound or compartment syndrome of the forearm. This case demonstrates the weakest point in the myotendinous junction and emphasizes the importance of a careful physical examination in patients with a traumatic amputation. Copyright 2011, SLACK Incorporated.

  2. Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis

    Science.gov (United States)

    Kim, Seong-Gil

    2018-01-01

    Background The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. Material/Methods This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. Results In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (pregression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). Conclusions Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement. PMID:29760375

  3. Asymmetry of Muscle Strength in Elite Athletes

    Science.gov (United States)

    Drid, Patrik; Drapsin, Miodrag; Trivic, Tatjana; Lukac, Damir; Obadov, Slavko; Milosevic, Zoran

    2009-01-01

    "Study aim": To determine muscle strength variables in elite judoists and wrestlers since thigh muscle strength and bilaterally balanced flexor-to-extensor ratio minimise injury risk and are desirable for achieving sport successes. "Material and methods": Judoists, wrestlers and untrained subjects, 10 each, were subjected to isokinetic strength…

  4. Acute Hemorrhagic Flexor Tenosynovitis due to Vincula Injury

    Science.gov (United States)

    Maher, Rory

    2015-01-01

    Summary: A 20-year-old previously well woman presented to the emergency department with classical signs of acute flexor tenosynovitis, 4 hours after a minor puncture wound over the volar aspect of her right middle finger distal interphalangeal joint. Exploration of the flexor sheath in theatre revealed frank blood within the sheath and extension of the puncture wound through the profundus tendon into the short vincula beneath. The blood was irrigated from the sheath, and the patient made a complete recovery by 2 weeks postoperatively. Although rare, irritation and distension of the flexor sheath caused by vincular hemorrhage can be an alternative mechanism for the development of acute flexor tenosynovitis, and as with pyogenic flexor tenosynovitis, prompt surgical treatment can minimize the risk of long-term functional impairment. PMID:26301147

  5. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running

    Science.gov (United States)

    McDonald, Kirsty A.; Stearne, Sarah M.; Alderson, Jacqueline A.; North, Ian; Pires, Neville J.; Rubenson, Jonas

    2016-01-01

    Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ) excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9 forefoot and 9 rearfoot strike) performed three treadmill running trials; unrestricted shod, shod with restricted arch compression (via an orthotic-style insert), and barefoot. Three-dimensional motion capture and ground reaction force data were used to calculate lower limb kinematics and kinetics including MPJ angles, moments, powers and work. Estimates of plantar fascia strain due to arch compression and MPJ excursion were derived using a geometric model of the arch and a subject-specific musculoskeletal model of the plantar fascia, respectively. The plantar fascia exhibited a typical elastic stretch-shortening cycle with the majority of strain generated via arch compression. This strategy was similar in fore- and rear-foot strike runners. Restricting arch compression, and hence the elastic-spring function of the arch, was not compensated for by an increase in MPJ-derived strain. In the second half of stance the plantar fascia was found to transfer energy between the MPJ (energy absorption) and the arch (energy production during recoil). This previously unreported energy transfer mechanism reduces the strain required by the plantar fascia in generating useful positive mechanical work at the arch during running. PMID:27054319

  6. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running.

    Directory of Open Access Journals (Sweden)

    Kirsty A McDonald

    Full Text Available Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9 forefoot and 9 rearfoot strike performed three treadmill running trials; unrestricted shod, shod with restricted arch compression (via an orthotic-style insert, and barefoot. Three-dimensional motion capture and ground reaction force data were used to calculate lower limb kinematics and kinetics including MPJ angles, moments, powers and work. Estimates of plantar fascia strain due to arch compression and MPJ excursion were derived using a geometric model of the arch and a subject-specific musculoskeletal model of the plantar fascia, respectively. The plantar fascia exhibited a typical elastic stretch-shortening cycle with the majority of strain generated via arch compression. This strategy was similar in fore- and rear-foot strike runners. Restricting arch compression, and hence the elastic-spring function of the arch, was not compensated for by an increase in MPJ-derived strain. In the second half of stance the plantar fascia was found to transfer energy between the MPJ (energy absorption and the arch (energy production during recoil. This previously unreported energy transfer mechanism reduces the strain required by the plantar fascia in generating useful positive mechanical work at the arch during running.

  7. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running.

    Science.gov (United States)

    McDonald, Kirsty A; Stearne, Sarah M; Alderson, Jacqueline A; North, Ian; Pires, Neville J; Rubenson, Jonas

    2016-01-01

    Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ) excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9 forefoot and 9 rearfoot strike) performed three treadmill running trials; unrestricted shod, shod with restricted arch compression (via an orthotic-style insert), and barefoot. Three-dimensional motion capture and ground reaction force data were used to calculate lower limb kinematics and kinetics including MPJ angles, moments, powers and work. Estimates of plantar fascia strain due to arch compression and MPJ excursion were derived using a geometric model of the arch and a subject-specific musculoskeletal model of the plantar fascia, respectively. The plantar fascia exhibited a typical elastic stretch-shortening cycle with the majority of strain generated via arch compression. This strategy was similar in fore- and rear-foot strike runners. Restricting arch compression, and hence the elastic-spring function of the arch, was not compensated for by an increase in MPJ-derived strain. In the second half of stance the plantar fascia was found to transfer energy between the MPJ (energy absorption) and the arch (energy production during recoil). This previously unreported energy transfer mechanism reduces the strain required by the plantar fascia in generating useful positive mechanical work at the arch during running.

  8. Comparison of the Percentage Stance and Swing Phases and Ground Reaction Force between Young and Older Adults during Walking at different speeds

    Directory of Open Access Journals (Sweden)

    Neda Brooshak

    2017-09-01

    Conclusion: In general, the percentage of stance and swing phases of a gait cycle is similar between young and older adults. Lower VGRFs of weight acceptance and push off phases in the elders reflects the weakness of the knee extensor, hip extensors and ankle plantar flexors. It seems that older adults reduce the rate of force production during fast gait to achieve the necessary capacity for power generation and thereby, overcome the weakness of the lower extremity muscles.

  9. EMG activities and plantar pressures during ski jumping take-off on three different sized hills.

    Science.gov (United States)

    Virmavirta, M; Perttunen, J; Komi, P V

    2001-04-01

    Different profiles of ski jumping hills have been assumed to make the initiation of take-off difficult especially when moving from one hill to another. Neuromuscular adaptation of ski jumpers to the different jumping hills was examined by measuring muscle activation and plantar pressure of the primary take-off muscles on three different sized hills. Two young ski jumpers volunteered as subjects and they performed several trials from each hill (K-35 m, K-65 m and K-90 m) with the same electromyographic (EMG) electrode and insole pressure transducer set-up. The results showed that the differences in plantar pressure and EMGs between the jumping hills were smaller than expected for both jumpers. The small changes in EMG amplitudes between the hills support the assumption that the take-off was performed with the same intensity on different jumping hills and the timing of the gluteus EMG demonstrates well the similarity of the muscle activation on different hills. On the basis of the results obtained it seems that ski jumping training on small hills does not disturb the movement patterns for bigger hills and can also be helpful for special take-off training with low speed.

  10. Plantar fascia: imaging diagnosis and guided treatment.

    Science.gov (United States)

    McNally, Eugene G; Shetty, Shilpa

    2010-09-01

    Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described. Thieme Medical Publishers.

  11. Ultrasound diagnosis and evaluation of plantar heel pain.

    Science.gov (United States)

    Argerakis, Nicholas G; Positano, Rock G; Positano, Rock C J; Boccio, Ashley K; Adler, Ronald S; Saboeiro, Gregory R; Dines, Joshua S

    2015-03-01

    One of the most common causes of heel pain is plantar fasciitis; however, there are other pathologic disorders that can mimic the symptoms and clinical presentation of this disorder. The purpose of this study was to retrospectively review the prevalence of various pathologic disorders on ultrasound in patients with proximal plantar heel pain. The medical records and diagnostic ultrasound reports of patients presenting with plantar heel pain between March 1, 2006, and March 31, 2007, were reviewed retrospectively, and the prevalence of various etiologies was collected. The inclusion criteria were based on their clinical presentation of plantar fasciitis or previous diagnosis of plantar fasciitis from an unknown source. Ultrasound evaluation was then performed to confirm the clinical diagnosis. We examined 175 feet of 143 patients (62 males and 81 females; age range, 16-79 years). Plantar fibromas were present in 90 feet (51%). Plantar fasciitis was diagnosed in 128 feet (73%). Coexistent plantar fibroma and plantar fascial thickening was found in 63 feet (36%). Of the 47 feet that were negative for plantar fasciitis on ultrasound, 27 (57%) revealed the presence of plantar fibroma. Diagnostic ultrasound can effectively and safely identify the prevalence of various etiologies of heel pain. The high prevalence of plantar fibromas and plantar fascial tears cannot be determined by clinical examination alone, and, therefore, ultrasound evaluation should be performed for confirmation of diagnosis.

  12. Systemic inflammatory responses to maximal versus submaximal lengthening contractions of the elbow flexors.

    Science.gov (United States)

    Peake, Jonathan M; Nosaka, Kazunori; Muthalib, Makii; Suzuki, Katsuhiko

    2006-01-01

    We compared changes in markers of muscle damage and systemic inflammation after submaximal and maximal lengthening muscle contractions of the elbow flexors. Using a cross-over design, 10 healthy young men not involved in resistance training completed a submaximal trial (10 sets of 60 lengthening contractions at 10% maximum isometric strength, 1 min rest between sets), followed by a maximal trial (10 sets of three lengthening contractions at 100% maximum isometric strength, 3 min rest between sets). Lengthening contractions were performed on an isokinetic dynamometer. Opposite arms were used for the submaximal and maximal trials, and the trials were separated by a minimum of two weeks. Blood was sampled before, immediately after, 1 h, 3 h, and 1-4 d after each trial. Total leukocyte and neutrophil numbers, and the serum concentration of soluble tumor necrosis factor-alpha receptor 1 were elevated after both trials (P < 0.01), but there were no differences between the trials. Serum IL-6 concentration was elevated 3 h after the submaximal contractions (P < 0.01). The concentrations of serum tumor necrosis factor-alpha, IL-1 receptor antagonist, IL-10, granulocyte-colony stimulating factor and plasma C-reactive protein remained unchanged following both trials. Maximum isometric strength and range of motion decreased significantly (P < 0.001) after both trials, and were lower from 1-4 days after the maximal contractions compared to the submaximal contractions. Plasma myoglobin concentration and creatine kinase activity, muscle soreness and upper arm circumference all increased after both trials (P < 0.01), but were not significantly different between the trials. Therefore, there were no differences in markers of systemic inflammation, despite evidence of greater muscle damage following maximal versus submaximal lengthening contractions of the elbow flexors.

  13. Distribution of skeletal muscle involvement in autosomal recessive distal muscular dystrophy. A clinical and computed tomographic study

    Energy Technology Data Exchange (ETDEWEB)

    Mizusawa, Hidehiro; Nakanishi, Takao; Kobayashi, Fumie

    1987-02-01

    Distribution of skeletal muscle involvement in 5 cases with autosomal recessive distal muscular dystrophy was studied clinically and by computed tomography (CT). Manual muscle test showed muscle involvement with a predilection for flexors in the lower leg and adductors in the thigh. Flexion and extension of the thigh and the lower leg was impaired to similar degree. In progressed cases, neck flexors and trunk muscles were also affected mildly. CT disclosed more clearly the preferential involvement of flexors in the lower leg, and involvement of both hamstrings center dot adductors group and extensors group of the thigh to similar degree. However, m. popliteus was curiously well preserved. In addition, there was a stage showing high density and hypertrophy of m. sartorius, m. gracilis, m. adductor, m. biceps femoris, m. semimenbranosus, m. semitendinosus or m. rectus femoris, which in thought to be compensatory hypertrophy. M. gluteus minimus in the pelvic girdle and m. dorsi proprii in the trunk were also liable to be affected. The CT findings are regarded as characteristic features noted clearly before muscle weakness and atrophy become apparent clinically. CT is very useful for distinguishing distal muscular dystrophy from rimmed vacuolar distal myopathy in which m. quadriceps femoris and flexors of the lower leg are usually well preserved without compensatory hypertrophy on CT.

  14. Use of muscle functional magnetic resonance imaging to compare cervical flexor activity between patients with whiplash-associated disorders and people who are healthy.

    Science.gov (United States)

    Cagnie, Barbara; Dolphens, Mieke; Peeters, Ian; Achten, Eric; Cambier, Dirk; Danneels, Lieven

    2010-08-01

    Chronic whiplash-associated disorders (WAD) have been shown to be associated with motor dysfunction. Increased electromyographic (EMG) activity in neck and shoulder girdle muscles has been demonstrated during different tasks in participants with persistent WAD. Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique to evaluate muscle activity and differential recruitment of deep and superficial muscles following exercise. The purpose of this study was to compare the recruitment pattern of deep and superficial neck flexors between patients with WAD and controls using mfMRI. A cross-sectional design was used. The study was conducted in a physical and rehabilitation medicine department. The participants were 19 controls who were healthy (10 men, 9 women; mean [+/-SD] age=22.2+/-0.6 years) and 16 patients with WAD (5 men, 11 women; mean [+/-SD] age=32.9+/-12.7 years). The T2 values were calculated for the longus colli (Lco), longus capitis (Lca), and sternocleidomastoid (SCM) muscles at rest and following cranio-cervical flexion (CCF). In the overall statistical model for T2 shift, there was a significant main effect for muscle (F=3.906, P=.033) but not for group (F=2.855, P=.101). The muscle x group interaction effect was significant (F=3.618, P=.041). Although not significant, there was a strong trend for lesser Lco (P=.061) and Lca (P=.060) activity for the WAD group compared with the control group. Although the SCM showed higher T2 shifts, this difference was not significant (P=.291). Although mfMRI is an innovative and useful technique for the evaluation of deep cervical muscles, consideration is required, as this method encompasses a postexercise evaluation and is limited to resistance types of exercises. Muscle functional magnetic resonance imaging demonstrated a difference in muscle recruitment between the Lco, Lca, and SCM during CCF in the control group, but failed to demonstrate a changed activity pattern in the WAD group compared

  15. Plantar fascia-specific stretching versus radial shock-wave therapy as initial treatment of plantar fasciopathy.

    Science.gov (United States)

    Rompe, Jan D; Cacchio, Angelo; Weil, Lowell; Furia, John P; Haist, Joachim; Reiners, Volker; Schmitz, Christoph; Maffulli, Nicola

    2010-11-03

    Whether plantar fascia-specific stretching or shock-wave therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously. One hundred and two patients with acute plantar fasciopathy were randomly assigned to perform an eight-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial shock-wave therapy without local anesthesia, administered weekly for three weeks (Group II, n = 48). All patients completed the seven-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire. Patients were evaluated at baseline and at two, four, and fifteen months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment. No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline. At two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with shock-wave therapy (p plantar fascia is superior to repetitive low-energy radial shock-wave therapy for the treatment of acute symptoms of proximal plantar fasciopathy.

  16. Plantar fasciitis (fasciosis) treatment outcome study: plantar fascia thickness measured by ultrasound and correlated with patient self-reported improvement.

    Science.gov (United States)

    Fabrikant, Jerry M; Park, Tae Soon

    2011-06-01

    Ultrasound, well recognized as an effective diagnostic tool, reveals a thickening of the plantar fascia in patients with plantar fasciitis/fasciosis disease. The authors hypothesized that ultrasound would also reveal a decrease in the plantar fascia thickness for patients undergoing treatment for the disease, a hypothesis that, heretofore, had been only tested on a limited number of subjects. They conducted a more statistically significant study that found that clinical treatment with injection and biomechanical correction does indeed diminish plantar fascia thickness as shown on ultrasound. The study also revealed that patients experience the most heightened plantar fascia tenderness toward the end of the day, and improvement in their symptomatic complaints were associated with a reduction in plantar fascia thickness. As a result, the authors conclude that office-based ultrasound can help diagnose and confirm plantar fasciitis/fasciosis through the measurement of the plantar fascia thickness. Because of the advantages of ultrasound--that it is non-invasive with greater patient acceptance, cost effective and radiation-free--the imaging tool should be considered and implemented early in the diagnosis and treatment of plantar fasciitis/fasciosis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations.

    Science.gov (United States)

    Kirkpatrick, Joshua; Yassaie, Omid; Mirjalili, Seyed Ali

    2017-06-01

    The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship between the PCS and surrounding soft tissues as well as examining the histology of the PCS. We identify a number of key associations with PCS, including age, weight, gender, arthritides, plantar fasciitis and foot position; these factors may function as risk factors in PCS formation. The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories. We review these and finish by looking clinically at the evidence that PCS causes heel pain. © 2017 Anatomical Society.

  18. Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Rachel L. [Cornell University Medical College, New York, NY (United States); Umans, Benjamin D. [Harvard University, Cambridge, MA (United States); Umans, Hilary [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States)

    2016-07-15

    To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear. We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements. Consistency and concordance were assessed. Pearson's Chi-square test was used to test the correlation between qualitative findings and PP tear status. Correlation between measurements and PP status was assessed using t tests and Wilcoxon's rank-sum test (p values < 0.05 considered significant). Classification and regression trees were utilized to identify attributes that, taken together, would consistently distinguish PP tear from controls. Quantitative measurements were highly reproducible (concordance 0.88-0.99). Elevated 2nd MT protrusion, lesser MT supination and rotational divergence of >45 between the 1st-2nd MT axis correlated with PP tear. Pericapsular soft tissue thickening correlated most strongly with PP tear, correctly classifying 95 % of cases and controls. Excluding pericapsular soft tissue thickening, sequential assessment of 2nd toe enthesitis, 2nd flexor tendon subluxation, and splaying of the second and third toes accurately classified PP status in 92 %. Pericapsular soft tissue thickening most strongly correlated with PP tear. For cases in which it might be difficult to distinguish pericapsular fibrosis from neuroma, sequential assessment of 2nd toe enthesitis, flexor tendon subluxation and splaying of the 2nd and 3rd toe is most helpful for optimizing accurate diagnosis of PP tear. (orig.)

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

    Science.gov (United States)

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

    2018-01-01

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

  20. Muscle response to pneumatic hand tool torque reaction forces.

    Science.gov (United States)

    Radwin, R G; VanBergeijk, E; Armstrong, T J

    1989-06-01

    Surface electromyography was used for studying the effects of torque reaction force acting against the hand, on forearm muscle activity and grip force for five subjects operating right angle, air shut-off nutrunners. Four tools having increasing spindle torque were operated using short and long torque reaction times. Nutrunner spindle torque ranged between 30 Nm and 100 Nm. Short torque reaction time was considered 0.5 s while long torque reaction time was 2 s. Peak horizontal force was the greatest component of the reaction force acting against the hand and accounted for more than 97% of the peak resultant hand force. Peak hand force increased from 89 N for the smallest tool to 202 N for the largest tool. Forearm muscle rms EMG, scaled for grip force, indicated average flexor activity during the Torque-reaction phase was more than four times greater than the Pre-start and Post Shut-off phases, and two times greater than the Run-down phase. Flexor EMG activity during the Torque-reaction phase increased for increasing tool peak spindle torque. Average flexor rms EMG activity, scaled for grip force, during the Torque-reaction phase increased from 372 N for the 30 Nm nutrunner to 449 N for the 100 Nm nutrunner. Flexor rms EMG activity averaged during the Torque-reaction phase and scaled for grip force was 390 N for long torque reaction times and increased to 440 N for short torque reaction times. Flexor rms EMG integrated over the torque reaction phase was 839 Ns for long torque reaction times and decreased to 312 Ns for short torque reaction times. The average latency between tool spindle torque onset and peak initial flexor rms EMG for long torque reaction times was 294 ms which decreased to 161 ms for short torque reaction times. The average latency between peak tool spindle torque, just prior to tool shut-off, and peak final rms EMG for long torque reaction times was 97 ms for flexors and 188 ms for extensors, which decreased for short torque reaction times to 47

  1. Sonographic evaluation of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sook Ja; Choi, Yun Sun; Tien, Kuang Lung; Jung, Hye Jeon; Lee, Kyoung Tae; Yoon, Yong Kyu [Eulji College of Medicine Eulji Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the sonographic findings of plantar fasciitis. Both feet of 30 patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthy volunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel pain was unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. We also evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. Plantar fascia thickness was significantly greater in the heels of patients with plantar fasciitis(3.2-8mm; mean, 5.1{+-}1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5{+-}0.78)(p<0.0001), in which it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0{+-}0.71)(p<0.0001). The proximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and in none of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%), and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomatic heels(5.9%). In plantar fasciitis, sonography demonstrates that the fascia is thicker as well as hypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinical diagnosis.

  2. Sonographic evaluation of plantar fasciitis

    International Nuclear Information System (INIS)

    Yoon, Sook Ja; Choi, Yun Sun; Tien, Kuang Lung; Jung, Hye Jeon; Lee, Kyoung Tae; Yoon, Yong Kyu

    1999-01-01

    To evaluate the sonographic findings of plantar fasciitis. Both feet of 30 patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthy volunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel pain was unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. We also evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. Plantar fascia thickness was significantly greater in the heels of patients with plantar fasciitis(3.2-8mm; mean, 5.1±1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5±0.78)(p<0.0001), in which it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0±0.71)(p<0.0001). The proximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and in none of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%), and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomatic heels(5.9%). In plantar fasciitis, sonography demonstrates that the fascia is thicker as well as hypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinical diagnosis

  3. Intermuscular aponeuroses between the flexor muscles of the forearm and their relationships with the ulnar nerve.

    Science.gov (United States)

    Won, Hyung-Sun; Liu, Hong-Fu; Kim, Jun-Ho; Kwak, Dai-Soon; Chung, In-Hyuk; Kim, In-Beom

    2016-12-01

    The aim of this study was to clarify the morphological characteristics of the intermuscular aponeurosis between the flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS; IMAS), and that between the FCU and flexor digitorum profundus (FDP; IMAP), and their topographic relationships with the ulnar nerve. Fifty limbs of 38 adult cadavers were studied. The IMAS extended along the deep surface of the FCU adjoining the FDS, having the appearance of a ladder, giving off "steps" that decreased in width from superficial to deep around the middle of the forearm. Its proximal part divided into two bands connected by a thin membrane, and was attached to the medial epicondyle and the tubercle (the most medial prominent part of the coronoid process of the ulna), respectively. The IMAP extended deep between the FCU and FDP from the antebrachial fascia, and its distal end was located on the posterior border of the FCU. The IMAP became broader toward its proximal part, and its proximal end was attached anterior and posterior to the tubercle and the olecranon, respectively. The ulnar nerve passed posterior to the medial epicondyle and then medial to the tubercle, and was crossed by the deep border of the IMAS at 58.3 ± 14.1 mm below the medial epicondyle. The deep border of the IMAS and aberrant tendinous structure passing across the ulnar nerve, or the parts of the IMAS and IMAP passing posterior to the ulnar nerve are potential causes of ulnar nerve compression.

  4. Effect of viscoelastic properties of plantar soft tissues on plantar pressures at the first metatarsal head in diabetics with peripheral neuropathy

    International Nuclear Information System (INIS)

    Jan, Yih-Kuen; Rong, Daqian; Lung, Chi-Wen; Cuaderes, Elena; Boyce, Kari

    2013-01-01

    Diabetic foot ulcers are one of the most serious complications associated with diabetes mellitus. Current research studies have demonstrated that biomechanical alterations of the diabetic foot contribute to the development of foot ulcers. However, the changes of soft tissue biomechanical properties associated with diabetes and its influences on the development of diabetic foot ulcers have not been investigated. The purpose of this study was to investigate the effect of diabetes on the biomechanical properties of plantar soft tissues and the relationship between biomechanical properties and plantar pressure distributions. We used the ultrasound indentation tests to measure force-deformation relationships of plantar soft tissues and calculate the effective Young's modulus and quasi-linear viscoelastic parameters to quantify biomechanical properties of plantar soft tissues. We also measured plantar pressures to calculate peak plantar pressure and plantar pressure gradient. Our results showed that diabetics had a significantly greater effective Young's modulus and initial modulus of quasi-linear viscoelasticity compared to non-diabetics. The plantar pressure gradient and biomechanical properties were significantly correlated. Our findings indicate that diabetes is linked to an increase in viscoelasticity of plantar soft tissues that may contribute to a higher peak plantar pressure and plantar pressure gradient in the diabetic foot. (paper)

  5. Effectiveness of Plantar Fascia-Specific Stretching Exercises in Plantar Fasciitis

    Directory of Open Access Journals (Sweden)

    Devrim Özer

    2015-12-01

    Full Text Available Aim: Plantar fasciitis (PF is a painful and disabling disease that affects the quality of life and daily activities of patients and it is the most common cause of heel pain in adults. In primary treatment, conservative treatment is suggested and different conservative options are described in the literature. In our study, we evaluated the efficacy of plantar fascia-specific stretching exercises in the treatment of PF. Methods: Twenty-nine feet - 21 patients with the mean age of 49.3 years were included in the study. The mean length of follow-up was 19.8 months and the mean length of exercise period was 4.94 months. Non-weight bearing plantar fascia-specific stretching exercise was done twice daily, for 10 times at each session. In addition to exercises, silicone heel pad and nonsteroidal anti-inflammatory drugs (NSAID were added. Visual analog scale (VAS was used for pain evaluation. Results: Full recovery detected in 15 feet in 10 patients (52% and a decrease in pain was seen in 10 feet in 8 patients (34%. There was no response in 4 feet in 3 patients (14%. There was statistically significant difference between pre-treatment and post-treatment visual analog scale scores (p=0.0001. Conclusion: Plantar fascia-specific stretching exercise is an effective treatment option in PF.

  6. [Spasticity and dynamic plantar pressure distribution measurements in hemiplegic spastic children].

    Science.gov (United States)

    Femery, V; Moretto, P; Renaut, H; Thévenon, A

    2001-02-01

    The aim of this study was to analyse the plantar pressure distribution in nine hemiplegic spastic children to illustrate the dynamic alteration during stance phase linked spasticity grade. The graduation of the lower limbs muscle tone related to the Aschworth spasticity scale enabled us to identify two groups of hemiplegics subjects. The groups Asch 1 and Asch 3 have respectively presented a low and a strong spasticity. The peak pressures during consecutive gait cycles were determined under the feet of 30 healthy subjects and two cerebral palsy groups using a wearable footprint analysis system. A statistical study showed a similarity between the two disabled groups. Peak pressures under the midfoot were significantly higher compared to the control group. While the plantar pressure distribution profile was specific for each group under all other anatomical structures. The significant alterations were observed under the forefoot and hallux. Spasticity modifies the foot contact to ground and leads to a specific plantar pressure distribution profile linked to the spasticity grade. The equinovarus with clawed toes deformity due to higher spasticity seems to be an important factor in terminal stance phase perturbations. However spastic hemiplegic subjects seem to adopt a gait pattern in agreement with stability optimization criteria.

  7. Metatarsophalangeal joint extension changes ultrasound measurements for plantar fascia thickness.

    Science.gov (United States)

    Granado, Michael J; Lohman, Everett B; Gordon, Keith E; Daher, Noha S

    2018-01-01

    Ultrasound is an inexpensive method for quantifying plantar fascia thickness, especially in those with plantar fasciitis. Ultrasound has also been used to assess the effectiveness of various treatments for plantar fasciitis by comparing plantar fascia thickness before and after an intervention period. While a plantar fascia thickness over 4 mm via ultrasound has been proposed to be consistent with plantar fasciitis, some researchers believe the 4 mm plantar fascia thickness level to be a dubious guideline for diagnosing plantar fasciitis due to the lack of standardization of the measurement process for plantar fascia thickness. In particular, no universal guidelines exist on the positioning of the metatarsophalangeal (MTP) joints during the procedure and the literature also has inconsistent protocols. The purpose of this study is to investigate and compare the influence of MTP joint extension on plantar fascia thickness in healthy participants and those with unilateral plantar fasciitis. The plantar fascia thickness of forty participants (20 with unilateral plantar fasciitis and 20 control) was measured via ultrasound three times at three different MTP joint positions: 1) at rest, 2) 30° of extension from the plantar surface, and 3) maximal extension possible. The plantar fascia became significantly thinner as MTP joint extension increased in both the plantar fasciitis group ( p  plantar fasciitis group, the involved plantar fascia was 1.2 to 1.3 mm thicker (p plantar fascia thickness between the two sides was less than 0.1 mm ( p  plantar fascia thickness. It is recommended that plantar fascia thickness measurements be performed with the toes at rest. If MTP joints must be extended, then the toes should be extended maximally and then noted to ensure subsequent ultrasound procedures are repeated. Standardizing the position of the MTP joints is not only important for attaining the most accurate thickness measurement of the plantar fascia, but is also

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

    Science.gov (United States)

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

    2001-07-01

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

  9. Acute effect of different stretching methods on isometric muscle strength

    Directory of Open Access Journals (Sweden)

    Gabriel Vasconcellos de Lima Costa e Silva

    2014-03-01

    This study investigated the acute effect of static stretching methods (SS and proprioceptive neuromuscular facilitation (PNF on the static muscle strength (SMS. Eleven young male subjects with strength training experience, performed 3 tests with a 48h interval between them, randomly selected, where each one subject carried out all procedures: a hand grip without stretching; b hand grip preceded by static stretching of wrist flexors muscles; c hand grip preceded by PNF stretching of wrist flexors muscles. The Shapiro-Wilk test verified the normality of data, and a one-way ANOVA with repeated measures, followed by Tukey’s post hoc test, evaluated the differences between the groups. The significance was set at p 0.05. In conclusion, both stretching methods had caused negative effects on isometric strength, reducing its levels.

  10. Effectiveness of the Simultaneous Stretching of the Achilles Tendon and Plantar Fascia in Individuals With Plantar Fasciitis.

    Science.gov (United States)

    Engkananuwat, Phoomchai; Kanlayanaphotporn, Rotsalai; Purepong, Nithima

    2018-01-01

    Since the plantar fascia and the Achilles tendon are anatomically connected, it is plausible that stretching of both structures simultaneously will result in a better outcome for plantar fasciitis. Fifty participants aged 40 to 60 years with a history of plantar fasciitis greater than 1 month were recruited. They were prospectively randomized into 2 groups. Group 1 was instructed to stretch the Achilles tendon while group 2 simultaneously stretched the Achilles tendon and plantar fascia. After 4 weeks of both stretching protocols, participants in group 2 demonstrated a significantly greater pressure pain threshold than participants in group 1 ( P = .040) with post hoc analysis. No significant differences between groups were demonstrated in other variables ( P > .05). Concerning within-group comparisons, both interventions resulted in significant reductions in pain at first step in the morning and average pain at the medial plantar calcaneal region over the past 24 hours, while there were increases in the pressure pain threshold, visual analog scale-foot and ankle score, and range of motion in ankle dorsiflexion ( P plantar fascia for 4 weeks was a more effective intervention for plantar fasciitis. Patients who reported complete relief from symptoms at the end of the 4-week intervention in the simultaneous stretching group (n = 14; 56%) were double that of the stretching of the Achilles tendon-only group (n = 7; 28%). II, lesser quality RCT or prospective comparative study.

  11. Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test: A Cross-Sectional Study

    Science.gov (United States)

    Silvestre, Rony; Fuentes, Jorge; da Costa, Bruno R.; Gadotti, Inae C.; Warren, Sharon; Major, Paul W.; Thie, Norman M.R.; Magee, David J.

    2011-01-01

    Background Most patients with temporomandibular disorders (TMD) have been shown to have cervical spine dysfunction. However, this cervical dysfunction has been evaluated only qualitatively through a general clinical examination of the cervical spine. Purpose The purpose of this study was to determine whether patients with TMD had increased activity of the superficial cervical muscles when performing the craniocervical flexion test (CCFT) compared with a control group of individuals who were healthy. Design A cross-sectional study was conducted. Methods One hundred fifty individuals participated in this study: 47 were healthy, 54 had myogenous TMD, and 49 had mixed TMD. All participants performed the CCFT. Data for electromyographic activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles were collected during the CCFT for all participants. A 3-way mixed-design analysis of variance for repeated measures was used to evaluate the differences in EMG activity for selected muscles while performing the CCFT under 5 incremental levels. Effect size values were calculated to evaluate the clinical relevance of the results. Results Although there were no statistically significant differences in electromyographic activity in the SCM or AS muscles during the CCFT in patients with mixed and myogenous TMD compared with the control group, those with TMD tended to have increased activity of the superficial cervical muscles. Limitations The results obtained in this research are applicable for the group of individuals who participated in this study under the protocols used. They could potentially be applied to people with TMD having characteristics similar to those of the participants of this study. Conclusion This information may give clinicians insight into the importance of evaluation and possible treatment of the deep neck flexors in patients with TMD. However, future research should test the effectiveness of this type of program through a randomized controlled

  12. Fascitis plantar

    OpenAIRE

    López Pérez, Diego

    2014-01-01

    La fascitis plantar (FP) es una de las causas más frecuentes de dolor en el pie, afectando al talón. Es un síndrome degenerativo de la fascia plantar que se produce como resultado de traumas repetidos en el origen de ésta, en el calcáneo, y es la causa más común de dolor en el talón en las personas adultas. Suele presentarse en atletas y corredores, aunque también aparece en la población general, afectando aproximadamente a un 10% en ambos casos. La función que desempeña la fascia es doble...

  13. Inhibition of xanthine oxidase reduces oxidative stress and improves skeletal muscle function in response to electrically stimulated isometric contractions in aged mice

    Science.gov (United States)

    Ryan, Michael J.; Jackson, Janna R.; Hao, Yanlei; Leonard, Stephen S.; Alway, Stephen E.

    2012-01-01

    Oxidative stress is a putative factor responsible for reducing function and increasing apoptotic signaling in skeletal muscle with aging. This study examined the contribution and functional significance of the xanthine oxidase enzyme as a potential source of oxidant production in aged skeletal muscle during repetitive in situ electrically stimulated isometric contractions. Xanthine oxidase activity was inhibited in young adult and aged mice via a subcutaneously placed time release (2.5 mg/day) allopurinol pellet, 7 days prior to the start of in situ electrically stimulated isometric contractions. Gastrocnemius muscles were electrically activated with 20 maximal contractions for three consecutive days. Xanthine oxidase activity was 65% greater in the gastrocnemius muscle of aged mice compared to young mice. Xanthine oxidase activity also increased after in situ electrically stimulated isometric contractions in muscles from both young (33%) and aged (28%) mice, relative to contralateral non-contracted muscles. Allopurinol attenuated the exercise-induced increase in oxidative stress, but it did not affect the elevated basal levels of oxidative stress that was associated with aging. In addition, inhibition of xanthine oxidase activity decreased caspase 3 activity, but it had no effect on other markers of mitochondrial associated apoptosis. Our results show that compared to control conditions, suppression of xanthine oxidase activity by allopurinol reduced xanthine oxidase activity, H2O2 levels, lipid peroxidation and caspase-3 activity, prevented the in situ electrically stimulated isometric contraction-induced loss of glutathione, prevented the increase of catalase and copper-zinc superoxide dismutase activities, and increased maximal isometric force in the plantar flexor muscles of aged mice after repetitive electrically evoked contractions. PMID:21530649

  14. Acute Medial Plantar Fascia Tear.

    Science.gov (United States)

    Pascoe, Stephanie C; Mazzola, Timothy J

    2016-06-01

    A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409.

  15. Monosynaptic Ia projections from intrinsic hand muscles to forearm motoneurones in humans.

    Science.gov (United States)

    Marchand-Pauvert, V; Nicolas, G; Pierrot-Deseilligny, E

    2000-05-15

    Heteronymous Ia excitatory projections from intrinsic hand muscles to human forearm motoneurones (MNs) were investigated. Changes in firing probability of single motor units (MUs) in the flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), extensor carpi radialis (ECR), extensor carpi ulnaris (ECU) and extensor digitorum communis (EDC) were studied after electrical stimuli were applied to the median and ulnar nerve at wrist level and to the corresponding homonymous nerve at elbow level. Homonymous facilitation, occurring at the same latency as the H reflex, and therefore attributed to monosynaptic Ia EPSPs, was found in all the sampled units. In many MUs an early facilitation was also evoked by heteronymous low-threshold afferents from intrinsic hand muscles. The low threshold (between 0.5 and 0.6 times motor threshold (MT)) and the inability of a pure cutaneous stimulation to reproduce this effect indicate that it is due to stimulation of group I muscle afferents. Evidence for a similar central delay (monosynaptic) in heteronymous as in homonymous pathways was accepted when the difference in latencies of the homonymous and heteronymous peaks did not differ from the estimated supplementary afferent conduction time from wrist to elbow level by more than 0.5 ms (conduction velocity in the fastest Ia afferents between wrist and elbow levels being equal to 69 m s-1). A statistically significant heteronymous monosynaptic Ia excitation from intrinsic hand muscles supplied by both median and ulnar nerves was found in MUs belonging to all forearm motor nuclei tested (although not in ECU MUs after ulnar stimulation). It was, however, more often found in flexors than in extensors, in wrist than in finger muscles and in muscles operating in the radial than in the ulnar side. It is argued that the connections of Ia afferents from intrinsic hand muscles to forearm MNs, which are stronger and more widely distributed than in the cat

  16. Muscle response to leg lengthening during distraction osteogenesis.

    Science.gov (United States)

    Thorey, Fritz; Bruenger, Jens; Windhagen, Henning; Witte, Frank

    2009-04-01

    Continuous lengthening of intact muscles during distraction osteogenesis leads to an increase of sarcomeres and enhances the regeneration of tendons and blood vessels. A high distraction rate leads to an excessive leg and muscle lengthening and might cause damages of muscle fibers with fibrosis, necrosis, and muscle weakness. Complications like muscle contractures or atrophy after postoperative immobilization emphazize the importance of muscles and their function in the clinical outcome. In an animal model of distraction osteogenesis, 18 sheep were operated with an external fixator followed by 4 days latency, 21 days distraction (1.25 mm per day) and 51 days consolidation. The anatomical location (gastrocnemius, peroneus tertius, and first flexor digitorum longus muscle), dimension and occurrence of muscular defects were characterized histologically. The callus formation and leg axis was monitored by weekly X-rays. Additionally, serum creatine kinase was analyzed during a distraction and consolidation period. Significant signs of muscle lesions in all three observed muscles can be found postoperatively, whereas normal callus formation and regular leg axis was observed radiologically. The peroneus tertius and first flexor digitorum longus muscles were found to have significantly more signs of fibrosis, inflammatory, and necrosis. Creatine kinase showed two peaks: 4 and 39 days postoperative as an indication of muscle damage and regeneration. The study implicates that muscle damages should be considered when a long-distance distraction osteogenesis is planned. The surgeon should consider these muscle responses and individually discuss a two-stage treatment or additional muscle tendon releases to minimize the risk of muscle damages.

  17. Muscle and Liver Carbohydrates: Response to Military Task Performance by Women and Men

    Science.gov (United States)

    2001-10-01

    three different occasions with the knee at three different degrees of flexion / extension. Knee orientations were: 1) plantar flexion with the knee fully...extended (1800), 2) plantar flexion with the knee flexed at 900, and 3) plantar flexion with the knee at an intermediate extension (135’). This data...selected so as to avoid vessels, fascia , and MRI artifacts. In order to accumulate a statistically significant number of ROI’s for each muscle in a given

  18. Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis.

    Science.gov (United States)

    Kim, Seong-Gil; Kim, Wan-Soo

    2018-05-15

    BACKGROUND The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. MATERIAL AND METHODS This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. RESULTS In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (psimple correlation analysis, all variables that passed the correlation analysis procedure had significant influence (plinear regression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). CONCLUSIONS Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement.

  19. Tuberculous flexor tenosynovitis of the hand

    OpenAIRE

    Mohamed Ali Sbai; Sofien Benzarti; Monia Boussen; Riadh Maalla

    2015-01-01

    Tuberculosis is a major public health problem in developing countries. Flexor tenosynovitis of the fingers constitutes an exceptional tuberculosis localization (Gabl et al., 1997; Senda et al., 2011) [1],[2]. Unusual presentations, such as tuberculous tenosynovitis, often go undetected and are associated with a diagnostic and therapeutic delay, especially when bacteriological research proves to be negative. Here, we report a case of tuberculous flexor tenosynovitis of the hand.

  20. Proximo-distal organization and fibre type regionalization in rat hindlimb muscles

    NARCIS (Netherlands)

    Wang, LC; Kernell, D

    Five muscles of the rat's lower hindlimb were compared with regard to their histochemical fibre type distribution at seven different proximo-distal levels. The muscles were: extensor digitorum longus (ED), flexor digitorum and hallucis longus (FD), gastrocnemius medialis (GM), peroneus longus (PE)

  1. Does muscle morphology change in chronic neck pain patients? - A systematic review.

    Science.gov (United States)

    De Pauw, R; Coppieters, I; Kregel, J; De Meulemeester, K; Danneels, L; Cagnie, B

    2016-04-01

    Neck pain is a common disabling worldwide health problem with a high socio-economic burden. Changes underlying the transition to, or the maintenance of a chronic state are still barely understood. Increasing evidence suggests that morphological muscle changes, including changes in cross-sectional area (CSA) or fatty infiltration, play a role in chronic neck pain. However, a structured overview of the current evidence of morphological changes is lacking. To systematically review the morphological muscle changes in patients with chronic neck pain, including those with whiplash-associated disorders (WAD) and chronic idiopathic neck pain. A systematic review using the PRISMA-guidelines. Fourteen of 395 papers were included after extensive screening. Most studies were of moderate methodological quality. A higher CSA was found in all flexor muscles in both patients with WAD and patients with chronic idiopathic neck pain, except for the deeper flexor muscles in patients with chronic idiopathic neck pain. The cervical extensor muscles show an increased CSA at the highest cervical segments in patients with WAD, while most studies in patients with chronic idiopathic neck pain report a decreased CSA in all extensor muscles. Fatty infiltration, which could be accountable for an increased CSA, of both cervical extensors and flexors seems to occur only in patients with WAD. Some evidence is available for changes in muscle morphology, however more high quality prospective and cross-sectional research is needed to confirm these changes and to identify potential underlying causes that need yet to be discovered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Muscular atrophy in diabetic neuropathy

    DEFF Research Database (Denmark)

    Andersen, H; Gadeberg, P C; Brock, B

    1997-01-01

    Diabetic patients with polyneuropathy develop motor dysfunction. To establish whether motor dysfunction is associated with muscular atrophy the ankle dorsal and plantar flexors of the non-dominant leg were evaluated with magnetic resonance imaging in 8 patients with symptomatic neuropathy, in 8 non...... confirmed that the atrophy predominated distally. We conclude that muscular atrophy underlies motor weakness at the ankle in diabetic patients with polyneuropathy and that the atrophy is most pronounced in distal muscles of the lower leg indicating that a length dependent neuropathic process explains...

  3. Muscle thickness and muscle quality measured by ultrasound: influence of different sites of measurement DOI: 10.5007/1980-0037.2011v13n2p87

    Directory of Open Access Journals (Sweden)

    Ronei Silveira Pinto

    2011-03-01

    Full Text Available The aims of this study were: a to investigate differences in muscle thickness (MT measured by ultrasound and muscle quality (MQ at three sites in the elbow flexors and knee extensors, and b to correlate MT with isometric force production of the elbow flexors and knee extensors. Sixty-nine young male subjects participated in this study. The isometric force production values of the elbow flexors and knee extensors were obtained at 90° and 60°, respectively. MT was assessed at three sites in the elbow flexors (proximal – BB1, middle – BB2, and distal – BB3 and knee extensors (proximal – RI1, middle – RI2, and distal – RI3. Differences between the three measurements of MT and MQ were evaluated by one-way repeated measures ANOVA. Pearson’s correlation test was used to assess the correlation between MT and isometric force. The level of significance was set at p<0.05. The results showed significant differences (p<0.001 between the three MT and MQ sites in the elbow flexors (BB1, BB2, BB3 and in the knee extensors (RI1, RI2, RI3. The correlation between BB1, BB2 and BB3 and force production was r=0.57, r=0.52 and r=0.59, respectively (p<0.05. In the knee extensors, the correlation between RI1, RI2 and RI3 and force production was r=0.47, r=0.51 and r=0.53, respectively (p<0.01. There were significant differences in MQ between elbow flexors (p<0.001 and knee extensors (p<0.001. The present results showed that the site of measurement has a significant influence on MT and MQ. Furthermore, MT was positively correlated with isometric force production in the elbow flexors and knee extensors.

  4. Quantifying the aging response and nutrient composition for muscles of the beef round.

    Science.gov (United States)

    Dixon, C L; Woerner, D R; Tokach, R J; Chapman, P L; Engle, T E; Tatum, J D; Belk, K E

    2012-03-01

    The objective of this study was to determine the optimal postmortem aging period and nutrient composition for Beef Value Cuts of the round. Forty USDA Select and 40 Premium USDA Choice beef carcasses were selected from a commercial beef packing plant in Colorado over a 12-wk period. The bottom and inside rounds were collected from both sides of each carcass for further fabrication into the following muscles: adductor, gastrocnemius, gracilis, pectineus, and superficial digital flexor. Each pair of muscles was cut into 7 steaks and randomly assigned to 1 of the following aging periods: 2, 4, 6, 10, 14, 21, and 28 d, and placed in refrigerated storage (2°C, never frozen). Upon completion of the designated aging period, steaks were removed from storage, cooked to a peak internal temperature of 72°C, and evaluated using Warner-Bratzler shear force (WBSF). A 2-way interaction was detected (P digital flexor decreased with increased time of postmortem aging. Quality grade did not affect (P > 0.05) WBSF values for the adductor, gastrocnemius, pectineus, and superficial digital flexor muscles. Exponential decay models were used to predict the change in WBSF from 2 to 28 d postmortem (aging response). The adductor, gastrocnemius, Select gracilis, Premium Choice gracilis, and pectineus required 21, 14, 23, 23, and 25 d, respectively, to complete the majority of the aging response. To determine the nutrient composition of the adductor, gastrocnemius, gracilis, pectineus, semimembranosus, and superficial digital flexor, bottom and inside rounds were collected from 10 USDA Select and 10 Premium USDA Choice carcasses and fabricated into the respective muscles, cut into 2.54-cm cubes, frozen (-20°C), and then homogenized. The adductor, gracilis, pectineus, semimembranosus, and superficial digital flexor were analyzed for DM, moisture, CP, and ash percentages. All muscles were evaluated for total lipid, fatty acid, and cholesterol composition. When quality grades were combined

  5. Spontaneous distal rupture of the plantar fascia.

    Science.gov (United States)

    Gitto, Salvatore; Draghi, Ferdinando

    2018-07-01

    Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

  6. Strengths of lower extremity and lower trunk muscles in females with patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Fateme Bokaee

    2010-09-01

    Full Text Available Introduction: Patellofemoral pain syndrome (PFPS is one of the most common orthopaedic problemsof the knee joint. Muscular weakness considered as a risk factor of this syndrome. Muscular weaknesscan alter lower extremity kinematics and lead to this syndrome. Also according to the kinetic chain,weakness in one motor segment can influence other motor segments. So the aim of this study was todetermine the association between muscular strengths of both lower extremity and trunks muscles andPFPS.Materials and Methods: 40 women participated in this study (20 subjects with PFPS and 20 ascontrols. In both groups isometric strengths of the lower extremity and lower trunk muscles wereevaluated with Nicholas hand-held dynamometer and then compared with each other.Results: There was a significant decrease in strength of the hip abductors, adductors, external rotators,flexors and extensors, quadriceps, ankle plantarflexors, dorsiflexors, flexor and lateral flexors of the trunkin patients with PFPS.Conclusion: Our results indicate that decrease in strength of the hip and trunk muscles is associatedwith the knee injury. It seems strengthening of muscles of these areas to be effective in preventing theinjury, reducing the risk of more injury and treatment of patients with this syndrome.

  7. Sonoelastography of the plantar fascia.

    Science.gov (United States)

    Wu, Chueh-Hung; Chang, Ke-Vin; Mio, Sun; Chen, Wen-Shiang; Wang, Tyng-Guey

    2011-05-01

    To compare the stiffness of the plantar fascia by using sonoelastography in healthy subjects of different ages, as well as patients with plantar fasciitis. The study protocol was approved by the Research Ethics Committee of the hospital, and all of the subjects gave their informed consent. Bilateral feet of 40 healthy subjects and 13 subjects with plantar fasciitis (fasciitis group) were examined by using color-coded sonoelastography. Healthy subjects were divided into younger (18-50 years) and older (> 50 years) groups. The color scheme was red (hard), green (medium stiffness), and blue (soft). The color histogram was subsequently analyzed. Each pixel of the image was separated into red, green, and blue components (color intensity range, 0-255). The color histogram then computed the mean intensity of each color component of the pixels within a standardized area. Mixed model for repeated measurements was used for comparison of the plantar fascia thickness and the intensity of the color components on sonoelastogram. Quantitative analysis of the color histogram revealed a significantly greater intensity of blue in older healthy subjects than in younger (94.5 ± 5.6 [± standard deviation] vs 90.0 ± 4.6, P = .002) subjects. The intensity of red and green was the same between younger and older healthy subjects (P = .68 and 0.12). The intensity of red was significantly greater in older healthy subjects than in the fasciitis group (147.8 ± 10.3 vs 133.7 ± 13.4, P plantar fascia softens with age and in subjects with plantar fasciitis. RSNA, 2011

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

    DEFF Research Database (Denmark)

    Brincks, John; Sørensen, Henrik; Dalgas, Ulrik

    2018-01-01

    flexors in mildly disabled persons with MS and healthy controls at different walking speeds. METHODS:Thirteen persons with MS and thirteen healthy controls participated and peak net joint power was calculated using 3D motion analysis. RESULTS:In general, no differences were found between speed......-matched healthy controls and persons with MS, but the fastest walking speed was significantly higher in healthy controls (2.42 m/s vs. 1.70 m/s). The net joint power increased in hip flexors, hip extensors, hip abductors, knee extensors and plantar flexors in both groups, when walking speed increased. Significant...... correlations between changes in walking speed and changes in net joint power of plantar flexors, hip extensors and hip flexors existed in healthy controls and persons with MS, and in net knee extensor absorption power of persons with MS only. CONCLUSION:In contrast to previous studies, these findings suggest...

  9. Incidence of plantar fascia ruptures following corticosteroid injection.

    Science.gov (United States)

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

  10. Association between plantar fascia vascularity and morphology and foot dysfunction in individuals with chronic plantar fasciitis.

    Science.gov (United States)

    Chen, Hongying; Ho, Hok-Ming; Ying, Michael; Fu, Siu Ngor

    2013-10-01

    Single-cohort laboratory-based study. To identify whether plantar fascia vascularity and thickness are associated with foot pain and dysfunction in individuals with chronic plantar fasciitis. Background Altered plantar fascia vascularity and thickening of the fascia have been identified in individuals with chronic plantar fasciitis. Thirty-eight patients with chronic unilateral plantar fasciitis and 21 controls participated in this study. Proximal plantar fascia vascularization and thickness were assessed using ultrasound imaging, and pain and foot dysfunction were quantified with a visual analog scale and the Chinese version of the Foot Function Index, respectively. Paired t tests were used to assess the side-to-side differences in fascia thickness and vascularity index (VI) in the control and patient groups, and an unpaired t test was used to make comparisons with the patient group. Multiple regression analysis was performed to identify whether the VI and fascia thickness were associated with pain and foot dysfunction. There were significantly higher VI (mean ± SD, 2.4% ± 1.4%) and fascia thickness (5.0 ± 1.3 mm) values in the affected feet when compared with the unaffected feet in the patient group (VI, 1.4% ± 0.5%; fascia thickness, 3.3 ± 0.7 mm) and with the dominant side of the controls (VI, 1.6% ± 0.4%; fascia thickness, 2.9 ± 0.6 mm). After accounting for age, gender, body mass index, and duration of symptoms, the VI explained 13% and 33% of the variance in pain scores measured with a visual analog scale and the pain subscale of the Foot Function Index, respectively; the VI and fascia thickness explained 42% of the variance in the Foot Function Index. Individuals with unilateral chronic plantar fasciitis demonstrated significantly greater vascularity and thickened fascia on the affected side compared to the unaffected side and also to healthy controls. Fascia vascularity was associated independently with self-perceived pain, and both fascia

  11. [Assessment of plantar fasciitis using shear wave elastography].

    Science.gov (United States)

    Zhang, Lining; Wan, Wenbo; Zhang, Lihai; Xiao, Hongyu; Luo, Yukun; Fei, Xiang; Zheng, Zhixin; Tang, Peifu

    2014-02-01

    To assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis. The bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion. The elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the two points in the elderly or young volunteers (P=0.172, P=0.126). SWE allows quantitative assessment of the stiffness of the plantar fascia, which decreases with aging and in patients with plantar fasciitis.

  12. Risk factors affecting chronic rupture of the plantar fascia.

    Science.gov (United States)

    Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

    2014-03-01

    Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

  13. Manual therapy for plantar heel pain.

    Science.gov (United States)

    Pollack, Yosefa; Shashua, Anat; Kalichman, Leonid

    2018-03-01

    Manual therapy employed in the treatment of plantar heel pain includes joint or soft tissue mobilizations. Efficacy of these methods is still under debate. To determine whether manual therapy, consisting of deep massage, myofascial release or joint mobilization is effective in treating plantar heel pain. A critical review of all available studies with an emphasis on randomized controlled trials (RCTs) was performed. PubMed, PEDro, and Google Scholar databases were searched for keywords relating to plantar heel pain, joint, and soft tissue mobilizations. There were no search limitations or language restrictions. The reference lists of all retrieved articles were searched. The PEDro score was used to assess the quality of the reviewed papers. A total of six relevant RCTs were found: two examined the effectiveness of joint mobilization on plantar heel pain and four the effectiveness of soft tissue techniques. Five studies showed a positive short-term effect after manual therapy treatment, mostly soft tissue mobilizations, with or without stretching exercises for patients with plantar heel pain, compared to other treatments. One study observed that adding joint mobilization to the treatment of plantar heel pain was not effective. The quality of all studies was moderate to high. According to reviewed moderate and high-quality RCTs, soft tissue mobilization is an effective modality for treating plantar heel pain. Outcomes of joint mobilizations are controversial. Further studies are needed to evaluate the short and long-term effect of different soft tissue mobilization techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Effect of Different Exercise Programs on Size and Function of Deep Cervical Flexor Muscles in Patients With Chronic Nonspecific Neck Pain: A Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Amiri Arimi, Somayeh; Mohseni Bandpei, Mohammad Ali; Javanshir, Khodabakhsh; Rezasoltani, Asghar; Biglarian, Akbar

    2017-08-01

    Neck pain is one of the major public health problems, which has a great impact on people's lives. The purpose of this study was to systematically review published studies conducted on the effect of different exercise programs on activity, size, endurance, and strength of deep cervical flexor (DCF) muscles in patients with chronic neck pain. The PubMed, Science Direct, OVID, Google scholar, Cochrane Library, and Physiotherapy Evidence Databases were searched to determine relevant articles published from 1990 to March 2016. The articles were qualitatively assessed based on the Physiotherapy Evidence Databases scale for randomized controlled trials studies. Nine articles were identified and evaluated in the final analysis. Four studies had moderate quality, and five studies had good quality. From those nine studies, eight studies gave support to the effectiveness of specific low-load exercise training on DCF muscles parameters, while one study reported no significant difference between this exercise and other cervical exercise programs. The results of reviewed studies are in favor of specific low-load craniocervical flexion exercise, which seems to be a highly effective exercise regimen compared to other types of exercises in improving DCF muscles impairments in patients with chronic neck pain.

  15. Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome.

    Science.gov (United States)

    Saeki, J; Nakamura, M; Nakao, S; Fujita, K; Yanase, K; Ichihashi, N

    2018-01-01

    Previous history of medial tibial stress syndrome (MTSS) is a risk factor for MTSS relapse, which suggests that there might be some physical factors that are related to MTSS development in runners with a history of MTSS. The relationship between MTSS and muscle stiffness can be assessed in a cross-sectional study that measures muscle stiffness in subjects with a history of MTSS, who do not have pain at the time of measurement, and in those without a history of MTSS. The purpose of this study was to compare the shear elastic modulus, which is an index of muscle stiffness, of all posterior lower leg muscles of subjects with a history of MTSS and those with no history and investigate which muscles could be related to MTSS. Twenty-four male collegiate runners (age, 20.0±1.7 years; height, 172.7±4.8 cm; weight, 57.3±3.7 kg) participated in this study; 14 had a history of MTSS, and 10 did not. The shear elastic moduli of the lateral gastrocnemius, medial gastrocnemius, soleus, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus, and tibialis posterior were measured using shear wave elastography. The shear elastic moduli of the flexor digitorum longus and tibialis posterior were significantly higher in subjects with a history of MTSS than in those with no history. However, there was no significant difference in the shear elastic moduli of other muscles. The results of this study suggest that flexor digitorum longus and tibialis posterior stiffness could be related to MTSS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Lipofibromatous Hamartoma of the Plantar Nerve An Extremely Rare Localization.

    Science.gov (United States)

    Mert, Murat; Hacısalihoglu, Payam

    2018-03-01

    Lipofibromatous hamartoma (LFH) is a rare, benign, tumor-like soft-tissue lesion that affects the peripheral nerves and forms a palpable neurogenic mass. Lipofibromatous hamartoma is associated with pain and sensory and/or motor deficits in the area of innervation of the affected nerve. This report describes a rare case of LFH of the plantar nerve. A 48-year-old woman presented to our outpatient orthopedic clinic with pain and a burning sensation on her left foot. The patient had a history of Morton's neuroma and had undergone a tarsal tunnel operation 2 years earlier at another center. None of her symptoms was alleviated by two previous operations. Magnetic resonance imaging with contrast revealed tenosynovitis of the flexor hallucis longus tendon and signal changes at deep tissue planes of the foot at the levels of the second and third toes, on the dorsal site and subcutaneous soft-tissue planes, suggesting edema and Morton's neuroma. The lesion was excised under spinal anesthesia, and histopathologic examination of the specimen revealed a diagnosis of LFH. The patient was discharged without any symptoms and her foot was normal at 8-month outpatient follow-up, with no indications of postoperative complications and/or recurrence.

  17. An exploratory study on differences in cumulative plantar tissue stress between healing and non-healing plantar neuropathic diabetic foot ulcers

    NARCIS (Netherlands)

    van Netten, Jaap J.; van Baal, Jeff G.; Bril, Adriaan; Wissink, Marieke; Bus, Sicco A.

    2018-01-01

    Mechanical stress is important in causing and healing plantar diabetic foot ulcers, but almost always studied as peak pressure only. Measuring cumulative plantar tissue stress combines plantar pressure and ambulatory activity, and better defines the load on ulcers. Our aim was to explore differences

  18. Getting to the heel of the problem: plantar fascia lesions

    International Nuclear Information System (INIS)

    Jeswani, T.; Morlese, J.; McNally, E.G.

    2009-01-01

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  19. Getting to the heel of the problem: plantar fascia lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeswani, T. [Department of Radiology, Worthing and Southlands Hospitals, West Sussex (United Kingdom); Morlese, J. [Department of Radiology, Royal Free Hospital, Pond street, London, NW3 2QG (United Kingdom); McNally, E.G. [Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)], E-mail: eugene.mcnally@gmail.com

    2009-09-15

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  20. Getting to the heel of the problem: plantar fascia lesions.

    Science.gov (United States)

    Jeswani, T; Morlese, J; McNally, E G

    2009-09-01

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  1. Imaging in the diagnosis of symptomatic forearm muscle herniation

    Energy Technology Data Exchange (ETDEWEB)

    Kendi, Tuba Karaguelle; Altinok, Deniz; Erdal, Haydar Hueseyin; Kara, Simay [Department of Radiology, Kirikkale University School of Medicine (Turkey)

    2003-06-01

    Muscle herniation can be defined as protrusion of a portion of muscle through an acquired or congenital defect of enclosing fascia. Although it is usually a cosmetic problem, it can lead to local pain and tenderness after prolonged exertion. In this report, we present a case of flexor digitorum superficialis muscle herniation in a 58-year-old man. The radiographic, ultrasonographic and magnetic resonance imaging findings are described with dynamic examination, permitting demonstration of muscle herniation through the fascial defect during muscle contraction. (orig.)

  2. Management of plantar fasciitis in the outpatient setting

    Science.gov (United States)

    Lim, Ang Tee; How, Choon How; Tan, Benedict

    2016-01-01

    Plantar fasciitis is a very common cause of inferior heel pain that can be triggered and aggravated by prolonged standing, walking, running and obesity, among other factors. Treatments are largely noninvasive and efficacious. Supportive treatments, including the plantar fascia-specific stretch, calf stretching, appropriate orthotics and night dorsiflexion splinting, can alleviate plantar fascia pain. While local injections of corticosteroids can help with pain relief, the effects are short-lived and must be weighed against the risk of fat pad atrophy and plantar fascia rupture. Ultrasonography-guided focal extracorporeal shock wave therapy is useful for patients with chronic plantar fasciitis and referrals for this treatment can be made in recalcitrant cases. Activity modification to decrease cyclical repetitive loading of the plantar fascia should be advised during the treatment phase regardless of the chosen treatment modality. PMID:27075037

  3. Targeting the Plantar Fascia for Corticosteroid Injection.

    Science.gov (United States)

    Salvi, Andrea Emilio

    2015-01-01

    Plantar fasciitis is often a difficult condition to treat. It is related to repetitive strain of the fascia at its attachment to the heel bone. This condition quite often appears with the concomitant presence of a plantar calcaneal heel spur. Corticosteroid injection is a popular treatment choice for plantar fasciitis, and accurate localization of the injected medication is essential for successful resolution of symptoms after the injection. In the present brief technical communication, a method for targeting the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus is described. The targeting method uses the lateral radiograph of the foot to aid in localization of the proximal attachment of the plantar fascia to the calcaneus. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  4. [The history of flexor tendon surgery].

    Science.gov (United States)

    Chamay, A

    1997-01-01

    Flexor tendon injuries were already treated in antiquity by Hippocrates, Galien and Avicenne. Since the Renaissance, other surgeons have attempted to repair flexor tendon injuries, but without success due to problems related to unsuitable materials and ignorance of the basic rules of asepsis and the absence of antiseptics until the second half of the 19th century. The first successful flexor tendon grafts in man were performed by K. Biesalski in 1910, E. Lexer in 1912 and L. Mayer in 1916. These three authors published their series of grafts and described in detail the anatomical, physiological and technical principles to be respected. St. Bunnell, in 1918, developed various pull-out direct suture procedures, but faced with the problems of adhesions, he abandoned this technique and proposed not to repair flexors in the digital tunnels but to graft them. He defined the famous zone which he called No man's land, which subsequently became Claude Verdan's zone II, in 1959. In 1960, C. Verdan published his first series of sutures maintained by 2 pins in zone II with comparable results to those obtained after grafting. In 1967, H. Kleinert, with his mobile suture, became the leader of direct tendon repair in zone II. 2-stage grafts were introduced in 1965 under the impetus of J. Hunter, who revised and popularized the studies conducted by A. Bassett and R.E. Caroll in 1950.

  5. Neck movement and muscle activity characteristics in female office workers with neck pain.

    Science.gov (United States)

    Johnston, V; Jull, G; Souvlis, T; Jimmieson, N L

    2008-03-01

    Cross-sectional study. To explore aspects of cervical musculoskeletal function in female office workers with neck pain. Evidence of physical characteristics that differentiate computer workers with and without neck pain is sparse. Patients with chronic neck pain demonstrate reduced motion and altered patterns of muscle control in the cervical flexor and upper trapezius (UT) muscles during specific tasks. Understanding cervical musculoskeletal function in office workers will better direct intervention and prevention strategies. Measures included neck range of motion; superficial neck flexor muscle activity during a clinical test, the craniocervical flexion test; and a motor task, a unilateral muscle coordination task, to assess the activity of both the anterior and posterior neck muscles. Office workers with and without neck pain were formed into 3 groups based on their scores on the Neck Disability Index. Nonworking women without neck pain formed the control group. Surface electromyographic activity was recorded bilaterally from the sternocleidomastoid, anterior scalene (AS), cervical extensor (CE) and UT muscles. Workers with neck pain had reduced rotation range and increased activity of the superficial cervical flexors during the craniocervical flexion test. During the coordination task, workers with pain demonstrated greater activity in the CE muscles bilaterally. On completion of the task, the UT and dominant CE and AS muscles demonstrated an inability to relax in workers with pain. In general, there was a linear relationship between the workers' self-reported levels of pain and disability and the movement and muscle changes. These results are consistent with those found in other cervical musculoskeletal disorders and may represent an altered muscle recruitment strategy to stabilize the head and neck. An exercise program including motor reeducation may assist in the management of neck pain in office workers.

  6. Fatigue Responses in Various Muscle Groups in Well-Trained Competitive Male Players after a Simulated Soccer Game

    DEFF Research Database (Denmark)

    Fransson, Dan; Vigh-Larsen, Jeppe Foged; Fatouros, Ioannis G

    2018-01-01

    soccer protocol, following baseline measures of maximal voluntary contractions of multiple muscle groups and systemic markers of muscle damage and inflammation at 0, 24 and 48 h into recovery. All muscle groups had a strength decrement (p ≤ 0.05) at 0 h post-match with knee flexors (14 ± 3%) and hip...... decrement still persistent (4 ± 1%, p ≤ 0.05) for trunk muscles 24 h into recovery. Large inter-player variations were observed in game-induced fatigue and recovery patterns in the various muscle groups. Markers of muscle damage and inflammation peaked 0 h post-match (myoglobin) and 24 h into recovery...... (creatine kinase), respectively, but thereafter returned to baseline. Intermittent test performance correlated with creatine kinase activity 24 h after the Copenhagen Soccer Test (r = -0.70; p = 0.02). In conclusion, post-game fatigue is evident in multiple muscle groups with knee flexors showing...

  7. Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

    Science.gov (United States)

    Nosaka, K; Muthalib, M; Lavender, A; Laursen, P B

    2007-01-01

    This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

  8. Hip flexor strain -- aftercare

    Science.gov (United States)

    ... flexors. Runners, people who do martial arts, and football, soccer, and hockey players are more likely to ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  9. Voluntary Control of Residual Antagonistic Muscles in Transtibial Amputees: Feedforward Ballistic Contractions and Implications for Direct Neural Control of Powered Lower Limb Prostheses.

    Science.gov (United States)

    Huang, Stephanie; Huang, He

    2018-04-01

    Discrete, rapid (i.e., ballistic like) muscle activation patterns have been observed in ankle muscles (i.e., plantar flexors and dorsiflexors) of able-bodied individuals during voluntary posture control. This observation motivated us to investigate whether transtibial amputees are capable of generating such a ballistic-like activation pattern accurately using their residual ankle muscles in order to assess whether the volitional postural control of a powered ankle prosthesis using proportional myoelectric control via residual muscles could be feasible. In this paper, we asked ten transtibial amputees to generate ballistic-like activation patterns using their residual lateral gastrocnemius and residual tibialis anterior to control a computer cursor via proportional myoelectric control to hit targets positioned at 20% and 40% of maximum voluntary contraction of the corresponding residual muscle. During practice conditions, we asked amputees to hit a single target repeatedly. During testing conditions, we asked amputees to hit a random sequence of targets. We compared movement time to target and end-point accuracy. We also examined motor recruitment synchronization via time-frequency representations of residual muscle activation. The result showed that median end-point error ranged from -0.6% to 1% maximum voluntary contraction across subjects during practice, which was significantly lower compared to testing ( ). Average movement time for all amputees was 242 ms during practice and 272 ms during testing. Motor recruitment synchronization varied across subjects, and amputees with the highest synchronization achieved the fastest movement times. End-point accuracy was independent of movement time. Results suggest that it is feasible for transtibial amputees to generate ballistic control signals using their residual muscles. Future work on volitional control of powered power ankle prostheses might consider anticipatory postural control based on ballistic-like residual

  10. Enhanced muscle blood flow with intermittent pneumatic compression of the lower leg during plantar flexion exercise and recovery.

    Science.gov (United States)

    Zuj, K A; Prince, C N; Hughson, R L; Peterson, S D

    2018-02-01

    This study tested the hypothesis that intermittent compression of the lower limb would increase blood flow during exercise and postexercise recovery. Data were collected from 12 healthy individuals (8 men) who performed 3 min of standing plantar flexion exercise. The following three conditions were tested: no applied compression (NoComp), compression during the exercise period only (ExComp), and compression during 2 min of standing postexercise recovery. Doppler ultrasound was used to determine superficial femoral artery (SFA) blood flow responses. Mean arterial pressure (MAP) and cardiac stroke volume (SV) were assessed using finger photoplethysmography, with vascular conductance (VC) calculated as VC = SFA flow/MAP. Compared with the NoComp condition, compression resulted in increased MAP during exercise [+3.5 ± 4.1 mmHg (mean ± SD)] but not during postexercise recovery (+1.6 ± 5.9 mmHg). SV increased with compression during both exercise (+4.8 ± 5.1 ml) and recovery (+8.0 ± 6.6 ml) compared with NoComp. There was a greater increase in SFA flow with compression during exercise (+52.1 ± 57.2 ml/min) and during recovery (+58.6 ± 56.7 ml/min). VC immediately following exercise was also significantly greater in the ExComp condition compared with the NoComp condition (+0.57 ± 0.42 ml·min -1 ·mmHg -1 ), suggesting the observed increase in blood flow during exercise was in part because of changes in VC. Results from this study support the hypothesis that intermittent compression applied during exercise and recovery from exercise results in increased limb blood flow, potentially contributing to changes in exercise performance and recovery. NEW & NOTEWORTHY Blood flow to working skeletal muscle is achieved in part through the rhythmic actions of the skeletal muscle pump. This study demonstrated that the application of intermittent pneumatic compression during the diastolic phase of the cardiac cycle, to mimic the mechanical

  11. Talalgia: plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2014-06-01

    Full Text Available Plantar fasciitis is a very common painful syndrome, but its exact etiology still remains obscure. The diagnosis is essentially clinical, based on history-taking and physical examination. Complementary laboratory tests and imaging examinations may be useful for differential diagnoses. The treatment is essentially conservative, with a high success rate (around 90%. The essence of the conservative treatment is the home-based program of exercises to stretch the plantar fascia. Indications for surgical treatment are only made when the symptoms persist without significant improvement, after at least six months of conservative treatment supervised directly by the doctor.

  12. Talalgia: plantar fasciitis☆

    Science.gov (United States)

    Cardenuto Ferreira, Ricardo

    2014-01-01

    Plantar fasciitis is a very common painful syndrome, but its exact etiology still remains obscure. The diagnosis is essentially clinical, based on history-taking and physical examination. Complementary laboratory tests and imaging examinations may be useful for differential diagnoses. The treatment is essentially conservative, with a high success rate (around 90%). The essence of the conservative treatment is the home-based program of exercises to stretch the plantar fascia. Indications for surgical treatment are only made when the symptoms persist without significant improvement, after at least six months of conservative treatment supervised directly by the doctor. PMID:26229803

  13. Muscle metabolism from near infrared spectroscopy during rhythmic handgrip in humans

    DEFF Research Database (Denmark)

    Boushel, Robert Christopher; Pott, F; Madsen, P

    1998-01-01

    The rate of metabolism in forearm flexor muscles (MO2) was derived from near-infrared spectroscopy (NIRS-O2) during ischaemia at rest rhythmic handgrip at 15% and 30% of maximal voluntary contraction (MVC), post-exercise muscle ischaemia (PEMI), and recovery in seven subjects. The MO2 was compared...

  14. Increased central facilitation of antagonist reciprocal inhibition at the onset of dorsiflexion following explosive strength training

    DEFF Research Database (Denmark)

    Geertsen, Svend Sparre; Jensen, Jesper Lundbye; Nielsen, Jens Bo

    2008-01-01

    At the onset of dorsiflexion disynaptic reciprocal inhibition (DRI) of soleus motoneurons is increased to prevent activation of the antagonistic plantar flexors. This is caused by descending facilitation of transmission in the DRI pathway. Because the risk of eliciting stretch reflexes in the ankle...... of the ankle dorsiflexor muscles 3 times a week for 4 wk. Test sessions were conducted before, shortly after, and 2 wk after the training period. The rate of torque development measured at 30, 50, 100, and 200 ms after onset of voluntary explosive isometric dorsiflexion increased by 24-33% (P

  15. Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity

    DEFF Research Database (Denmark)

    Pedersen, E; Petersen, T; Schrøder, H D

    1986-01-01

    The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely de...

  16. Changes in hip joint muscle-tendon lengths with mode of locomotion.

    Science.gov (United States)

    Riley, Patrick O; Franz, Jason; Dicharry, Jay; Kerrigan, D Casey

    2010-02-01

    We have reported that peak hip extension is nearly identical in walking and running, suggesting that anatomical constraints, such as flexor muscle tightness may limit the range of hip extension. To obtain a more mechanistic insight into mobility at the hip and pelvis we examined the lengths of the muscle-tendons units crossing the hip joint. Data defining the three-dimensional kinematics of 26 healthy runners at self-selected walking and running speeds were obtained. These data were used to scale and drive musculoskeletal models using OpenSIM. Muscle-tendon unit (MTU) lengths were calculated for the trailing limb illiacus, rectus femoris, gluteus maximus, and biceps femoris long head and the advancing limb biceps femoris and gluteus maximus. The magnitude and timing of MTU length peaks were each compared between walking and running. The peak length of the right (trailing limb) illiacus MTU, a pure hip flexor, was nearly identical between walking and running, while the maximum length of the rectus femoris MTU, a hip flexor and knee extensor, increased during running. The maximum length of the left (leading limb) biceps femoris was also unchanged between walking and running. Further, the timing of peak illiacus MTU length and peak contralateral biceps femoris MTU length occurred essentially simultaneously during running, at a time during gait when the hamstrings are most vulnerable to stretch injury. This latter finding suggests exploring the role for hip flexor stretching in combination with hamstring stretching to treat and/or prevent running related hamstring injury. Copyright 2009 Elsevier B.V. All rights reserved.

  17. Ultrasound evaluation of a spontaneous plantar fascia rupture.

    Science.gov (United States)

    Louwers, Michael J; Sabb, Brian; Pangilinan, Percival H

    2010-11-01

    Plantar fascia rupture is an occasional complication in patients with chronic plantar fasciitis or in patients with plantar fasciitis treated with steroid injection. Very few cases of spontaneous plantar fascia rupture have been reported in the literature (Herrick and Herrick, Am J Sports Med 1983;11:95; Lun et al, Clin J Sports Med 1999;9:48-9; Rolf et al, J Foot Ankle Surg 1997;36:112-4; Saxena and Fullem, Am J Sports Med 2004;32:662-5). Spontaneous medial plantar fascia rupture in a 37-yr-old man with no preceding symptoms or steroid injections was confirmed with diagnostic ultrasound, which revealed severe fasciitis at the calcaneal insertion with partial tearing. After conservative treatment, the patient returned to full activities. We discuss the anatomy, risk factors, examination findings, and treatment for this condition, as well as the unique benefits that ultrasound offers over magnetic resonance imaging. It is important to consider plantar fascia rupture in patients with hindfoot pain and medioplantar ecchymosis, particularly if an injury occurred during acceleration maneuvers. Ultrasound in these cases can be used to diagnose a plantar fascia tear quickly, accurately, and cost-effectively.

  18. Endoscopic plantar fascia release via a suprafascial approach is effective for intractable plantar fasciitis.

    Science.gov (United States)

    Miyamoto, Wataru; Yasui, Youichi; Miki, Shinya; Kawano, Hirotaka; Takao, Masato

    2017-10-14

    To evaluate the medium-term clinical results of endoscopic plantar fascia release (EPFR) using a suprafascial approach for recalcitrant plantar fasciitis. Twenty-four feet of twenty-three patients who underwent EPFR using a suprafascial approach were followed up for more than 2 years using the American Orthopedic Foot and Ankle Society (AOFAS) score. The AOFAS score at final follow-up was compared between patients who participated in athletic activity (group A) and those who were sedentary (group S) and between those with and those without calcaneal spur (group with CS and group without CS, respectively). The ability of patients to return to athletic activity, and if so, the time interval between surgery and return to athletic activity, were investigated in group A. Complications were recorded. The median follow-up duration was 48 months. The mean AOFAS score in all patients increased significantly between before surgery and final follow-up (P plantar nerve occurred in three feet. EPFR using a suprafascial approach was effective for recalcitrant plantar fasciitis. However, the prognosis of sedentary patients was inferior to that of patients engaged in athletic activity. IV.

  19. Isometric muscle strength and mobility capacity in children with cerebral palsy.

    Science.gov (United States)

    Dallmeijer, Annet J; Rameckers, Eugene A; Houdijk, Han; de Groot, Sonja; Scholtes, Vanessa A; Becher, Jules G

    2017-01-01

    To determine the relationship between isometric leg muscle strength and mobility capacity in children with cerebral palsy (CP) compared to typically developing (TD) peers. Participants were 62 children with CP (6-13 years), able to walk with (n = 10) or without (n = 52) walking aids, and 47 TD children. Isometric muscle strength of five muscle groups of the leg was measured using hand-held dynamometry. Mobility capacity was assessed with the 1-min walk, the 10-m walk, sit-to-stand, lateral-step-up and timed-stair tests. Isometric strength of children with CP was reduced to 36-82% of TD. When adjusted for age and height, the percentage of variance in mobility capacity that was explained by isometric strength of the leg muscles was 21-24% (walking speed), 25% (sit-to-stand), 28% (lateral-step-up) and 35% (timed-stair) in children with CP. Hip abductors and knee flexors had the largest contribution to the explained variance, while knee extensors showed the weakest correlation. Weak or no associations were found between strength and mobility capacity in TD children. Isometric strength, especially hip abductor and knee flexor strength, is moderately related to mobility capacity in children with CP, but not in TD children. To what extent training of these muscle groups will lead to better mobility capacity needs further study. Implications for Rehabilitation Strength training in children with cerebral palsy (CP) may be targeted more specifically at hip abductors and knee flexors. The moderate associations imply that large improvements in mobility capacity may not be expected when strength increases.

  20. Muscle fatigue and metabolic responses following three different antagonist pre-load resistance exercises

    NARCIS (Netherlands)

    Carregaro, Rodrigo; Cunha, Rafael; Oliveira, Carlos Gomes; Brown, Lee E.; Bottaro, Martim

    2013-01-01

    Purpose: Preload of antagonist muscles can be achieved by reciprocal actions (RAs) or by opposing muscle actions. However, evidence concerning neuromuscular and fatigue responses are scarce. Objective: To compare the effects of different knee flexor (KF) preload methods on knee extension (KE) vastus

  1. Percutaneous release of the plantar fascia. New surgical procedure.

    Science.gov (United States)

    Oliva, Francesco; Piccirilli, Eleonora; Tarantino, Umberto; Maffulli, Nicola

    2017-01-01

    Plantar fasciopathy presents with pain at the plantar and medial aspect of the heel. If chronic, it can negatively impact on quality of life. Plantar fasciopathy is not always self-limiting, and can be debilitating. Surgical management involves different procedures. We describe a percutaneous plantar fascia release. A minimally invasive access to the plantar tuberosity of the calcaneus is performed, and a small scalpel blade is used to release the fascia. With this procedure, skin healing problems, nerve injuries, infection and prolonged recovery time are minimised, allowing early return to normal activities. V.

  2. Ultrasound-assisted endoscopic partial plantar fascia release.

    Science.gov (United States)

    Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

    2013-01-01

    Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure.

  3. Plantar pressure during gait in pregnant women

    OpenAIRE

    Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipel, Véronique

    2016-01-01

    Background: During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Methods: Fifty-eight women in the last 4 months of pregnancy, nine postpa...

  4. Topical glyceryl trinitrate for chronic Achilles tendinopathy.

    Science.gov (United States)

    Hunte, Garth; Lloyd-Smith, Rob

    2005-03-01

    To determine whether continuous application of topical glyceryl trinitrate decreases pain and symptoms in chronic noninsertional Achilles tendinopathy. Randomized double-blind placebo-controlled study of 6-months' duration. Community and referral study at an Australian University Hospital. Recruitment was through newspaper advertisements and private consulting rooms. Eligibility criteria were age >18 years, a history of insidious onset of Achilles tendon pain, a tender nodule localized to the region of the calcaneal insertion, and an ultrasound examination that excluded a tendon tear. Exclusion criteria were Achilles tendinopathy of calf muscle-strengthening program. At the baseline, 2, 6, 12, and 24-week examinations the patient completed a symptom assessment sheet to rate the severity of Achilles pain with activity, at rest, and at night (0 = no pain, 4 = very severe pain). The single assessor used the same scale to measure local tenderness; an 11-point scale for the patient to report pain after the single-leg 10-hop test; and also measured the ankle plantar flexor mean peak force and ankle plantar flexor work. Follow-up was 89% complete. The groups did not differ in pain with activity, night pain, or local tenderness until the 12-week assessment when participants in the glyceryl trinitrate group reported less pain on each measure (mean scores, 0.9 vs. 1.6 [P = 0.02]; 0.2 vs. 0.7 [P = 0.04]; and 0.9 vs. 1.6 [P = 0.02], respectively). The difference was maintained at 24 weeks for pain with activity (mean scores, 0.4 vs. 1.0 [P = 0.03]). At 24 weeks the glyceryl trinitrate group reported less pain on the 10-hop test than the placebo group (mean scores, 0.5 vs. 1.6 [P = 0.005]). Although the intervention group showed a greater increase in plantar flexor mean total work at 24 weeks than the placebo group, the baseline scores were significantly different. The groups did not differ in pain at rest or in ankle plantar flexor peak force. Combining all the measures showed

  5. Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Saotome, Kousaku; Ueno, Tomoyuki; Abe, Tetsuya; Marushima, Aiki; Watanabe, Hiroki; Endo, Ayumu; Tsurumi, Kazue; Ishimoto, Ryu; Matsushita, Akira; Koda, Masao; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2018-01-19

    We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

  6. IFSSH Flexor Tendon Committee report 2014: from the IFSSH Flexor Tendon Committee (Chairman: Jin Bo Tang).

    Science.gov (United States)

    Tang, Jin Bo; Chang, James; Elliot, David; Lalonde, Donald H; Sandow, Michael; Vögelin, Esther

    2014-01-01

    Hand surgeons continue to search for the best surgical flexor tendon repair and treatment of the tendon sheaths and pulleys, and they are attempting to establish postoperative regimens that fit diverse clinical needs. It is the purpose of this report to present the current views, methods, and suggestions of six senior hand surgeons from six different countries - all experienced in tendon repair and reconstruction. Although certainly there is common ground, the report presents provocative views and approaches. The report reflects an update in the views of the committee. We hope that it is helpful to surgeons and therapists in treating flexor tendon injuries.

  7. Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

    Science.gov (United States)

    Yamakado, Kotaro

    2013-01-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging. PMID:23875139

  8. Plantar Fascia Rupture: Ultrasound to Facilitate Recognition.

    Science.gov (United States)

    Servey, Jessica T; Jonas, Christopher

    2018-01-01

    Plantar fascia rupture in the absence of previous diagnosis of plantar fasciitis, corticosteroid injection, or injury is a rare occurrence with only 7 case reports in the literature since 1978. This is a case of spontaneous plantar fascia rupture in a 38-year-old active-duty US military member with current considerations in musculoskeletal ultrasound, other radiologic imaging, treatment, and followup of this diagnosis. © Copyright 2018 by the American Board of Family Medicine.

  9. Avaliação da inibição recíproca em humanos durante contrações isométricas dos músculos tibial anterior e sóleo Assessment of reciprocal inhibition in humans during isometric contractions of the tibialis anterior and soleus muscles

    Directory of Open Access Journals (Sweden)

    José Eduardo Pompeu

    2009-09-01

    Full Text Available Os objetivos do presente trabalho foram: (1 desenvolver um método para estimar o grau de inibição recíproca (IR entre músculos antagonistas em humanos (sóleo e tibial anterior e (2 comparar os níveis de IR no repouso, na dorsiflexão (DF e na flexão plantar (FP. Participaram nove sujeitos saudáveis com idade entre 20 e 30 anos, quatro homens e cinco mulheres. Os sujeitos permaneceram sentados numa cadeira com o pé direito apoiado e fixo num pedal acoplado a um torquímetro; as medições foram feitas no repouso e durante contração isométrica dos músculos dorsiflexores e flexores plantares do tornozelo. A onda H do músculo sóleo foi captada por eletrodos de superfície. O reflexo H (RH "teste" do músculo sóleo foi medido aplicando-se um estímulo na fossa poplítea (nervo tibial. O reflexo H "condicionado" foi obtido pelo pareamento de dois estímulos: o primeiro aplicado sobre a cabeça da fíbula e o segundo, na fossa poplítea, após 1 a 3 ms.. As amplitudes pico-a-pico dos RH teste e condicionado foram utilizadas para o cálculo da IR. Os valores de IR foram: 16,41%±8,68 no repouso; 21,94%±5,39 na DF e 3,12%±11,84 na FP. Foi constatada menor inibição recíproca na FP quando comparada às demais condições (pThe purposes of the present study were (1 to develop a method to estimate the level of reciprocal inhibition (RI between antagonist (soleus and anterior tibial muscles in humans, and (2 to compare RI levels during rest, dorsiflexion (DF and plantar flexion (PF. Nine healthy subjects (four men, five women aged between 20 and 30 years were assessed. Each subject remained seated with his/her right foot strapped to a rigid foot plate coupled to a torquemeter; measurements were taken at rest and during isometric contraction of the ankle dorsiflexor and plantar flexor muscles. The soleus muscle H-wave was captured by surface electrodes. A "test" H- reflex was elicited by a stimulus (electrical pulse to the popliteal fossa

  10. Sonographic evaluation of plantar fasciitis and relation to body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Ozdemir, Huseyin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)]. E-mail: ozdemir@firat.edu.tr; Yilmaz, Erhan [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Murat, Ayse [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Karakurt, Lokman [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Poyraz, A. Kursad [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Ogur, Erkin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)

    2005-06-01

    Purpose: We have investigated the role of sonography in the diagnosis of plantar fasciitis. Materials and methods: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. Results: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5 mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p = 0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m{sup 2} in patients with heel pain and 25 kg/m{sup 2} in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). Conclusion: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis.

  11. Sonographic evaluation of plantar fasciitis and relation to body mass index

    International Nuclear Information System (INIS)

    Ozdemir, Huseyin; Yilmaz, Erhan; Murat, Ayse; Karakurt, Lokman; Poyraz, A. Kursad; Ogur, Erkin

    2005-01-01

    Purpose: We have investigated the role of sonography in the diagnosis of plantar fasciitis. Materials and methods: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. Results: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5 mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p = 0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m 2 in patients with heel pain and 25 kg/m 2 in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). Conclusion: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis

  12. Fascitis plantar

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    Dinorah Artidiello Bustio

    2015-04-01

    Full Text Available Introducción: la fascitis plantar es la inflamación del tejido denso que ocupa la parte anterior del tubérculo interno del calcáneo y constituye la causa más frecuente de dolor en la planta de los pies y dificulta en gran medida el desempeño laboral del individuo. Objetivo: caracterizar la fascitis plantar en pacientes asistidos en los servicios del Hospital General Docente "Abel Santamaría Cuadrado" en Pinar del Río. Material y método: estudio descriptivo, longitudinal y aplicado en el Departamento de Medicina Física y Rehabilitación del Hospital "Abel Santamaría Cuadrado", en el periodo comprendido desde abril del 2013 hasta abril del 2014, a los pacientes con diagnóstico de fascitis plantar. El universo coincidió con la muestra (60 pacientes. Resultados: de la muestra distribuida según ocupación laboral, 53 permanecen el mayor tiempo de pie, siendo el sexo femenino más predominante que el masculino y la edad promedio más afectada es de 40 a 49 años. El 70,0% de los pacientes mostraron dolor en las categorías de moderado a severo. Conclusiones: el sobrepeso y la obesidad crean un estrés adicional. Otro de los factores a considerar, son las neuropatías, el abuso del alcohol y el factor hereditario.

  13. Recruitment of single human low-threshold motor units with increasing loads at different muscle lengths.

    Science.gov (United States)

    McNulty, P A; Cresswell, A G

    2004-06-01

    We investigated the recruitment behaviour of low threshold motor units in flexor digitorum superficialis by altering two biomechanical constraints: the load against which the muscle worked and the initial muscle length. The load was increased using isotonic (low load), loaded dynamic (intermediate load) and isometric (high load) contractions in two studies. The initial muscle position reflected resting muscle length in series A, and a longer length with digit III fully extended in series B. Intramuscular EMG was recorded from 48 single motor units in 10 experiments on five healthy subjects, 21 units in series A and 27 in series B, while subjects performed ramp up, hold and ramp down contractions. Increasing the load on the muscle decreased the force, displacement and firing rate of single motor units at recruitment at shorter muscle lengths (Precruitment pattern was observed between loaded dynamic and isotonic contractions, but not between isometric and loaded dynamic contractions. Thus, the recruitment properties of single motor units in human flexor digitorum superficialis are sensitive to changes in both imposed external loads and the initial length of the muscle.

  14. Torque and Muscle Activation Impairment Along With Insulin Resistance Are Associated With Falls in Women With Fibromyalgia.

    Science.gov (United States)

    Góes, Suelen M; Stefanello, Joice M F; Homann, Diogo; Lodovico, Angélica; Hubley-Kozey, Cheryl L; Rodacki, André L F

    2016-11-01

    Góes, SM, Stefanello, JMF, Homann, D, Lodovico, A, Hubley-Kozey, CL, and Rodacki, ALF. Torque and muscle activation impairment along with insulin resistance are associated with falls in women with fibromyalgia. J Strength Cond Res 30(11): 3155-3164, 2016-Fibromyalgia (FM) is a chronic pain condition associated with reduced muscle strength, which can lead to functional incapacity and higher risk of falls. The purpose of the study was to compare maximal ankle joint torque, muscle activation, and metabolic changes between women with and without FM. In addition, the relationship between those aspects and retrospectively reported falls in women with FM was determined. Twenty-nine middle-aged women with FM and 30 controls were recruited. Fall history, pain intensity, and pain threshold were assessed. Plasma glucose levels and insulin resistance (IR) were determined. Peak torque and rate of torque development (RTD) were calculated, and muscle activation was assessed from maximum isometric voluntary ankle dorsiflexion and plantar flexion contractions. In addition, voluntary muscle activation failure of the anterior tibialis muscle during maximal dorsiflexion was calculated. When compared to controls, women with FM reported higher number of retrospectively reported falls, exhibited higher IR, showed reduced plantar flexion and dorsiflexion RTD, had lower plantar flexion peak torque, and demonstrated more antagonist coactivation and higher muscle activation failure (p ≤ 0.05). Higher muscle activation failure was explained by glucose level and pain intensity (adj R = 0.28; p ≤ 0.05). Reduced plantar flexion and dorsiflexion peak torque explained 80% of retrospectively reported falls variance; also, high antagonist coactivation (odds ratio [OR] = 1.6; p ≤ 0.05) and high IR (OR = 1.8; p ≤ 0.05) increased the chance of falls in the FM group. A combination of metabolic factors and muscle function increased the odds of retrospectively reporting a fall in FM. Both aspects

  15. Shall We Inject Superficial or Deep to the Plantar Fascia? An Ultrasound Study of the Treatment of Chronic Plantar Fasciitis.

    Science.gov (United States)

    Gurcay, Eda; Kara, Murat; Karaahmet, Ozgur Zeliha; Ata, Ayşe Merve; Onat, Şule Şahin; Özçakar, Levent

    We compared the effectiveness of ultrasound (US)-guided corticosteroid, injected superficial or deep to the fascia, in patients with plantar fasciitis. Thirty patients (24 females [75%] and 6 males [25%]) with unilateral chronic plantar fasciitis were divided into 2 groups according to the corticosteroid injection site: superficial (n = 15) or deep (n = 15) to the plantar fascia. Patient heel pain was measured using a Likert pain scale and the Foot Ankle Outcome Scale (FAOS) for foot disability, evaluated at baseline and repeated in the first and sixth weeks. The plantar fascia and heel pad thicknesses were assessed on US scans at baseline and the sixth week. The groups were similar in age, gender, and body mass index (p > .05 for all). Compared with the baseline values, the Likert pain scale (p plantar fascia thickness had decreased significantly in both groups at the sixth week (p  .05 for both). The difference in the FAOS subscales (pain, p = .002; activities of daily living, p = .003; sports/recreational activities, p = .008; quality of life, p = .009) and plantar fascia thickness (p = .049) showed better improvement in the deep than in the superficial injection group. US-guided corticosteroid injections are safe and effective in the short-term therapeutic outcome of chronic plantar fasciitis. Additionally, injection of corticosteroid deep to the fascia might result in greater reduction in plantar fascia thickness, pain, and disability and improved foot-related quality of life. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Rotational foot placement specifies the lever arm of the ground reaction force during the push-off phase of walking initiation.

    Science.gov (United States)

    Erdemir, Ahmet; Piazza, Stephen J

    2002-06-01

    The lever arm of the ground reaction force (GRF) about the talocrural joint axis is a functionally important indicator of the nature of foot loading. Walking initiation experiments (ten subjects; age, 23-29 years) were completed to demonstrate that rotational foot placement is a possible strategy to specify the lever arm. Externally-rotated foot placement resulted in larger lever arms during push-off. A computer simulation of push-off revealed that a decreased lever arm reduces the plantarflexion moment necessary to maintain a constant forward velocity, while increasing the required plantarflexion velocity. Shortening of the foot thus diminishes the muscular force demand but also requires high muscle fiber shortening velocities that may limit the force generating capacity of plantar flexors. Decreased plantar flexion moment and slow walking previously noted in partial-foot amputees may result from shortened lever arms in this manner.

  17. LONG-LASTING SUPERNORMAL CONDUCTION-VELOCITY AFTER SUSTAINED MAXIMAL ISOMETRIC CONTRACTION IN HUMAN MUSCLE

    NARCIS (Netherlands)

    VANDERHOEVEN, JH; VANWEERDEN, TW; ZWARTS, MJ

    Local muscle fatigue (1 min maximal voluntary contraction) and recovery were studied by means of surface and invasive EMG on elbow flexors to record the changes in muscle fiber conduction velocity (MFCV), median power frequency (MPF), integrated EMG (IEMG), and force. The main finding was a

  18. High lateral plantar pressure is related to an increased tibialis anterior/fibularis longus activity ratio in patients with recurrent lateral ankle sprain

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    Mineta S

    2017-06-01

    Full Text Available Shinshiro Mineta,1 Takayuki Inami,2 Raldy Mariano,3 Norikazu Hirose4 1Graduate School of Sport Sciences, 2Institute of Physical Education, Keio University, Hiyoshi, Yokohama, 3Graduate School of Asia-Pacific Studies, Waseda University, Shinjuku, Tokyo, 4Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Japan Introduction: Center of pressure (COP is a sudden displacement at the time of a lateral ankle sprain (LAS. It has been suggested that the distribution of plantar pressure and the quantity of COP displacement are important for assessing the risk of LAS. Therefore, we evaluated the plantar pressure during a single-leg balance test with eyes closed (SLB-C to identify the factors and characteristics of plantar pressure in people with repeated cases of LAS.Methods: We recruited 22 collegiate athletes and divided them into an instability group (IG; n=11 and a control group (CG; n=11. We measured the distribution of plantar pressure and lower extremity muscle activity during a SLB-C along with static alignment and isometric ankle strength.Results: The fibularis longus (FL activity was significantly lower in the IG than in the CG. The lateral plantar pressure (LPP/medial plantar pressure (MPP ratio was also higher in the IG than in the CG. In addition, the LPP/MPP ratio was correlated with the tibialis anterior (TA/FL ratio.Conclusion: These results suggest that increased lateral plantar pressure is related to decreased FL activity and increased TA/FL ratio. Keywords: chronic ankle instability, ankle sprain, postural stability, soccer, prevention

  19. Alterations in upper limb muscle synergy structure in chronic stroke survivors

    Science.gov (United States)

    Rymer, William Z.; Perreault, Eric J.; Yoo, Seng Bum; Beer, Randall F.

    2013-01-01

    Previous studies in neurologically intact subjects have shown that motor coordination can be described by task-dependent combinations of a few muscle synergies, defined here as a fixed pattern of activation across a set of muscles. Arm function in severely impaired stroke survivors is characterized by stereotypical postural and movement patterns involving the shoulder and elbow. Accordingly, we hypothesized that muscle synergy composition is altered in severely impaired stroke survivors. Using an isometric force matching protocol, we examined the spatial activation patterns of elbow and shoulder muscles in the affected arm of 10 stroke survivors (Fugl-Meyer synergies were identified using non-negative matrix factorization. In both groups, muscle activation patterns could be reconstructed by combinations of a few muscle synergies (typically 4). We did not find abnormal coupling of shoulder and elbow muscles within individual muscle synergies. In stroke survivors, as in controls, two of the synergies were comprised of isolated activation of the elbow flexors and extensors. However, muscle synergies involving proximal muscles exhibited consistent alterations following stroke. Unlike controls, the anterior deltoid was coactivated with medial and posterior deltoids within the shoulder abductor/extensor synergy and the shoulder adductor/flexor synergy in stroke was dominated by activation of pectoralis major, with limited anterior deltoid activation. Recruitment of the altered shoulder muscle synergies was strongly associated with abnormal task performance. Overall, our results suggest that an impaired control of the individual deltoid heads may contribute to poststroke deficits in arm function. PMID:23155178

  20. Acute effects of short and long duration dynamic stretching protocols on muscle strength

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    Christiano Francisco dos Santos

    Full Text Available Objective Compare the acute effects of dynamic stretching protocols on the isokinetic performance of the quadriceps and hamstring muscles at two velocities in adult males.Methodology Included the participation of 14 males (21 ± 2.6 years; 178 ± 0.4 cm; 73.2 ± 20.9 kg were assessed using an isokinetic dynamometer before and after following a short or long-duration dynamic stretching protocol or a control protocol. The results were assessed by a two-way ANOVA and a Scheffé’s post hoc test at a 5% significance level.Results No difference was found in the variables assessed at 180°/s after LDDS. At 60°/s, LDDS reduced the power of the knee flexors. The control protocol reduced the power of the knee flexors and increased the power of the extensors. At 60°/s, the work of the knee flexors exhibited a reduction after LDDS. The control protocol resulted in a reduction in the work of the flexors. The peak torque angle exhibited a reduction in the extensors and flexors after LDDS and SDDS.Conclusion Dynamic stretching did not cause any change in the peak torque, which points to its possible use in activities involving velocity and muscle strength. The executing dynamic stretching before physical activities such as running and high-intensity sports might be beneficial by promoting increases in heart rate and in body temperature.

  1. The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review

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    Parish Ben

    2011-06-01

    Full Text Available Abstract Background Plantar heel pain is a commonly occurring foot complaint. Stretching is frequently utilised as a treatment, yet a systematic review focusing only on its effectiveness has not been published. This review aimed to assess the effectiveness of stretching on pain and function in people with plantar heel pain. Methods Medline, EMBASE, CINAHL, AMED, and The Cochrane Library were searched from inception to July 2010. Studies fulfilling the inclusion criteria were independently assessed, and their quality evaluated using the modified PEDro scale. Results Six studies including 365 symptomatic participants were included. Two compared stretching with a control, one study compared stretching to an alternative intervention, one study compared stretching to both alternative and control interventions, and two compared different stretching techniques and durations. Quality rating on the modified Pedro scale varied from two to eight out of a maximum of ten points. The methodologies and interventions varied significantly between studies, making meta-analysis inappropriate. Most participants improved over the course of the studies, but when stretching was compared to alternative or control interventions, the changes only reached statistical significance in one study that used a combination of calf muscle stretches and plantar fascia stretches in their stretching programme. Another study comparing different stretching techniques, showed a statistically significant reduction in some aspects of pain in favour of plantar fascia stretching over calf stretches in the short term. Conclusions There were too few studies to assess whether stretching is effective compared to control or other interventions, for either pain or function. However, there is some evidence that plantar fascia stretching may be more effective than Achilles tendon stretching alone in the short-term. Appropriately powered randomised controlled trials, utilizing validated outcome

  2. Assessing the Level of Disability, Deep Cervical Flexor Endurance and Fear Avoidance Beliefs in Bankers with Neck Pain

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    Deptee Warikoo

    2013-08-01

    Full Text Available Objective: To assess the level of disability, the deep cervical flexor endurance and fear avoidance beliefs (FAB in bankers with neck pain and to find a correlation between disability and deep cervical muscle endurance, FAB and disability, FAB and deep flexor muscle endurance. Methods: It ws an observational study. The Subjects who had neck pain and minimum 5 years’ experience as a Banker participated in the study. Total 100 subjects were selected. All the subjects were assessed for their disability by the neck pain and disability score (NPDI, their deep cervical flexor endurance using Pressure Biofeedback using Cranio-Cervical flexion test (CCFT and Fear Avoidance Belief by using questionnaire( FABQ. Results: It was found that bankers have a moderate level of disability. The results showed an elevated fear avoidance belief with a mean value of FABQ-PA 21.61±4.42 and FABQ-W 37.81± 5.69. The results indicated that a negative correlation was found between NPDI and CCFT (r=0.855. A positive correlation was found between NPDI and FABQ-PA(r=0.337, FABQ-W(r=0.500. In the present study a negative correlation was found between CCFT and FABQ-W(r=0.553, FABQ-PA (0.348 and positive correlation (r=0.540 was found between FABQ-PA and FABQ-W. Conclusion: The present study concluded that there was a significant level of disability and significantly decreased endurance level and increased fear avoidance beliefs (both work and physical activity related among bankers with neck pain. In addition to that there was a significant correlation found between NPDI and CCFT, NPDI and FABQ, CCFT and FABQ, FABQ-W and FABQ-PA.

  3. "An Investigation Into The Interrater Reliability Of The Modified Ashworth Scale In The Assessment Of Muscle Spasticity In Hemiplegic Patients "

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    N. Nokhostin-Ansari

    2006-06-01

    Full Text Available Background and Aim: Spasticity is a velocity-dependent increase in tonic stretch reflexes (muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The measurement of spasticity is necessary to determine the effect of treatments. The Modified Ashworth Scale is the most widely used method for assessing muscle spasticity in clinical practice and research. The purpose of this study was to investigate the interrater reliability of Modified Ashworth Scale in hemiplegic patients. Materials and Methods: Thirty subjects (16 males, 14 females with a mean age of 59.40 (SD =14.013 recruited. Shoulder adductor , elbow flexor , wrist dorsiflexor , hip adductor , knee extensor and ankle plantarflexor on the hemiplegic side were tested by two physiotherapists. Results: In the upper limb, the interrater reliability for shoulder adductor and elbow flexor muscles was fair (0.372 and 0.369, respectively. The reliability for the wrist flexors was good (0.612. The difference in Kappa value for the proximal muscle (shoulder adductor; 0.372 and the distal muscle (wrist flexor; 0.612 was significant (²X=33.87, df=1, p0.05. The mean value for the upper limb (0.505 and the lower limb (0,.516 was not significantly different (²X=0.1407, df=1, p>0.05. Conclusion: The interrater reliability of Modified Ashworth Scale was not good . The limb, upper or lower, had no significant effect on the reliability. In the upper limb, the reliability for the proximal and distal muscle was significantly different. However. The difference in the lower limb was not significant.When using the scale, one should consider it's limitation.

  4. Musculoskeletal Geometry, Muscle Architecture and Functional Specialisations of the Mouse Hindlimb (Open Access)

    Science.gov (United States)

    2016-04-26

    example, studies in cats [18], guinea pigs [16] and rabbits [19] have shown that the hamstring muscles, a bi-articular group of muscles which act around...energy in compliant tendons [20, 21], whereas others, such as the hamstrings (hip extensors and knee flexors), function to produce fast contractions

  5. Additional diagnostic value of digital radiology in plantar fasciitis diagnosis

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    Marcel Prasetyo

    2017-08-01

    Full Text Available Background: Ultrasonography (USG is regarded as the gold standard to differentiate normal plantar fascia and plantar fasciitis. Conventional radiography or plain X-ray is typically used to exclude differential diagnosis. Lately, conventional radiography has been digitalized and leads to better visualization of the soft tissue. However, it is not known whether digital radiography evaluation for calcaneus area, both qualitative and quantitative, has a similar diagnostic value as USG findings. Therefore, this study aimed to evaluate whether there is a strong correlation between digital radiographic and USG findings for diagnosing plantar fasciitis.Methods: This is a cross sectional study examining adult patients (>18 years old presenting with inferior heel pain. Plantar aponeurosis thickness was measured by digital radiography and ultrasonography; measurement was performed three times in each modality, and the average value was recorded. Fat stranding, presence of calcaneal enthesophyte, and microfracture were also evaluated in digital radiography. Measurement results were classified into plantar fasciitis diagnosis using the cut-off value 4 mm.Results: There was no significant correlation between plantar aponeurosis thickness measured by digital radiography and by ultrasonography (r=0.069, p=0.688. There was no significant association between plantar fasciitis diagnosis by digital radiography and ultrasonography (p=0.162. However, digital radiography showed good sensitivity to detect plantar fasciitis using a cut-off value of >4 mm plantar fascia thickness.Conclusion: Digital radiography might be used to aid definitive diagnosis for plantar fasciitis.

  6. Bed rest attenuates sympathetic and pressor responses to isometric exercise in antigravity leg muscles in humans.

    Science.gov (United States)

    Kamiya, Atsunori; Michikami, Daisaku; Shiozawa, Tomoki; Iwase, Satoshi; Hayano, Junichiro; Kawada, Toru; Sunagawa, Kenji; Mano, Tadaaki

    2004-05-01

    Although spaceflight and bed rest are known to cause muscular atrophy in the antigravity muscles of the legs, the changes in sympathetic and cardiovascular responses to exercises using the atrophied muscles remain unknown. We hypothesized that bed rest would augment sympathetic responses to isometric exercise using antigravity leg muscles in humans. Ten healthy male volunteers were subjected to 14-day 6 degrees head-down bed rest. Before and after bed rest, they performed isometric exercises using leg (plantar flexion) and forearm (handgrip) muscles, followed by 2-min postexercise muscle ischemia (PEMI) that continues to stimulate the muscle metaboreflex. These exercises were sustained to fatigue. We measured muscle sympathetic nerve activity (MSNA) in the contralateral resting leg by microneurography. In both pre- and post-bed-rest exercise tests, exercise intensities were set at 30 and 70% of the maximum voluntary force measured before bed rest. Bed rest attenuated the increase in MSNA in response to fatiguing plantar flexion by approximately 70% at both exercise intensities (both P antigravity leg muscles.

  7. Identification of Foot Pathologies Based on Plantar Pressure Asymmetry

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    Linah Wafai

    2015-08-01

    Full Text Available Foot pathologies can negatively influence foot function, consequently impairing gait during daily activity, and severely impacting an individual’s quality of life. These pathologies are often painful and correspond with high or abnormal plantar pressure, which can result in asymmetry in the pressure distribution between the two feet. There is currently no general consensus on the presence of asymmetry in able-bodied gait, and plantar pressure analysis during gait is in dire need of a standardized method to quantify asymmetry. This paper investigates the use of plantar pressure asymmetry for pathological gait diagnosis. The results of this study involving plantar pressure analysis in fifty one participants (31 healthy and 20 with foot pathologies support the presence of plantar pressure asymmetry in normal gait. A higher level of asymmetry was detected at the majority of the regions in the feet of the pathological population, including statistically significant differences in the plantar pressure asymmetry in two regions of the foot, metatarsophalangeal joint 3 (MPJ3 and the lateral heel. Quantification of plantar pressure asymmetry may prove to be useful for the identification and diagnosis of various foot pathologies.

  8. Whole plantar nerve conduction study with disposable strip electrodes.

    Science.gov (United States)

    Hemmi, Shoji; Kurokawa, Katsumi; Nagai, Taiji; Okamoto, Toshio; Murakami, Tatsufumi; Sunada, Yoshihide

    2016-02-01

    A new method to evaluate whole plantar nerve conduction with disposable strip electrodes (DSEs) is described. Whole plantar compound nerve action potentials (CNAPs) were recorded at the ankle. DSEs were attached to the sole for simultaneous stimulation of medial and lateral plantar nerves. We also conducted medial plantar nerve conduction studies using an established method and compared the findings. Whole plantar CNAPs were recorded bilaterally from 32 healthy volunteers. Mean baseline to peak amplitude for CNAPs was 26.9 ± 11.8 μV, and mean maximum conduction velocity was 65.8 ± 8.3 m/s. The mean amplitude of CNAPs obtained by our method was 58.2% higher than that of CNAPs obtained by the Saeed method (26.9 μV vs. 17.0 μV; P < 0.0001). The higher mean amplitude of whole plantar CNAPs obtained by our method suggests that it enables CNAPs to be obtained easily, even in elderly people. © 2015 Wiley Periodicals, Inc.

  9. The Fine Wire Technique for Flexor Tenolysis

    Science.gov (United States)

    Baltodano, Pablo A.; Weinberg, Maxene H.; Whipple, Lauren A.; Gemmiti, Amanda L.; Whipple, Richard E.

    2017-01-01

    Background: Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures. Methods: This article describes a new technique with potential for reduced complication rates: The Fine Wire Technique for Flexor Tenolysis (FWT). Results: Following FWT, the patient detailed in this article had an excellent recovery of function and no complications: including tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire’s thinness allows for a swift tenolysis. Conclusions: The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive. PMID:29263961

  10. The Fine Wire Technique for Flexor Tenolysis.

    Science.gov (United States)

    Rosenblum, Matthew K; Baltodano, Pablo A; Weinberg, Maxene H; Whipple, Lauren A; Gemmiti, Amanda L; Whipple, Richard E

    2017-11-01

    Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures. This article describes a new technique with potential for reduced complication rates: The Fine Wire Technique for Flexor Tenolysis (FWT). Following FWT, the patient detailed in this article had an excellent recovery of function and no complications: including tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire's thinness allows for a swift tenolysis. The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive.

  11. Accessory brachialis muscle associated with high division of brachial artery

    OpenAIRE

    Krishnamurthy A; David S; Bagoji IB; Nayak SR; Pai MM; Murlimanju BV; Kumar GC

    2010-01-01

    During routine dissection for the undergraduate students in the Department of Anatomy, Kasturba Medical College, Mangalore, of a male cadaver aged 73 years, we encountered an additional slip of brachialis muscle taking origin in the flexor compartment of left arm and inserting into the forearm. The origin of the additional muscle belly was from the anteromedial surface of shaft and medial supracondylar ridge of lower end of humerus. The additional muscle slip merged with the tendon of pronato...

  12. The importance of cutaneous feedback on neural activation during maximal voluntary contraction

    NARCIS (Netherlands)

    Cruz-Montecinos, Carlos; Maas, Huub; Pellegrin-Friedmann, Carla; Tapia, Claudio

    2017-01-01

    Purpose: The purpose of this study was to investigate the importance of cutaneous feedback on neural activation during maximal voluntary contraction (MVC) of the ankle plantar flexors. Methods: The effects of cutaneous plantar anaesthesia were assessed in 15 subjects and compared to 15 controls,

  13. Modifications of baropodograms after transcutaneous electric stimulation of the abductor hallucis muscle in humans standing erect.

    Science.gov (United States)

    Gaillet, Jean-Claude; Biraud, Jean-Claude; Bessou, Monique; Bessou, Paul

    2004-12-01

    Objective data on abductor hallucis muscle biomechanical function in the loaded foot (subject standing erect on both legs) are unavailable. To evaluate the effects of electrical stimulation of the abductor hallucis muscle in the loaded foot on the change of plantar pressures, as measured by digital baropodograms. Six indices were defined to compare baropodograms. The abductor hallucis muscle in 1 foot was subjected to transcutaneous electrical stimulation (20 min) while the subject was standing erect on the floor. Baropodograms were recorded before, immediately thereafter, then 15 days and 2 months later. Differences between baropodogram indices were subjected to one-way anova. Electrical abductor hallucis muscle stimulation induced, on the stimulation side, a post-contraction state easily detected on baropodograms as the increased plantar pressure on the anterior-medial part of the sole, and lateral displacements of the anterior maximal pressure point and the foot thrust center. These mechanical signs, consistent with foot inversion, induce external rotation of the leg and pelvic rotation on the stimulated side, leading to contralateral plantar-pressure changes: decreased maximal pressure point and thrust in the posterior part of the footprint and lateral displacement of the foot thrust center. Electrical stimulation of the abductor hallucis muscle in the loaded foot induces immediate specific changes in baropodogram indices, some of which persist 2 months later. The mechanical effect of abductor hallucis muscle stimulation (foot inversion) and its post-contraction state could be useful in podiatric and postural rehabilitation.

  14. Effects of wearing different personal equipment on force distribution at the plantar surface of the foot.

    Science.gov (United States)

    Schulze, Christoph; Lindner, Tobias; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

    2013-01-01

    The wearing of personal equipment can cause specific changes in muscle activity and posture. In the present study, we investigated the influence of differences in equipment related weight loading and load distribution on plantar pressure. In addition, we studied functional effects of wearing different equipment with a particular focus on relevant changes in foot shape. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p feet deformities which seem to flatten at an earlier load condition with a greater amount compared to subjects with normal arches. Improving load distribution should be a main goal in the development of military equipment in order to prevent injuries or functional disorders of the lower extremity.

  15. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm.

    Science.gov (United States)

    Atoni, Atoni Dogood; Oyinbo, Charles Aidemise

    2017-03-01

    Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  16. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm

    Directory of Open Access Journals (Sweden)

    Atoni Atoni Dogood

    2017-03-01

    Full Text Available Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  17. A Case Study: Effect of Progressive Resistance and Balance Training on Upper Trunk Muscle Strength of Children with Cerebral Palsy

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    Mehrnoush Ismailiyan

    2016-04-01

    Conclusion The results of this study showed that 8 weeks of progressive resistance and balance training (in combination has increased muscle strength in children with cerebral palsy. The present research showed that resistance and balanced trainings have significant effects on muscle strength of children with CP. It seems that these practices have been effective, especially for the wrist flexor and elbow flexor muscles. It can be said that the increase in the muscles of children with CP was due to practice principle along with increase in neuronal compatibility. One of the important points in the effectiveness of resistance training is the intensity of training. The results showed that resistance and balanced trainings increase the muscle strength of children with CP. This power could be partly due to increase in muscle volume and partly due to anabolic hormones.

  18. Plantar tendons of the foot: MR imaging and US.

    Science.gov (United States)

    Donovan, Andrea; Rosenberg, Zehava Sadka; Bencardino, Jenny T; Velez, Zoraida Restrepo; Blonder, David B; Ciavarra, Gina A; Adler, Ronald Steven

    2013-01-01

    Tendon disorders along the plantar aspect of the foot may lead to significant symptoms but are often clinically misdiagnosed. Familiarity with the normal anatomy of the plantar tendons and its appearance at magnetic resonance (MR) imaging and ultrasonography (US) is essential for recognizing plantar tendon disorders. At MR imaging, the course of the plantar tendons is optimally visualized with dedicated imaging of the midfoot and forefoot. This imaging should include short-axis images obtained perpendicular to the long axis of the metatarsal shafts, which allows true cross-sectional evaluation of the plantar tendons. Normal plantar tendons appear as low-signal-intensity structures with all MR sequences. At US, accurate evaluation of the tendons requires that the ultrasound beam be perpendicular to the tendon. The normal tendon appears as a compact linear band of echogenic tissue that contains a fine, mixed hypoechoic and hyperechoic internal fibrillar pattern. Tendon injuries can be grouped into six major categories: tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, and instability (subluxation or dislocation) and can be well assessed with both MR imaging and US. The radiologist plays an important role in the diagnosis of plantar tendon disorders, and recognizing their imaging appearances at MR imaging and US is essential.

  19. The effect of elbow angle and external moment on load sharing of elbow muscles

    NARCIS (Netherlands)

    Praagman, M.; Chadwick, E.K.J.; van der Helm, F.C.T.; Veeger, H.E.J.

    2010-01-01

    To study elbow muscle load sharing we investigated the effect of external flexion-extension (FE) and pronation-supination (PS) moments and elbow angle on muscle activation and oxygen consumption (V̇O2).Two data sets were obtained. First, (n=6) electromyography (EMG) of elbow flexors (long and short

  20. Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study.

    Science.gov (United States)

    Najafi, Bijan; Talal, Talal K; Grewal, Gurtej Singh; Menzies, Robert; Armstrong, David G; Lavery, Lawrence A

    2017-07-01

    People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN. Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks. No difference were observed between groups for baseline characteristics ( P > .050). Posttherapy, ankle and COM sway with eyes open were significantly improved ( P 1.20 ( P = .041, d = 0.99) Conclusion: This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.

  1. LOWER LIMB STRENGTH IN PROFESSIONAL SOCCER PLAYERS: PROFILE, ASYMMETRY, AND TRAINING AGE

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    Konstantinos Fousekis

    2010-09-01

    Full Text Available Kicking and cutting skills in soccer are clearly unilateral, require asymmetrical motor patterns and lead to the development of asymmetrical adaptations in the musculoskeletal function of the lower limbs. Assuming that these adaptations constitute a chronicity-dependent process, this study examined the effects of professional training age (PTA on the composite strength profile of the knee and ankle joint in soccer players. One hundred soccer players (n=100 with short (5-7 years, intermediate (8-10 years and long (>11 years PTA were tested bilaterally for isokinetic concentric and eccentric strength of the knee and ankle muscles. Knee flexion-extension was tested concentrically at 60°, 180° and 300 °/sec and eccentrically at 60° and 180 °/sec. Ankle dorsal and plantar flexions were tested at 60 °/sec for both the concentric and eccentric mode of action. Bilaterally averaged muscle strength [(R+L/2] increased significantly from short training age to intermediate and stabilized afterwards. These strength adaptations were mainly observed at the concentric function of knee extensors at 60°/sec (p = 0. 023, knee flexors at 60°/sec (p = 0.042 and 180°/sec (p = 0.036, and ankle plantar flexors at 60o/sec (p = 0.044. A linear trend of increase in isokinetic strength with PTA level was observed for the eccentric strength of knee flexors at 60°/sec (p = 0.02 and 180°/sec (p = 0.03. Directional (R/L asymmetries decreased with PTA, with this being mainly expressed in the concentric function of knee flexors at 180°/sec (p = 0.04 and at 300 °/sec (p = 0.03. These findings confirm the hypothesis of asymmetry in the strength adaptations that take place at the knee and ankle joint of soccer players mainly along with short and intermediate PTA. Players with a longer PTA seem to adopt a more balanced use of their lower extremities to cope with previously developed musculoskeletal asymmetries and possibly reduce injury risk. This has certain

  2. Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain

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    Fernanda Pasinato

    Full Text Available Abstract Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG and 14 women with mechanical neck pain (NPG took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI, respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095. The NPG showed lower strength of the cervical flexor (p = 0.044 and extensor (p=0.006 muscles, and higher TI (p = 0.038 than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547 and non-dominant (p = 0.007, r = -0.695 upper trapezius, and cervical flexors (p = 0.023, r = -0.606 in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.

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

    Science.gov (United States)

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

    2015-11-01

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

  4. Applicability of contrast-enhanced ultrasound in the diagnosis of plantar fasciitis.

    Science.gov (United States)

    Broholm, R; Pingel, J; Simonsen, L; Bülow, J; Johannsen, F

    2017-12-01

    Contrast-enhanced ultrasound (CEUS) is used to visualize the microvascularization in various tissues. The purpose of this study was to investigate whether CEUS could be used to visualize the microvascular volume (MV) in the plantar fascia, and to compare the method to clinical symptoms and B-mode ultrasound (US) in patients with plantar fasciitis (PF). Twenty patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5), and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat pad were measured independently by two observers. Inter- and intra-observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients, a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter-observer correlation as well as intra-observer agreement was excellent. The MV in the plantar fascia and plantar fat pad can be measured reliably using CEUS, suggesting that it is a reproducible method to examine patients with plantar fasciitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2013-11-01

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

  6. The effects of neural mobilization on cervical radiculopathy patients' pain, disability, ROM, and deep flexor endurance.

    Science.gov (United States)

    Kim, Dong-Gyu; Chung, Sin Ho; Jung, Ho Bal

    2017-09-22

    Cervical radiculopathy (CR) is a disease of the cervical spine and a space-occupying lesion that occurs because of pathological problems with cervical nerve roots. Nerve root injury to produce functional disability. The purpose of this study was to examine the effects of neural mobilization with manual cervical traction (NMCT) compared with manual cervical traction (MCT) on pain, functional disability, muscle endurance, and range of motion (ROM) in individuals with CR patients. A blinded randomized clinical trial was conducted. Thirty CR patients were divided into two groups - those who received NMCT and those who received MCT. The intervention was applied three times per week for eight weeks. It was measured in order to determine the pain and functional disability in patients with CR. The numeric pain rating scale (NPRS), neck disability index (NDI), ROM, and deep flexor endurance of patients were measured prior to the experiment, four weeks, and eight weeks after the experiment to compare the time points. A repeated-measures analysis of variance was used to compare differences within each group prior to the experiment. And Bonferroni test was performed to examine the significance of each time point. There were significant differences within each group prior to the intervention, four weeks after the intervention, and eight weeks after the intervention in NPRS, NDI, ROM, and deep flexor endurance (Ppain relief, recovery from neck disability, ROM, and deep flexor endurance for patients with CR.

  7. Bilateral Posterior Tibial Tendon and Flexor Digitorum Longus Dislocations.

    Science.gov (United States)

    Padegimas, Eric M; Beck, David M; Pedowitz, David I

    2017-04-01

    The authors present a case of a previously healthy and athletic 17-year-old female who presented with a 3.5-year history of medial left ankle pain after sustaining an inversion injury while playing basketball. Prior to presentation, she had failed prior immobilization and physical therapy for a presumed ankles sprain. Physical examination revealed a dislocated posterior tibial tendon (PTT) that was temporarily reducible, but would spontaneously dislocate immediately after reduction. She had pain and snapping of the PTT with resisted ankle plantar flexion and resisted inversion as well as 4/5 strength in ankle inversion. The diagnosis of dislocated PTT was confirmed on magnetic resonance imaging (MRI). The patient underwent suture anchor repair of the medial retinaculum of the left ankle. At the time of surgery both the PTT and flexor digitorum longus (FDL) were dislocated. Three months postoperatively, the patient represented with PTT dislocation of the right (nonoperative) ankle confirmed by MRI. After failure of immobilization, physical therapy, and oral anti-inflammatory medications, the patient underwent suture anchor repair of the medial retinaculum of the right ankle. At 6 months postoperatively, the patient has 5/5 strength inversion bilaterally, no subluxation of either PTT, and has returned to all activities without limitation. The authors present this unique case of bilateral PTT dislocation and concurrent PTT/FDL dislocation along with review of the literature for PTT dislocation. The authors highlight the common misdaiganosis of this injury and highlight the successful results of surgical intervention. Level V: Case report.

  8. Alteration in Peripheral Muscle Strength among Overweight and Obese Individuals: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Vikram Mohan

    2017-04-01

    Full Text Available Peripheral muscle dysfunction in Overweight (OW and Obesity (OB leads to fatigue and activity limitations. However, there are contradictory views regarding the exact level with regard to hand grip and quadriceps muscle strength in OW and OB. The main objective of the present systematic review was to synthesize the literature for the strength part of the hand grip and quadriceps muscle strength among OW and OB. Literature search of Scopus, EBSCO and PubMed databases from 01.01.2004 to 30.06.2016, was performed. We set our search strategy using the terms “overweight OR obesity” AND “muscle strength” AND “grip OR quadriceps”. Two reviewers administered established eligible criteria and extracted the data. Strengthening the Reporting of Observational studies in Epidemiology (STROBE was used to assess the risk of bias. Sixteen articles which were included identified Handgrip Strength (HGS, shoulder flexor, elbow flexor and knee extensor were found to be altered. There were consistent results with an increase in quadriceps muscle strength, whereas differed results were found in hand grip to increase and decrease in muscle strength in the presence of OW and OB. It is concluded that HGS appeared to be diversified with findings of increased and decrease strength, whereas regarding the quadriceps muscles, the findings were homogeneous.

  9. Trunk muscle activity is modified in osteoporotic vertebral fracture and thoracic kyphosis with potential consequences for vertebral health.

    Directory of Open Access Journals (Sweden)

    Alison M Greig

    Full Text Available This study explored inter-relationships between vertebral fracture, thoracic kyphosis and trunk muscle control in elderly people with osteoporosis. Osteoporotic vertebral fractures are associated with increased risk of further vertebral fractures; but underlying mechanisms remain unclear. Several factors may explain this association, including changes in postural alignment (thoracic kyphosis and altered trunk muscle contraction patterns. Both factors may increase risk of further fracture because of increased vertebral loading and impaired balance, which may increase falls risk. This study compared postural adjustments in 24 individuals with osteoporosis with and without vertebral fracture and with varying degrees of thoracic kyphosis. Trunk muscle electromyographic activity (EMG associated with voluntary arm movements was recorded and compared between individuals with and without vertebral fracture, and between those with low and high thoracic kyphosis. Overall, elderly participants in the study demonstrated co-contraction of the trunk flexor and extensor muscles during forwards arm movements, but those with vertebral fractures demonstrated a more pronounced co-contraction than those without fracture. Individuals with high thoracic kyphosis demonstrated more pronounced alternating flexor and extensor EMG bursts than those with less kyphosis. Co-contraction of trunk flexor and extensor muscles in older individuals contrasts the alternating bursts of antagonist muscle activity in previous studies of young individuals. This may have several consequences, including altered balance efficacy and the potential for increased compressive loads through the spine. Both of these outcomes may have consequences in a population with fragile vertebrae who are susceptible to fracture.

  10. Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study.

    Science.gov (United States)

    Pasco, Julie A; Holloway, Kara L; Brennan-Olsen, Sharon L; Moloney, David J; Kotowicz, Mark A

    2015-05-24

    Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years. This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition. Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass. There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.

  11. Cardiopulmonary fitness and muscle strength in patients with osteogenesis imperfecta type I.

    Science.gov (United States)

    Takken, Tim; Terlingen, Heike C; Helders, Paul J M; Pruijs, Hans; Van der Ent, Cornelis K; Engelbert, Raoul H H

    2004-12-01

    To evaluate cardiopulmonary function, muscle strength, and cardiopulmonary fitness (VO 2 peak) in patients with osteogenesis imperfecta (OI). In 17 patients with OI type I (mean age 13.3 +/- 3.9 years) cardiopulmonary function was assessed at rest using spirometry, plethysmography, electrocardiography, and echocardiography. Exercise capacity was measured using a maximal exercise test on a bicycle ergometer and an expired gas analysis system. Muscle strength in shoulder abductors, hip flexors, ankle dorsal flexor, and grip strength were measured. All results were compared with reference values. Cardiopulmonary function at rest was within normal ranges, but when it was compared with normal height for age and sex, vital capacities were reduced. Mean absolute and relative VO 2 peak were respectively -1.17 (+/- 0.67) and -1.41 (+/- 1.52) standard deviations lower compared with reference values ( P exercise tolerance and muscle strength were significantly reduced in patients with OI, which might account for their increased levels of fatigue during activities of daily living.

  12. Transcranial direct current stimulation does not affect lower extremity muscle strength training in healthy individuals

    DEFF Research Database (Denmark)

    Maeda, Kazuhei; Yamaguchi, Tomofumi; Tatemoto, Tsuyoshi

    2017-01-01

    The present study investigated the effects of anodal transcranial direct current stimulation (tDCS) on lower extremity muscle strength training in 24 healthy participants. In this triple-blind, sham-controlled study, participants were randomly allocated to the anodal tDCS plus muscle strength...... training (anodal tDCS) group or sham tDCS plus muscle strength training (sham tDCS) group. Anodal tDCS (2 mA) was applied to the primary motor cortex of the lower extremity during muscle strength training of the knee extensors and flexors. Training was conducted once every 3 days for 3 weeks (7 sessions......). Knee extensor and flexor peak torques were evaluated before and after the 3 weeks of training. After the 3-week intervention, peak torques of knee extension and flexion changed from 155.9 to 191.1 Nm and from 81.5 to 93.1 Nm in the anodal tDCS group. Peak torques changed from 164.1 to 194.8 Nm...

  13. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles.

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-07-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm(2)), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm(2)). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18-0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the 'design' of their

  14. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-01-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm2), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm2). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18–0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the ‘design’ of their

  15. Plantar Pressure During Gait in Pregnant Women.

    Science.gov (United States)

    Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipel, Véronique

    2016-11-01

    During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Fifty-eight women in the last 4 months of pregnancy, nine postpartum women, and 23 healthy nonpregnant women (control group) performed gait trials on an electronic walkway at preferred speeds. The results for the three groups were compared using analysis of variance. During pregnancy, peak pressure and contact area decreased for the forefoot and rearfoot. These parameters increased significantly for the midfoot. The gait strategy seemed to be lateralization of gait with an increased contact area of the lateral midfoot and both reduced pressure and a later peak time on the medial forefoot. In the postpartum group, footprint parameters were modified compared with the pregnant group, indicating a trend toward partial return to control values, although differences persisted between the postpartum and control groups. Pregnant women had altered plantar pressures during gait. These findings could define a specific pattern of gait footprints in late pregnancy because plantar pressures had characteristics that could maintain a stable and safe gait.

  16. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, S

    2011-01-01

    rather than implant design per se. Thus, the present data failed to support the hypothesis that R-THA would result in an enhanced strength rehabilitation compared to S-THA. Further, between-limb asymmetry remained present for hip flexors and adductors after 52 wks. Trial registration: NCT01229293....... randomised into (A) standard total hip arthroplasty (S-THA) and (B) resurfacing total hip arthroplasty (R-THA). Pre-surgery assessment and follow-up were conducted (8, 26 and 52 wks). Maximal isometric muscle strength (Nm) and between-limb asymmetry for the knee extensors/flexors, hip adductors....../abductors, hip extensors/flexors were analysed. RESULTS: Maximal knee extensor and hip abductor strength were higher in S-THA than R-THA at 52 wks post-surgery (P ≤ 0.05) and hip extensors tended to be higher in S-THA at 52 wks (P = 0.06). All muscle groups showed substantial between-limb strength asymmetry (7...

  17. Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue

    Directory of Open Access Journals (Sweden)

    Edward W. J. Cadigan

    2017-09-01

    Full Text Available Transcranial magnetic (TMS and motor point stimulation have been used to determine voluntary activation (VA. However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs and Erb's point stimulation (maximal M-waves, Mmax were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05 decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05 underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05 higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05 decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at

  18. Neck muscle endurance and head posture: A comparison between adolescents with and without neck pain.

    Science.gov (United States)

    Oliveira, Ana Carolina; Silva, Anabela G

    2016-04-01

    The main aims of this study were to compare the neck flexor and extensor endurance and forward head posture between adolescents with and without neck pain. The secondary aims were to explore potential associations between muscles endurance, head posture and neck pain characteristics and to assess intra-rater reliability of the measurements used. Adolescents with neck pain (n = 35) and age-matched asymptomatic adolescents (n = 35) had their forward head posture, neck flexor endurance and neck extensor endurance measured using clinical tests. Intra-rater reliability was also assessed. Forward head posture and neck flexor and extensor endurance tests showed moderate to almost perfect intra-rater reliability (ICC between 0.58 and 0.88). Adolescents with neck pain showed significantly less forward head posture (neck pain = 46.62 ± 4.92; asymptomatic = 44.18°± 3.64°, p > 0.05) and less neck flexor (neck pain = 24.50 ± 23.03s; asymptomatic = 35.89 ± 21.53s, p > 0.05) and extensor endurance (neck pain = 12.6.64 ± 77.94s; asymptomatic = 168.66 ± 74.77s, p > 0.05) than asymptomatic adolescents. Results suggest that changes in posture and neck muscle endurance are a feature of adolescents with neck pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. MRI in flexor tendon rupture after collagenase injection

    International Nuclear Information System (INIS)

    Khurana, Shruti; Wadhwa, Vibhor; Chhabra, Avneesh; Amirlak, Bardia

    2017-01-01

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  20. MRI in flexor tendon rupture after collagenase injection

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Shruti [Lady Hardinge Medical College, New Delhi (India); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States); Johns Hopkins University, Baltimore, MD (United States); Amirlak, Bardia [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-02-15

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  1. Influence of Arm-cranking on Changes in Plasma CK Activity after High Force Eccentric Exercise of the Elbow Flexors

    OpenAIRE

    Kazunori, NOSAKA; Kei, SAKAMOTO; Mike, NEWTON; Exercise and Sports Science, Graduate School of Integrated Science, Yokohama City University:School of Biomedical and Sports Science, Edith Cowan University; Exercise and Sports Science, Graduate School of Integrated Science, Yokohama City University; School of Biomedical and Sports Science, Edith Cowan University

    2002-01-01

    It was hypothesized that the time course of changes in plasma creatine kinase (CK) activity following eccentric exercise was influenced by rhythmical muscle contractions performed after eccentric exercise. This study examined whether arm-cranking (AC) alters the time course of changes in plasma creatine kinase (CK) activity after eccentric exercise of the elbow flexors (ECC). Six male students performed two bouts of ECC separated by 3 weeks, and AC (25watts, 2-hours) was performed immediately...

  2. BIOMECHANICS AND HISTOLOGICAL ANALYSIS IN RABBIT FLEXOR TENDONS REPAIRED USING THREE SUTURE TECHNIQUES (FOUR AND SIX STRANDS) WITH EARLY ACTIVE MOBILIZATION.

    Science.gov (United States)

    Severo, Antônio Lourenço; Arenhart, Rodrigo; Silveira, Daniela; Ávila, Aluísio Otávio Vargas; Berral, Francisco José; Lemos, Marcelo Barreto; Piluski, Paulo César Faiad; Lech, Osvandré Luís Canfield; Fukushima, Walter Yoshinori

    2012-01-01

    Analyzing suture time, biomechanics (deformity between the stumps) and the histology of three groups of tendinous surgical repair: Brazil-2 (4-strands) which the end knot (core) is located outside the tendon, Indiana (4-strands) and Tsai (6-strands) with sutures technique which the end knot (core) is inner of the tendon, associated with early active mobilization. The right calcaneal tendons (plantar flexor of the hind paw) of 36 rabbits of the New Zealand breed (Oryctolagus cuniculus) were used in the analysis. This sample presents similar size to human flexor tendon that has approximately 4.5 mm (varying from 2mm). The selected sample showed the same mass (2.5 to 3kg) and were male or female adults (from 8 ½ months). For the flexor tendons of the hind paws, sterile and driven techniques were used in accordance to the Committee on Animal Research and Ethics (CETEA) of the University of the State of Santa Catarina (UDESC), municipality of Lages, in Brazil (protocol # 1.33.09). In the biomechanical analysis (deformity) carried out between tendinous stumps, there was no statistically significant difference (p>0.01). There was no statistical difference in relation to surgical time in all three suture techniques with a mean of 6.0 minutes for Tsai (6- strands), 5.7 minutes for Indiana (4-strands) and 5.6 minutes for Brazil (4-strands) (p>0.01). With the early active mobility, there was qualitative and quantitative evidence of thickening of collagen in 38.9% on the 15(th) day and in 66.7% on the 30(th) day, making the biological tissue stronger and more resistant (p=0.095). This study demonstrated that there was no histological difference between the results achieved with an inside or outside end knot with respect to the repaired tendon and the number of strands did not affect healing, vascularization or sliding of the tendon in the osteofibrous tunnel, which are associated with early active mobility, with the repair techniques applied.

  3. BIOMECHANICS AND HISTOLOGICAL ANALYSIS IN RABBIT FLEXOR TENDONS REPAIRED USING THREE SUTURE TECHNIQUES (FOUR AND SIX STRANDS) WITH EARLY ACTIVE MOBILIZATION

    Science.gov (United States)

    Severo, Antônio Lourenço; Arenhart, Rodrigo; Silveira, Daniela; Ávila, Aluísio Otávio Vargas; Berral, Francisco José; Lemos, Marcelo Barreto; Piluski, Paulo César Faiad; Lech, Osvandré Luís Canfield; Fukushima, Walter Yoshinori

    2015-01-01

    Objective: Analyzing suture time, biomechanics (deformity between the stumps) and the histology of three groups of tendinous surgical repair: Brazil-2 (4-strands) which the end knot (core) is located outside the tendon, Indiana (4-strands) and Tsai (6-strands) with sutures technique which the end knot (core) is inner of the tendon, associated with early active mobilization. Methods: The right calcaneal tendons (plantar flexor of the hind paw) of 36 rabbits of the New Zealand breed (Oryctolagus cuniculus) were used in the analysis. This sample presents similar size to human flexor tendon that has approximately 4.5 mm (varying from 2mm). The selected sample showed the same mass (2.5 to 3kg) and were male or female adults (from 8 ½ months). For the flexor tendons of the hind paws, sterile and driven techniques were used in accordance to the Committee on Animal Research and Ethics (CETEA) of the University of the State of Santa Catarina (UDESC), municipality of Lages, in Brazil (protocol # 1.33.09). Results: In the biomechanical analysis (deformity) carried out between tendinous stumps, there was no statistically significant difference (p>0.01). There was no statistical difference in relation to surgical time in all three suture techniques with a mean of 6.0 minutes for Tsai (6- strands), 5.7 minutes for Indiana (4-strands) and 5.6 minutes for Brazil (4-strands) (p>0.01). With the early active mobility, there was qualitative and quantitative evidence of thickening of collagen in 38.9% on the 15th day and in 66.7% on the 30th day, making the biological tissue stronger and more resistant (p=0.095). Conclusion: This study demonstrated that there was no histological difference between the results achieved with an inside or outside end knot with respect to the repaired tendon and the number of strands did not affect healing, vascularization or sliding of the tendon in the osteofibrous tunnel, which are associated with early active mobility, with the repair techniques

  4. Effects of Wearing Different Personal Equipment on Force Distribution at the Plantar Surface of the Foot

    Directory of Open Access Journals (Sweden)

    Christoph Schulze

    2013-01-01

    Full Text Available Background. The wearing of personal equipment can cause specific changes in muscle activity and posture. In the present study, we investigated the influence of differences in equipment related weight loading and load distribution on plantar pressure. In addition, we studied functional effects of wearing different equipment with a particular focus on relevant changes in foot shape. Methods. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. Results. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p < 0.05. We observed an increase in the contact area (p < 0.05 and an influence of load distribution through different ways to carry the rifle. Conclusions. The wearing of heavier weights leads to an increase in plantar pressure and contact area. This may be caused by flattening of the transverse and longitudinal arches. The effects are more evident in subjects with flat feet deformities which seem to flatten at an earlier load condition with a greater amount compared to subjects with normal arches. Improving load distribution should be a main goal in the development of military equipment in order to prevent injuries or functional disorders of the lower extremity.

  5. The plantar fasciotomy: MR imaging findings in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S.; Ashman, C. [Ohio State Univ. Medical Center, Department of Radiology, Columbus, OH (United States); Smith, G.; Kaeding, C. [Ohio State Univ. Medical Center, Department of Surgery, Columbus, OH (United States)

    1999-08-01

    % (range 9-20%), but the thickness at the fasciotomy nearly doubled. No edema was evident in the fascia, perifascial tissues, deep plantar muscles, or calcaneal bone marrow.< rate at head-abs-p1.lf>Conclusions. The average thickness of the plantar fascia in asymptomatic volunteers after surgery is nearly 2-3 times that of normal. While there is increased thickness at the site of surgery, the changes in morphology and signal intensity were most prominent at the enthesis. The key observation was absence of edema in the fascia and perifascial soft tissues. This baseline information may be of value when assessing MR studies of symptomatic patients. (orig.) With 3 figs., 24 refs.

  6. Hardness and posting of foot orthoses modify plantar contact area, plantar pressure, and perceived comfort when cycling.

    Science.gov (United States)

    Bousie, Jaquelin A; Blanch, Peter; McPoil, Thomas G; Vicenzino, Bill

    2018-07-01

    To evaluate the effects of hardness and posting of orthoses on plantar profile and perceived comfort and support during cycling. A repeated measures study with randomised order of orthoses, hardness, and posting conditions. Twenty-three cyclists cycled at a cadence of 90rpm and a perceived exertion rating of twelve. Contoured soft and hard orthoses with or without a medial forefoot or lateral forefoot post were evaluated. Plantar contact area, mean pressure and peak pressure were measured for nine plantar regions using the pedar ® -X system and represented as a percentage of the total (CA%, MP%, and PP% respectively). Perceived comfort and support was rated on a visual analogue scale. The softer orthosis significantly increased CA% (p=0.014) across the midfoot and heel with a decrease in the toe region and forefoot. MP% (p=0.034) and PP% (p=0.012) were significantly increased at the mid and lateral forefoot with reductions in MP% at the midfoot and in PP% at the hallux and toes. Forefoot posting significantly increased CA% (p=0.018) at the toes and forefoot and decreased it at the heel. PP% was significantly altered (p=0.013) based on posting position. Lateral forefoot posting significantly decreased heel comfort (p=0.036). When cycling, a soft, contoured orthosis increased contact across the midfoot and heel, modulating forefoot and midfoot plantar pressures but not altering comfort or support. Forefoot postings significantly modified contact areas and plantar pressures and reduced comfort at the heel. Copyright © 2017. Published by Elsevier Ltd.

  7. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated"

  8. Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments

    DEFF Research Database (Denmark)

    Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B

    2017-01-01

    INTRODUCTION: Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they r...... on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation....

  9. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  10. Acute flexor tendon injury following midshaft radius and ulna fractures in a paediatric patient

    Directory of Open Access Journals (Sweden)

    James Williams

    2018-06-01

    Full Text Available Delayed rupture of the extensor and flexor tendons are recognised complications of distal radius fractures. However, acute flexor tendon rupture in the context of forearm fractures is rare. A twelve-year-old female sustained midshaft fractures of the radius and ulna. Intra-operatively the flexor pollicis longus (FPL was found to be stripped from its musculotendinous junction at the level of the fracture fragment. The ruptured tendon was repaired using a modified Krackow technique at the time of fracture fixation. The repair was protected in plaster of Paris prior to referral to the paediatric hand clinic. The patient made a full recovery. Flexor tendon injury is a rare but potentially devastating consequence of acute forearm fractures. High energy trauma, significant volar angulation of the fracture fragment and clinical signs of flexor tendon injury should raise suspicion of this injury. A high index of suspicion in conjunction with repeat clinical examination of flexor tendon function should be performed before opting for closed management or intramedullary nailing in paediatric patients. Keywords: Acute, Flexor, Tendon, Fracture, Radius, Paediatric

  11. Applicability of contrast-enhanced ultrasound in the diagnosis of plantar fasciitis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Pingel, Jessica; Simonsen, Lene

    2017-01-01

    -mode ultrasound (US) in patients with plantar fasciitis (PF). 20 patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5) and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat...... pad were measured independently by two observers. Inter- and intra-observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter...

  12. Ultrasound evaluation of the abductor hallucis muscle: Reliability study

    Directory of Open Access Journals (Sweden)

    Hing Wayne A

    2008-09-01

    Full Text Available Abstract Background The Abductor hallucis muscle (AbdH plays an integral role during gait and is often affected in pathological foot conditions. The aim of this study was to evaluate the within and between-session intra-tester reliability using diagnostic ultrasound of the dorso-plantar thickness, medio-lateral width and cross-sectional area, of the AbdH in asymptomatic adults. Methods The AbdH muscles of thirty asymptomatic subjects were imaged and then measured using a Philips HD11 Ultrasound machine. Interclass correlation coefficients (ICC with 95% confidence intervals (CI were used to calculate both within and between session intra-tester reliability. Results The within-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.99–0.99; medio-lateral width an ICC: of 0.97 (95% CI: 0.92–0.97 and cross-sectional area an ICC of 0.98 (95% CI: 0.98–0.99. Between-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.95 to 0.98; medio-lateral width an ICC of 0.94 (95% CI 0.90 to 0.96 and for cross-sectional area an ICC of 0.79 (95% CI 0.65 to 0.88. Conclusion Diagnostic ultrasound has the potential to be a reliable tool for evaluating the AbdH muscle in asymptomatic subjects. Subsequent studies may be conducted to provide a better understanding of the AbdH function in foot and ankle pathologies.

  13. [Flexor tendon repair: a short story].

    Science.gov (United States)

    Moutet, F; Corcella, D; Forli, A; Mesquida, V

    2014-12-01

    This short story of flexor tendon repair aims to illustrate hesitations and wanderings of this surgery. Obviously tendon repair was very early considered, but it developed and diffused rather lately. It became a routine practice only in 20th century. This was due on the one hand, in Occident, to the Galen's dogmatic interdiction, on the other hand, to the repair difficulties of this paradoxical structure. Actually tendon is made of fibroblasts and collagen (sticky substances), and then its only goal is to move. According to this necessity, whatever the used techniques are, gliding is the final purpose. Technical evolutions are illustrated by historical contributions to flexor tendon surgery of several "giants" of hand surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Discrete sensors distribution for accurate plantar pressure analyses.

    Science.gov (United States)

    Claverie, Laetitia; Ille, Anne; Moretto, Pierre

    2016-12-01

    The aim of this study was to determine the distribution of discrete sensors under the footprint for accurate plantar pressure analyses. For this purpose, two different sensor layouts have been tested and compared, to determine which was the most accurate to monitor plantar pressure with wireless devices in research and/or clinical practice. Ten healthy volunteers participated in the study (age range: 23-58 years). The barycenter of pressures (BoP) determined from the plantar pressure system (W-inshoe®) was compared to the center of pressures (CoP) determined from a force platform (AMTI) in the medial-lateral (ML) and anterior-posterior (AP) directions. Then, the vertical ground reaction force (vGRF) obtained from both W-inshoe® and force platform was compared for both layouts for each subject. The BoP and vGRF determined from the plantar pressure system data showed good correlation (SCC) with those determined from the force platform data, notably for the second sensor organization (ML SCC= 0.95; AP SCC=0.99; vGRF SCC=0.91). The study demonstrates that an adjusted placement of removable sensors is key to accurate plantar pressure analyses. These results are promising for a plantar pressure recording outside clinical or laboratory settings, for long time monitoring, real time feedback or for whatever activity requiring a low-cost system. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  15. Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury.

    Science.gov (United States)

    Varoqui, Deborah; Niu, Xun; Mirbagheri, Mehdi M

    2014-03-31

    In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities-characterized by increases in the over-ground walking speed and endurance-is generally observed in patients. To better understand the mechanisms underlying these improvements, we studied the effects of Lokomat training on impaired ankle voluntary movement, known to be an important limiting factor in gait for iSCI patients. Fifteen chronic iSCI subjects performed twelve 1-hour sessions of Lokomat training over the course of a month. The voluntary movement was qualified by measuring active range of motion, maximal velocity peak and trajectory smoothness for the spastic ankle during a movement from full plantar-flexion (PF) to full dorsi-flexion (DF) at the patient's maximum speed. Dorsi- and plantar-flexor muscle strength was quantified by isometric maximal voluntary contraction (MVC). Clinical assessments were also performed using the Timed Up and Go (TUG), the 10-meter walk (10MWT) and the 6-minute walk (6MWT) tests. All evaluations were performed both before and after the training and were compared to a control group of fifteen iSCI patients. After the Lokomat training, the active range of motion, the maximal velocity, and the movement smoothness were significantly improved in the voluntary movement. Patients also exhibited an improvement in the MVC for their ankle dorsi- and plantar-flexor muscles. In terms of functional activity, we observed an enhancement in the mobility (TUG) and the over-ground gait velocity (10MWT) with training. Correlation tests indicated a significant relationship between ankle voluntary movement performance and the walking clinical assessments. The improvements of the kinematic and kinetic parameters of the ankle voluntary movement

  16. A comparison of free weight squat to Smith machine squat using electromyography.

    Science.gov (United States)

    Schwanbeck, Shane; Chilibeck, Philip D; Binsted, Gordon

    2009-12-01

    The purpose of this experiment was to determine whether free weight or Smith machine squats were optimal for activating the prime movers of the legs and the stabilizers of the legs and the trunk. Six healthy participants performed 1 set of 8 repetitions (using a weight they could lift 8 times, i.e., 8RM, or 8 repetition maximum) for each of the free weight squat and Smith machine squat in a randomized order with a minimum of 3 days between sessions, while electromyographic (EMG) activity of the tibialis anterior, gastrocnemius, vastus medialis, vastus lateralis, biceps femoris, lumbar erector spinae, and rectus abdominus were simultaneously measured. Electromyographic activity was significantly higher by 34, 26, and 49 in the gastrocnemius, biceps femoris, and vastus medialis, respectively, during the free weight squat compared to the Smith machine squat (p free weight and Smith machine squat for any of the other muscles; however, the EMG averaged over all muscles during the free weight squat was 43% higher when compared to the Smith machine squat (p free weight squat may be more beneficial than the Smith machine squat for individuals who are looking to strengthen plantar flexors, knee flexors, and knee extensors.

  17. Plantar Pressure Detection with Fiber Bragg Gratings Sensing System

    Directory of Open Access Journals (Sweden)

    Tsair-Chun Liang

    2016-10-01

    Full Text Available In this paper, a novel fiber-optic sensing system based on fiber Bragg gratings (FBGs to measure foot plantar pressure is proposed. This study first explores the Pedar-X insole foot pressure types of the adult-size chart and then defines six measurement areas to effectively identify four foot types: neutral foot, cavus foot, supinated foot and flat foot. The plantar pressure signals are detected by only six FBGs, which are embedded in silicone rubber. The performance of the fiber optic sensing is examined and compared with a digital pressure plate of i-Step P1000 with 1024 barometric sensors. In the experiment, there are 11 participants with different foot types to participate in the test. The Pearson correlation coefficient, which is determined from the measured results of the homemade fiber-optic plantar pressure system and i-Step P1000 plantar pressure plate, reaches up to 0.671 (p < 0.01. According to the measured results from the plantar pressure data, the proposed fiber optic sensing system can successfully identify the four different foot types. Measurements of this study have demonstrated the feasibility of the proposed system so that it can be an alternative for plantar pressure detection systems.

  18. Relationship between agility and lower limb muscle strength, targeting university badminton players.

    Science.gov (United States)

    Sonoda, Takuya; Tashiro, Yuto; Suzuki, Yusuke; Kajiwara, Yu; Zeidan, Hala; Yokota, Yuki; Kawagoe, Mirei; Nakayama, Yasuaki; Bito, Tsubasa; Shimoura, Kanako; Tatsumi, Masataka; Nakai, Kengo; Nishida, Yuichi; Yoshimi, Soyoka; Aoyama, Tomoki

    2018-02-01

    [Purpose] Targeting university badminton players, this study investigated the relationship between agility, which is associated with performance in badminton, and lower limb muscle strength, and examined which muscles influence agility. [Subjects and Methods] A total of 23 male university badminton players were evaluated for side-shuffle test scores and lower limb strength. The relationships between agility, lower limb strength, and duration of experience playing badminton were evaluated using a correlation analysis. Moreover, the relationship between agility and lower limb strength was evaluated by partial correlation analysis, adjusting for the effects of experience of each badminton player. [Results] The agility score correlated with hip extension and ankle plantar flexion strength, with adjustment for badminton experience. [Conclusion] This study suggests that hip extension training and improvement in ankle plantar flexion strength may improve agility.

  19. Characterisation of myosin heavy chain gene variants in the fast and slow muscle fibres of gammarid amphipods.

    Science.gov (United States)

    Whiteley, N M; Magnay, J L; McCleary, S J; Nia, S Khazraee; El Haj, A J; Rock, J

    2010-10-01

    Recent molecular work has revealed a large diversity of myosin heavy chain (MyHC) gene variants in the abdominal musculature of gammarid amphipods. An unusual truncated MyHC transcript from the loop 1 region (Variant A(3)) was consistently observed in multiple species and populations. The current study aimed to determine whether this MyHC variant is specific to a particular muscle fibre type, as a change in net charge to the loop 1 region of Variant A(3) could be functionally significant. The localisation of different fibre types within the abdominal musculature of several gammarid species revealed that the deep flexor and extensor muscles are fast-twitch muscle fibres. The dorsal superficial muscles were identified as slow fibres and the muscles extrinsic to the pleopods were identified as intermediate fibres. Amplification of loop 1 region mRNA from isolated superficial extensor and deep flexor muscles, and subsequent liquid chromatography and sequence analysis revealed that Variant A(3) was the primary MyHC variant in slow muscles, and the conserved A(1) sequence was the primary variant in fast muscles. The specific role of Variant A(3) in the slow muscles remains to be investigated. 2010 Elsevier Inc. All rights reserved.

  20. Deep Neck Flexor Endurance in the Adolescent and Young Adult: Normative Data and Associated Attributes.

    Science.gov (United States)

    Jarman, Nathan F; Brooks, Toby; James, C Roger; Hooper, Troy; Wilhelm, Mark; Brismée, Jean-Michel; Domenech, Manuel A; Kotara, Stanley J; Sizer, Phillip S

    2017-10-01

    Deep neck flexor (DNF) muscles stabilize the neck and contribute to head acceleration control. The function of DNF in cervical spine dynamic stabilization has not been examined in athletes of any age group, including adolescents. This investigation was necessary prior to studying the DNF muscles' role in cervical spine injury patterns. The objectives of this study were (1) to determine average Deep Neck Flexor Endurance Test (DNFET) time scores in high school-aged and university-aged subjects (aged 14-22 years); and (2) to establish the relationship between gender and age for adolescent DNFET time scores. Cross-sectional design. Public high school and private university. A total of 81 (40 male, 41 female) healthy high school and collegiate athletes. DNFET time scores (in seconds) were collected and means values were calculated. Interrater reliability was established using the first 15 university-aged subjects enrolled in the study. Mean DNFET time (seconds) scores. The DNF muscle endurance interrater reliability coefficient of reproducibility for 4 allied health clinicians was intraclass correlation coefficient (2,4) 0.712 (confidence interval, 0.24-0.85). The mean (± standard deviation) DNFET time score for females was 31.86 (±8.53) seconds versus 35.57 (±10.43) seconds for males. The DNFET performance demonstrated a significant but fair correlation with age (r = 0.401, P = .0001). No significant performance differences were found between male and female subjects in the 14- to 17-year-old group (U = 187.0, P = .285), the 18- to 22-year-old group (U = 145.0, P = .215), or the total male versus female subject groups (U = 653.0, P = .083). Our study establishes a normative data set available for the DNFET in the adolescent population. The fair correlation between DNFET time scores and age is consistent with other studies. These findings serve as a basis for clinician testing, objectifying, and monitoring DNF dysfunction in an adolescent athletic population. II

  1. Near infrared spectroscopy of human muscles

    Science.gov (United States)

    Gasbarrone, R.; Currà, A.; Cardillo, A.; Bonifazi, G.; Serranti, S.

    2018-02-01

    Optical spectroscopy is a powerful tool in research and industrial applications. Its properties of being rapid, non-invasive and not destructive make it a promising technique for qualitative as well as quantitative analysis in medicine. Recent advances in materials and fabrication techniques provided portable, performant, sensing spectrometers readily operated by user-friendly cabled or wireless systems. We used such a system to test whether infrared spectroscopy techniques, currently utilized in many areas as primary/secondary raw materials sector, cultural heritage, agricultural/food industry, environmental remote and proximal sensing, pharmaceutical industry, etc., could be applied in living humans to categorize muscles. We acquired muscles infrared spectra in the Vis-SWIR regions (350-2500 nm), utilizing an ASD FieldSpec 4 Standard-Res Spectroradiometer with a spectral sampling capability of 1.4 nm at 350-1000 nm and 1.1 nm at 1001-2500 nm. After a preliminary spectra pre-processing (i.e. signal scattering reduction), Principal Component Analysis (PCA) was applied to identify similar spectral features presence and to realize their further grouping. Partial Least-Squares Discriminant Analysis (PLS-DA) was utilized to implement discrimination/prediction models. We studied 22 healthy subjects (age 25-89 years, 11 females), by acquiring Vis-SWIR spectra from the upper limb muscles (i.e. biceps, a forearm flexor, and triceps, a forearm extensor). Spectroscopy was performed in fixed limb postures (elbow angle approximately 90‡). We found that optical spectroscopy can be applied to study human tissues in vivo. Vis-SWIR spectra acquired from the arm detect muscles, distinguish flexors from extensors.

  2. Effects of experimental insoles on body posture, mandibular kinematics and masticatory muscles activity. A pilot study in healthy volunteers.

    Science.gov (United States)

    Marini, Ida; Alessandri Bonetti, Giulio; Bortolotti, Francesco; Bartolucci, Maria Lavinia; Gatto, Maria Rosaria; Michelotti, Ambra

    2015-06-01

    It has been hypothesized that different plantar sensory inputs could influence the whole body posture and dental occlusion but there is a lack of evidence on this possible association. To investigate the effects of experimental insoles redistributing plantar pressure on body posture, mandibular kinematics and electromyographic (EMG) activity of masticatory muscles on healthy subjects. A pilot study was conducted on 19 healthy volunteers that wore custom-made insoles normalizing the plantar pressure distribution for 2 weeks. Body posture parameters were measured by means of an optoelectronic stereophotogrammetric analysis; mandibular kinematics was analyzed by means of gothic arch tracings; superficial EMG activity of head and neck muscles was performed. Measurements were carried out 10 days before the insertion of the insoles, immediately before the insertion, the day after, 7 and 14 days after, in four different exteroceptive conditions. The outcomes of the present study show that insoles do not modify significantly over time the parameters of body posture, SEMG activity of head and neck muscles and mandibular kinematics. In this pilot study the experimental insoles did not significantly influence the body posture, the mandibular kinematics and the activity of masticatory muscles during a 14-day follow up period. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Calcaneal attachment of the plantar fascia: MR findings in asymptomatic volunteers.

    Science.gov (United States)

    Ehrmann, Christine; Maier, Matthias; Mengiardi, Bernard; Pfirrmann, Christian W A; Sutter, Reto

    2014-09-01

    To determine the spectrum of magnetic resonance (MR) imaging findings at the calcaneal attachment of the plantar fascia in asymptomatic volunteers. The study was approved by the institutional review board, and informed consent was obtained from all subjects. MR imaging was performed in 77 asymptomatic volunteers (mean age, 48.0 years; age range, 23-83 years) with use of a 1.5-T system. There were 40 women (mean age, 49.0 years; age range, 24-83 years) and 37 men (mean age, 48.0 years; age range, 23-83 years). Signal intensity characteristics and thickness of the medial, central, and lateral fascicles of the plantar fascia were assessed independently by two radiologists. The presence of soft-tissue edema, bone marrow edema, and bone spur formation at the attachment of the plantar fascia was noted. Datasets were analyzed with inferential statistic procedures. The mean thickness of the plantar fascia was 0.6 mm (medial fascicle), 4.0 mm (central fascicle), and 2.3 mm (lateral fascicle). Increased signal intensity in the plantar fascia was seen with the T1-weighted sequence in 16 of the 77 volunteers (21%), the T2-weighted sequence in six (7.8%), and the short inversion time inversion-recovery sequence in six (7.8%). Soft-tissue edema was seen deep to the plantar fascia in five of the 77 volunteers (6.5%) and superficial to the plantar fascia in 16 (21%). A calcaneal spur was detected in 15 of the 77 volunteers (19%). Calcaneal bone marrow edema was present in four volunteers (5.2%). T1-weighted signal intensity changes in the plantar fascia, soft-tissue edema superficial to the plantar fascia, and calcaneal spurs are common findings in asymptomatic volunteers and should be used with caution in the diagnosis of plantar fasciitis. Increased signal intensity within the plantar fascia with fluid-sensitive sequences is uncommon in asymptomatic volunteers.

  4. The relationship between the flexible flatfoot and plantar fasciitis: ultrasonographic evaluation.

    Science.gov (United States)

    Huang, Yu-Chi; Wang, Lin-Yi; Wang, Her-Cherng; Chang, Kai-Lan; Leong, Chau-Peng

    2004-06-01

    The purpose of this study was to investigate the relationship between flexible flatfoot and plantar fasciitis. Twenty-three subjects with flexible flatfoot and 23 subjects with normal arched feet were enrolled. Footprint analysis was used to evaluate the foot conditions in both groups to calculate the individual arch index. We compared the sonographic images of plantar fascia in the flexible flatfoot group with the normal arch group using high-frequency ultrasound. The analysis results indicated that the thickening of the plantar fascia in the flexible flatfoot group was significantly different from the normal arch group. In the flexible flatfoot group, 10 of 23 patients (43.4%) had plantar fasciitis, but only two subjects (8.7%) in the normal arch group had plantar fasciitis. There was a higher incidence of plantar fasciitis in the flexible flatfoot group than the normal arch control group in this study.

  5. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    Science.gov (United States)

    2013-01-01

    Background This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle performance tests, which have shown promising psychometric properties, would remain reliable when examined under conditions similar to those of daily clinical practice. Methods The intra-rater (between-day) and inter-rater (within-day) reliability was assessed for five cervical muscle performance tests in patients with (n = 33) and without neck pain (n = 30). The five tests were joint position error, the cranio-cervical flexion test, the neck flexor muscle endurance test performed in supine and in a 45°-upright position and a new neck extensor test. Results Intra-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.48-0.82), the cranio-cervical flexion test (ICC ≥ 0.69), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.68) and in a 45°-upright position (ICC ≥ 0.41) with the exception of a new test (neck extensor test), which ranged from slight to moderate agreement (ICC = 0.14-0.41). Likewise, inter-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.51-0.75), the cranio-cervical flexion test (ICC ≥ 0.85), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.70) and in a 45°-upright position (ICC ≥ 0.56). However, only slight to fair agreement was found for the neck extensor test (ICC

  6. The gait and balance of patients with diabetes can be improved: a randomised controlled trial.

    Science.gov (United States)

    Allet, L; Armand, S; de Bie, R A; Golay, A; Monnin, D; Aminian, K; Staal, J B; de Bruin, E D

    2010-03-01

    Gait characteristics and balance are altered in diabetic patients. Little is known about possible treatment strategies. This study evaluates the effect of a specific training programme on gait and balance of diabetic patients. This was a randomised controlled trial (n=71) with an intervention (n=35) and control group (n=36). The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-orientated strengthening (twice weekly over 12 weeks). Controls received no treatment. Individuals were allocated to the groups in a central office. Gait, balance, fear of falls, muscle strength and joint mobility were measured at baseline, after intervention and at 6-month follow-up. The trial is closed to recruitment and follow-up. After training, the intervention group increased habitual walking speed by 0.149 m/s (pbalance (time to walk over a beam, balance index recorded on Biodex balance system), their performance-oriented mobility, their degree of concern about falling, their hip and ankle plantar flexor strength, and their hip flexion mobility compared with the control group. After 6 months, all these variables remained significant except for the Biodex sway index and ankle plantar flexor strength. Two patients developed pain in their Achilles tendon: the progression for two related exercises was slowed down. Specific training can improve gait speed, balance, muscle strength and joint mobility in diabetic patients. Further studies are needed to explore the influence of these improvements on the number of reported falls, patients' physical activity levels and quality of life. ClinicalTrials.gov NCT00637546 This work was supported by the Swiss National Foundation (SNF): PBSKP-123446/1/

  7. Mapping of calf muscle oxygenation and haemoglobin content during dynamic plantar flexion exercise by multi-channel time-resolved near-infrared spectroscopy

    International Nuclear Information System (INIS)

    Torricelli, Alessandro; Quaresima, Valentina; Pifferi, Antonio; Biscotti, Giovanni; Spinelli, Lorenzo; Taroni, Paola; Ferrari, Marco; Cubeddu, Rinaldo

    2004-01-01

    A compact and fast multi-channel time-resolved near-infrared spectroscopy system for tissue oximetry was developed. It employs semiconductor laser and fibre optics for delivery of optical signals. Photons are collected by eight 1 mm fibres and detected by a multianode photomultiplier. A time-correlated single photon counting board is used for the parallel acquisition of time-resolved reflectance curves. Estimate of the reduced scattering coefficient is achieved by fitting with a standard model of diffusion theory, while the modified Lambert-Beer law is used to assess the absorption coefficient. In vivo measurements were performed on five healthy volunteers to monitor spatial changes in calf muscle (medial and lateral gastrocnemius; MG, LG) oxygen saturation (SmO 2 ) and total haemoglobin concentration (tHb) during dynamic plantar flexion exercise performed at 50% of the maximal voluntary contraction. At rest SmO 2 was 73.0 ± 0.9 and 70.5 ± 1.7% in MG and LG, respectively (P = 0.045). At the end of the exercise, SmO 2 decreased (69.1 ± 1.8 and 63.8 ± 2.1% in MG and LG, respectively; P 2 and tHb

  8. Kinesthetic perception based on integration of motor imagery and afferent inputs from antagonistic muscles with tendon vibration.

    Science.gov (United States)

    Shibata, E; Kaneko, F

    2013-04-29

    The perceptual integration of afferent inputs from two antagonistic muscles, or the perceptual integration of afferent input and motor imagery are related to the generation of a kinesthetic sensation. However, it has not been clarified how, or indeed whether, a kinesthetic perception would be generated by motor imagery if afferent inputs from two antagonistic muscles were simultaneously induced by tendon vibration. The purpose of this study was to investigate how a kinesthetic perception would be generated by motor imagery during co-vibration of the two antagonistic muscles at the same frequency. Healthy subjects participated in this experiment. Illusory movement was evoked by tendon vibration. Next, the subjects imaged wrist flexion movement simultaneously with tendon vibration. Wrist flexor and extensor muscles were vibrated according to 4 patterns such that the difference between the two vibration frequencies was zero. After each trial, the perceived movement sensations were quantified on the basis of the velocity and direction of the ipsilateral hand-tracking movements. When the difference in frequency applied to the wrist flexor and the extensor was 0Hz, no subjects perceived movements without motor imagery. However, during motor imagery, the flexion velocity of the perceived movement was higher than the flexion velocity without motor imagery. This study clarified that the afferent inputs from the muscle spindle interact with motor imagery, to evoke a kinesthetic perception, even when the difference in frequency applied to the wrist flexor and extensor was 0Hz. Furthermore, the kinesthetic perception resulting from integrations of vibration and motor imagery increased depending on the vibration frequency to the two antagonistic muscles. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. ASSOCIATION OF KNEE PAIN WITH A REDUCTION IN THIGH MUSCLE STRENGTH – A CROSS-SECTIONAL ANALYSIS INCLUDING 4553 OSTEOARTHRITIS INITIATIVE PARTICIPANTS

    Science.gov (United States)

    Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

    2016-01-01

    Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675

  10. Evidence for repetitive load in the trapezius muscle during a tapping task.

    Science.gov (United States)

    Tomatis, L; Müller, C; Nakaseko, M; Läubli, T

    2012-08-01

    Many studies describe the trapezius muscle activation pattern during repetitive key-tapping focusing on continuous activation. The objectives of this study were to determine whether the upper trapezius is phasically active during supported key tapping, whether this activity is cross-correlated with forearm muscle activity, and whether trapezius activity depends on key characteristic. Thirteen subjects (29.7 ± 11.4 years) were tested. Surface EMG of the finger's extensor and flexor and of the trapezius muscles, as well as the key on-off signal was recorded while the subject performed a 2-min session of key tapping at 4 Hz. The linear envelopes obtained were cut into single tapping cycles extending from one onset to the next onset signal and subsequently time-normalized. Effect size between mean range and maximal standard deviation was calculated to determine as to whether a burst of trapezius muscle activation was present. Cross-correlation was used to determine the time-lag of the activity bursts between forearm and trapezius muscles. For each person the mean and standard deviation of the cross-correlations coefficient between forearm muscles and trapezius were determined. Results showed a burst of activation in the trapezius muscle during most of the tapping cycles. The calculated effect size was ≥0.5 in 67% of the cases. Cross-correlation factors between forearm and trapezius muscle activity were between 0.75 and 0.98 for both extensor and flexor muscles. The cross-correlated phasic trapezius activity did not depend on key characteristics. Trapezius muscle was dynamically active during key tapping; its activity was clearly correlated with forearm muscles' activity.

  11. The influence of foot position on stretching of the plantar fascia.

    Science.gov (United States)

    Flanigan, Ryan M; Nawoczenski, Deborah A; Chen, Linlin; Wu, Hulin; DiGiovanni, Benedict F

    2007-07-01

    A recent study found nonweightbearing stretching exercises specific to the plantar fascia to be superior to the standard program of weightbearing Achilles tendon-stretching exercises in patients with chronic plantar fasciitis. The present study used a cadaver model to demonstrate the influence of foot and ankle position on stretching of the plantar fascia. Twelve fresh-frozen lower-leg specimens were tested in 15 different configurations representing various combinations of ankle and metatarsophalangeal (MTP) joint dorsiflexion, midtarsal transverse plane abduction and adduction, and forefoot varus and valgus. Measurements were recorded by a differential variable reluctance transducer (DVRT) implanted into the medial band of the plantar fascia, and primary measurement was a percent deformation of the plantar fascia (stretch) with respect to a reference position (90 degrees ankle dorsiflexion, 0 degrees midtarsal and forefoot orientation, and 0 degrees MTP dorsiflexion). Ankle and MTP joint dorsiflexion produced a significant increase (14.91%) in stretch compared to the position of either ankle dorsiflexion alone (9.31% increase, p plantar fascia tissue-specific stretching exercises and lends support to the use of ankle and MTP joint dorsiflexion when employing stretching protocols for nonoperative treatment in patients with chronic proximal plantar fasciitis.

  12. Longitudinal Evaluation of Muscle Composition Using Magnetic Resonance in 4 Boys With Duchenne Muscular Dystrophy: Case Series.

    Science.gov (United States)

    Senesac, Claudia R; Lott, Donovan J; Forbes, Sean C; Mathur, Sunita; Arpan, Ishu; Senesac, Emily S; Walter, Glenn A; Vandenborne, Krista

    2015-07-01

    Duchenne muscular dystrophy (DMD), an inherited recessive X chromosome-linked disease, is the most severe childhood form of muscular dystrophy. Boys with DMD experience muscle loss, with infiltration of intramuscular fat into muscles. This case series describes the progression of DMD in boys using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). Magnetic resonance results are then compared with an established functional timed test. Four boys with DMD and 4 healthy age-matched controls were chosen from a larger cohort. Boys with DMD were assessed at 4 time points over 2 years, with controls assessed at baseline only. Progression of the disease was documented by assessing the plantar flexors using MRI and MRS techniques and by assessing ambulation using the 30-Foot Fast Walk Test. Transverse relaxation time (T2) values were elevated in all boys with DMD at baseline. The lipid ratio increased rapidly as the disease progressed in 2 boys. Discrete changes in T2 in the other 2 boys with DMD indicated a slower disease progression. Magnetic resonance imaging and MRS allowed monitoring of the disease over all time periods regardless of ambulation status. The magnetic resonance data were collected with 2 different magnets at 2 different field strengths (1.5 and 3.0 T). Although we corrected for this difference, care must be taken in interpreting data when different image collection systems are used. This was a case series of 4 boys with DMD taken from a larger cohort study. Magnetic resonance imaging and MRS are objective, noninvasive techniques for measuring muscle pathology and can be used to detect discrete changes in both people who are ambulatory and those who are nonambulatory. These techniques should be considered when monitoring DMD progression and assessing efficacy of therapeutic interventions. © 2015 American Physical Therapy Association.

  13. Is There a Role for MRI in Plantar Heel Pain.

    Science.gov (United States)

    Fazal, Muhammad Ali; Tsekes, Demetris; Baloch, Irshad

    2018-06-01

    There is an increasing trend to investigate plantar heel pain with magnetic resonance imaging (MRI) scan though plantar fasciitis is the most common cause. The purpose of our study was to evaluate the role of MRI in patients presenting with plantar heel pain. Case notes and MRI scans of 141 patients with a clinical diagnosis of plantar fasciitis were reviewed retrospectively. There were 98 females and 43 males patients. Fourteen patients had bilateral symptoms. Average age for male patients was 51 years (range = 26-78 years), and for female patients the average age was 52 years (range = 29-76 years). A total of 121 feet had MRI features suggestive of plantar fasciitis. MRI was normal in 32 feet. There was one case of stress fracture of calcaneus and another of a heel fibroma diagnosed on MRI scan. In our study, MRI scan was normal in 20.7% of the cases; 1.3% had a diagnosis other than plantar fasciitis but no sinister pathology. We therefore conclude that MRI scan is not routinely indicated and key is careful clinical assessment. Therapeutic, Level IV: Retrospective, Case series.

  14. Selective recruitment of single motor units in human flexor digitorum superficialis muscle during flexion of individual fingers.

    Science.gov (United States)

    Butler, T J; Kilbreath, S L; Gorman, R B; Gandevia, S C

    2005-08-15

    Flexor digitorum superficialis (FDS) is an extrinsic multi-tendoned muscle which flexes the proximal interphalangeal joints of the four fingers. It comprises four digital components, each with a tendon that inserts onto its corresponding finger. To determine the degree to which these digital components can be selectively recruited by volition, we recorded the activity of a single motor unit in one component via an intramuscular electrode while the subject isometrically flexed each of the remaining fingers, one at a time. The finger on which the unit principally acted was defined as the 'test finger' and that which flexed isometrically was the 'active' finger. Activity in 79 units was recorded. Isometric finger flexion forces of 50% maximum voluntary contraction (MVC) activated less than 50% of single units in components of FDS acting on fingers that were not voluntarily flexed. With two exceptions, the median recruitment threshold for all active-test finger combinations involving the index, middle, ring and little finger test units was between 49 and 60% MVC (60% MVC being the value assigned to those not recruited). The exceptions were flexion of the little finger while recording from ring finger units (median: 40% MVC), and vice versa (median: 2% MVC). For all active-test finger combinations, only 35/181 units were activated when the active finger flexed at less than 20% MVC, and the fingers were adjacent for 28 of these. Functionally, to recruit FDS units during grasping and lifting, relatively heavy objects were required, although systematic variation occurred with the width of the object. In conclusion, FDS components can be selectively activated by volition and this may be especially important for grasping at high forces with one or more fingers.

  15. Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes

    Directory of Open Access Journals (Sweden)

    Siqueira Cássio Marinho

    2002-01-01

    Full Text Available Participation in intensive sports activities leads to muscular specializations that may generate alterations in involved articular forces and cause static (posture and dynamic changes (alterations of articular stability, coordination, etc.. Prevention of injury requires specific functional muscular evaluation in all athletes and for any kind of sport. OBJECTIVE: To dynamically evaluate, through isokinetic tests, the peak torque, total work, and average power of the knee flexor and extensor muscles of jumper and runner athletes and compare them to those of a non-athletic population, evaluating dominance and balance between agonistic and antagonistic muscle groups. RESULTS: In the non-athlete group, we noted a higher asymmetry between the dominant and nondominant members. The jumpers had the highest values of the evaluated parameters of all groups, whereas parameters for the runners were intermediate between non-athletes and jumpers.

  16. Effects of a Nintendo Wii exercise program on spasticity and static standing balance in spastic cerebral palsy.

    Science.gov (United States)

    Gatica-Rojas, Valeska; Cartes-Velásquez, Ricardo; Méndez-Rebolledo, Guillermo; Guzman-Muñoz, Eduardo; Lizama, L Eduardo Cofré

    2017-08-01

    This study sought to evaluate the effects of a Nintendo Wii Balance Board (NWBB) intervention on ankle spasticity and static standing balance in young people with spastic cerebral palsy (SCP). Ten children and adolescents (aged 72-204 months) with SCP participated in an exercise program with NWBB. The intervention lasted 6 weeks, 3 sessions per week, 25 minutes for each session. Ankle spasticity was assessed using the Modified Modified Ashworth Scale (MMAS), and static standing balance was quantified using posturographic measures (center-of-pressure [CoP] measures). Pre- and post-intervention measures were compared. Significant decreases of spasticity in the ankle plantar flexor muscles (p balance in young people with SCP.

  17. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad Ali; Nakhaee, Masoomeh; Mousavi, Mohammad Ebrahim; Shakourirad, Ali; Safari, Mohammad Reza; Vahab Kashani, Reza

    2014-08-01

    Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. Lower limb strength in professional soccer players: profile, asymmetry, and training age.

    Science.gov (United States)

    Fousekis, Konstantinos; Tsepis, Elias; Vagenas, George

    2010-01-01

    Kicking and cutting skills in soccer are clearly unilateral, require asymmetrical motor patterns and lead to the development of asymmetrical adaptations in the musculoskeletal function of the lower limbs. Assuming that these adaptations constitute a chronicity-dependent process, this study examined the effects of professional training age (PTA) on the composite strength profile of the knee and ankle joint in soccer players. One hundred soccer players (n=100) with short (5-7 years), intermediate (8-10 years) and long (>11 years) PTA were tested bilaterally for isokinetic concentric and eccentric strength of the knee and ankle muscles. Knee flexion-extension was tested concentrically at 60°, 180° and 300 °/sec and eccentrically at 60° and 180 °/sec. Ankle dorsal and plantar flexions were tested at 60 °/sec for both the concentric and eccentric mode of action. Bilaterally averaged muscle strength [(R+L)/2] increased significantly from short training age to intermediate and stabilized afterwards. These strength adaptations were mainly observed at the concentric function of knee extensors at 60°/sec (p = 0. 023), knee flexors at 60°/sec (p = 0.042) and 180°/sec (p = 0.036), and ankle plantar flexors at 60o/sec (p = 0.044). A linear trend of increase in isokinetic strength with PTA level was observed for the eccentric strength of knee flexors at 60°/sec (p = 0.02) and 180°/sec (p = 0.03). Directional (R/L) asymmetries decreased with PTA, with this being mainly expressed in the concentric function of knee flexors at 180°/sec (p = 0.04) and at 300 °/sec (p = 0.03). These findings confirm the hypothesis of asymmetry in the strength adaptations that take place at the knee and ankle joint of soccer players mainly along with short and intermediate PTA. Players with a longer PTA seem to adopt a more balanced use of their lower extremities to cope with previously developed musculoskeletal asymmetries and possibly reduce injury risk. This has certain implications

  19. Contribution of denervated muscle to contractures after neonatal brachial plexus injury: not just muscle fibrosis.

    Science.gov (United States)

    Nikolaou, Sia; Liangjun, Hu; Tuttle, Lori J; Weekley, Holly; Christopher, Wylie; Lieber, Richard L; Cornwall, Roger

    2014-03-01

    We investigated the contribution of muscle fibrosis to elbow flexion contractures in a murine model of neonatal brachial plexus injury (NBPI). Four weeks after NBPI, biceps and brachialis fibrosis were assessed histologically and compared with the timing of contracture development and the relative contribution of each muscle to contractures. Modulus of elasticity and hydroxyproline (collagen) content were measured and correlated with contracture severity. The effect of halofuginone antifibrotic therapy on fibrosis and contractures was investigated. Elbow contractures preceded muscle fibrosis development. The brachialis was less fibrotic than the biceps, yet contributed more to contractures. Modulus and hydroxyproline content increased in both elbow flexors, but neither correlated with contracture severity. Halofuginone reduced biceps fibrosis but did not reduce contracture severity. Contractures after NBPI cannot be explained solely by muscle fibrosis, arguing for investigation of alternate pathophysiologic targets for contracture prevention and treatment. Copyright © 2013 Wiley Periodicals, Inc.

  20. TARGETED RADIOFREQUENCY THERAPY FOR TRAINING INDUCED MUSCLE FATIGUE EFFECTIVE OR NOT

    Directory of Open Access Journals (Sweden)

    Ondrej Prouza

    2016-12-01

    Full Text Available Background: Training induced muscle fatigue (hereinafter also referred as TIMF is leading to unwanted consequences among sportsmen and actively sporting people such as decreased muscle strength and additional painful discomfort and mobility issues. The knowledge about the mechanisms of influencing the fatigue induced processes in muscle tissue is not comprehensive. The conventional manual techniques, cold patches and conventional physiotherapy have some effect in improving these conditions, however, finding effective methods to influence these consequences appears beneficial in sports medicine. Such method could be Radiofrequency therapy up to 0.5 MHz, known as Targeted Radiofrequency Therapy (hereinafter also referred as TR-Therapy. Aim of this self-controlled study is to evaluate the effect of the TR-Therapy for over-exertion management including the effect on decreased muscle strength, limited range of motion and possible painful discomfort. Materials: 7 healthy and actively sporting participants underwent through 2 stages (Active stage – including overexertion of the forearm flexors and subsequent TR-Therapy session; and Control stage - including overexertion of the forearm flexors and subsequent resting period. Data for muscle strength in kg, active Range of Motion (ROM in (º and Pain and discomfort perception by 10 point Visual Analog Scale (VAS were obtained and evaluated. Results: 31% increase in the muscle strength during the active stage was observed and respectively 12% during the control stage, with level of significance p0.05. Conclusions: The results of this study suggest TR-Therapy as effective solution for muscle strength restoration after TIMF.

  1. The effects of denervation, reinnervation, and muscle imbalance on functional muscle length and elbow flexion contracture following neonatal brachial plexus injury.

    Science.gov (United States)

    Weekley, Holly; Nikolaou, Sia; Hu, Liangjun; Eismann, Emily; Wylie, Christopher; Cornwall, Roger

    2012-08-01

    The pathophysiology of paradoxical elbow flexion contractures following neonatal brachial plexus injury (NBPI) is incompletely understood. The current study tests the hypothesis that this contracture occurs by denervation-induced impairment of elbow flexor muscle growth. Unilateral forelimb paralysis was created in mice in four neonatal (5-day-old) BPI groups (C5-6 excision, C5-6 neurotomy, C5-6 neurotomy/repair, and C5-T1 global excision), one non-neonatal BPI group (28-day-old C5-6 excision), and two neonatal muscle imbalance groups (triceps tenotomy ± C5-6 excision). Four weeks post-operatively, motor function, elbow range of motion, and biceps/brachialis functional lengths were assessed. Musculocutaneous nerve (MCN) denervation and reinnervation were assessed immunohistochemically. Elbow flexion motor recovery and elbow flexion contractures varied inversely among the neonatal BPI groups. Contracture severity correlated with biceps/brachialis shortening and MCN denervation (relative axon loss), with no contractures occurring in mice with MCN reinnervation (presence of growth cones). No contractures or biceps/brachialis shortening occurred following non-neonatal BPI, regardless of denervation or reinnervation. Neonatal triceps tenotomy did not cause contractures or biceps/brachialis shortening, nor did it worsen those following neonatal C5-6 excision. Denervation-induced functional shortening of elbow flexor muscles leads to variable elbow flexion contractures depending on the degree, permanence, and timing of denervation, independent of muscle imbalance. Copyright © 2012 Orthopaedic Research Society.

  2. Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Smits-Engelsman Bouwien CM

    2008-10-01

    Full Text Available Abstract Background Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle strength or endurance in patients with non-specific neck pain, which can be used in daily practice. Methods A computerised literature search was performed in the Medline, CINAHL and Embase databases from 1980 to January 2007. Two reviewers independently assessed the clinimetric properties of identified measurement methods, using a checklist of generally accepted criteria for reproducibility (inter- and intra-observer reliability and agreement, construct validity, responsiveness and feasibility. Results The search identified a total of 16 studies. The instruments or tests included were: muscle endurance tests for short neck flexors, craniocervical flexion test with an inflatable pressure biofeedback unit, manual muscle testing of neck musculature, dynamometry and functional lifting tests (the cervical progressive iso-inertial lifting evaluation (PILE test and the timed weighted overhead test. All the articles included report information on the reproducibility of the tests. Acceptable intra- and inter-observer reliability was demonstrated for t enduranctest for short neck flexors and the cervical PILE test. Construct validity and responsiveness have hardly been documented for tests on muscle functioning. Conclusion The endurance test of the short neck flexors and the cervical PILE test can be regarded as appropriate instruments for measuring different aspects of neck muscle function in patients with non-specific neck pain. Common methodological flaws in the studies were their small sample size and an inappropriate description of the study design.

  3. The role of propriospinal neuronal network in transmitting the alternating muscular activities of flexor and extensor in parkinsonian tremor.

    Science.gov (United States)

    Hao, M; He, X; Lan, N

    2012-01-01

    It has been shown that normal cyclic movement of human arm and resting limb tremor in Parkinson's disease (PD) are associated with the oscillatory neuronal activities in different cerebral networks, which are transmitted to the antagonistic muscles via the same spinal pathway. There are mono-synaptic and multi-synaptic corticospinal pathways for conveying motor commands. This study investigates the plausible role of propriospinal neuronal (PN) network in the C3-C4 levels in multi-synaptic transmission of cortical commands for oscillatory movements. A PN network model is constructed based on known neurophysiological connections, and is hypothesized to achieve the conversion of cortical oscillations into alternating antagonistic muscle bursts. Simulations performed with a virtual arm (VA) model indicate that without the PN network, the alternating bursts of antagonistic muscle EMG could not be reliably generated, whereas with the PN network, the alternating pattern of bursts were naturally displayed in the three pairs of antagonist muscles. Thus, it is suggested that oscillations in the primary motor cortex (M1) of single and double tremor frequencies are processed at the PN network to compute the alternating burst pattern in the flexor and extensor muscles.

  4. ALTERATION OF MUSCLE FUNCTION AFTER ELECTRICAL STIMULATION BOUT OF KNEE EXTENSORS AND FLEXORS

    Directory of Open Access Journals (Sweden)

    Marc Vanderthommen

    2012-12-01

    Full Text Available The purpose was to study the effects on muscle function of an electrical stimulation bout applied unilaterally on thigh muscles in healthy male volunteers. One group (ES group, n = 10 received consecutively 100 isometric contractions of quadriceps and 100 isometric contractions of hamstrings (on-off ratio 6-6 s induced by neuromuscular electrical stimulations (NMES. Changes in muscle torque, muscle soreness (0-10 VAS, muscle stiffness and serum creatine kinase (CK activity were assessed before the NMES exercise (pre-ex as well as 24h (d+1, 48h (d+2 and 120h (d+5 after the bout. A second group (control group, n = 10 were submitted to the same test battery than the ES group and with the same time-frame. The between-group comparison indicated a significant increase in VAS scores and in serum levels of CK only in the ES group. In the ES group, changes were more pronounced in hamstrings than in quadriceps and peaked at d+2 (quadriceps VAS scores = 2.20 ± 1.55 a.u. (0 at pre-ex; hamstrings VAS scores = 3.15 ± 2.14 a.u. (0 at pre-ex; hip flexion angle = 62 ± 5° (75 ± 6° at pre-ex; CK activity = 3021 ± 2693 IU·l-1 (136 ± 50 IU·l-1 at pre-ex. The results of the present study suggested the occurrence of muscle damage that could have been induced by the peculiar muscle recruitment in NMES and the resulting overrated mechanical stress. The sensitivity to the damaging effects of NMES appeared higher in the hamstrings than in quadriceps muscles

  5. Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults.

    Science.gov (United States)

    Correa, Cleiton S; Cunha, Giovani; Marques, Nise; Oliveira-Reischak, Ãlvaro; Pinto, Ronei

    2016-07-01

    Previous studies presented different results regarding the maintenance time of muscular adaptations after strength training and the ability to resume the gains on muscular performance after resumption of the training programme. This study aimed to verify the effect of strength training on knee extensors and elbow flexor muscle strength, rectus femoris muscle volume and functional performance in older female adults after 12 weeks of strength training, 1 year of detraining and followed by 12 weeks of retraining. Twelve sedentary older women performed 12 weeks of strength training, 1 year of detraining and 12 weeks of retraining. The strength training was performed twice a week, and the assessment was made four times: at the baseline, after the strength training, after the detraining and after the retraining. The knee extensor and elbow flexor strength, rectus femoris muscle volume and functional task were assessed. Strength of knee extensor and elbow flexor muscles, rectus femoris muscle volume and 30-s sit-to-stand increased from baseline to post-training (respectively, 40%, 70%, 38% and 46%), decreased after detraining (respectively, -36%, -64%, -35% and -43%) and increased again these parameters after retraining (35%, 68%, 36% and 42%). Strength training induces gains on strength and hypertrophy, also increased the performance on functional tasks after the strength training. The stoppage of the strength caused strength loss and reduction of functional performance. The resumption of the strength training promoted the same gains of muscular performance in older female adults. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  6. Increasing preferred step rate during running reduces plantar pressures.

    Science.gov (United States)

    Gerrard, James M; Bonanno, Daniel R

    2018-01-01

    Increasing preferred step rate during running is a commonly used strategy in the management of running-related injuries. This study investigated the effect of different step rates on plantar pressures during running. Thirty-two healthy runners ran at a comfortable speed on a treadmill at five step rates (preferred, ±5%, and ±10%). For each step rate, plantar pressure data were collected using the pedar-X in-shoe system. Compared to running with a preferred step rate, a 10% increase in step rate significantly reduced peak pressure (144.5±46.5 vs 129.3±51 kPa; P=.033) and maximum force (382.3±157.6 vs 334.0±159.8 N; P=.021) at the rearfoot, and reduced maximum force (426.4±130.4 vs 400.0±116.6 N; P=.001) at the midfoot. In contrast, a 10% decrease in step rate significantly increased peak pressure (144.5±46.5 vs 161.5±49.3 kPa; P=.011) and maximum force (382.3±157.6 vs 425.4±155.3 N; P=.032) at the rearfoot. Changing step rate by 5% provided no effect on plantar pressures, and no differences in plantar pressures were observed at the medial forefoot, lateral forefoot or hallux between the step rates. This study's findings indicate that increasing preferred step rate by 10% during running will reduce plantar pressures at the rearfoot and midfoot, while decreasing step rate by 10% will increase plantar pressures at the rearfoot. However, changing preferred step rate by 5% will provide no effect on plantar pressures, and forefoot pressures are unaffected by changes in step rate. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Depression, Anxiety, and Stress in People With and Without Plantar Heel Pain.

    Science.gov (United States)

    Cotchett, Matthew; Munteanu, Shannon E; Landorf, Karl B

    2016-08-01

    Depression, anxiety, and stress are prevalent in patients with musculoskeletal pain, but the impact of these emotional states has not been evaluated in people with plantar heel pain. The aim of this study was to evaluate the association between depression, anxiety, and stress with plantar heel pain. Forty-five participants with plantar heel pain were matched by sex and age (±2 years) to 45 participants without plantar heel pain. Levels of depression, anxiety, and stress were measured using the Depression, Anxiety and Stress Scale (short version) in participants with and without plantar heel pain. Logistic regression was conducted to determine if levels of depression, anxiety, or stress were associated with having plantar heel pain. Univariate analysis indicated that participants with plantar heel pain had greater levels of depression (mean difference = 4.4, 95% CI 2.3 to 6.5), anxiety (mean difference = 2.6, 95% CI 0.9 to 4.3), and stress (mean difference = 4.8, 95% CI 1.9 to 7.8). After adjusting for age, sex, BMI, and education, for every 1 unit increase in depression, anxiety, or stress (in the DASS subscales), the odds ratios for having plantar heel pain were increased by 1.3 (95% CI 1.1 to 1.6), 1.3 (95% CI 1.1 to 1.5), and 1.2 (95% CI 1.1 to 1.3), respectively. Symptoms of depression, anxiety, and stress were independently associated with plantar heel pain. Larger prospective studies are necessary to evaluate the temporal association between these emotional states and plantar heel pain. Level III, cross sectional, observational. © The Author(s) 2016.

  8. Reproducibility of sonographic measurement of thickness and echogenicity of the plantar fascia.

    Science.gov (United States)

    Cheng, Ju-Wen; Tsai, Wen-Chung; Yu, Tung-Yang; Huang, Kuo-Yao

    2012-01-01

    To evaluate the intra- and interrater reliability of ultrasonographic measurements of the thickness and echogenicity of the plantar fascia. Eleven patients (20 feet), who complained of inferior heel pain, and 26 volunteers (52 feet) were enrolled. Two sonographers independently imaged the plantar fascia in both longitudinal and transverse planes. Volunteers were assessed twice to evaluate intrarater reliability. Quantitative evaluation of the echogenicity of the plantar fascia was performed by measuring the mean gray level of the region of interest using Digital Imaging and Communications in Medicine viewer software. Sonographic evaluation of the thickness of the plantar fascia showed high reliability. Sonographic evaluations of the presence or absence of hypoechoic change in the plantar fascia showed surprisingly low agreement. The reliability of gray-scale evaluations appears to be much better than subjective judgments in the evaluation of echogenicity. Transverse scanning did not show any advantage in sonographic evaluation of the plantar fascia. The reliability of sonographic examination of the thickness of the plantar fascia is high. Mean gray-level analysis of quantitative sonography can be used for the evaluation of echogenicity, which could reduce discrepancies in the interpretation of echogenicity by different sonographers. Longitudinal instead of transverse scanning is recommended for imaging the plantar fascia. Copyright © 2011 Wiley Periodicals, Inc.

  9. Age-related decreases in motor unit discharge rate and force control during isometric plantar flexion

    DEFF Research Database (Denmark)

    Kallio, J; Søgaard, Karen; Avela, J

    2012-01-01

    Aging is related to multiple changes in muscle physiology and function. Previous findings concerning the effects of aging on motor unit discharge rate (DR) and fluctuations in DR and force are somewhat contradictory. Eight YOUNG and nine OLD physically active males performed isometric ramp (RECR......) and isotonic (ISO) plantar flexions at 10 and 20% of surface EMG at MVC. Motor unit (MU) action potentials were recorded with intramuscular fine-wire electrodes and decomposed with custom build software "Daisy". DR was lower in OLD in RECR-10% (17.9%, p...

  10. [Experimental research of gaits based on young plantar pressure test].

    Science.gov (United States)

    Meng, Qingyun; Tan, Shili; Yu, Hongliu; Shen, Lixing; Zhuang, Jianhai; Wang, Jinwu

    2014-10-01

    The present paper is to study the center line of the plantar pressure of normal young people, and to find the relation between center line of the plantar pressure and gait stability and balance. The paper gives the testing principle and calculating methods for geometric center of plantar pressure distribution and the center of pressure due to the techniques of footprint frame. The calculating formulas in both x direction and y direction are also deduced in the paper. In the experiments carried out in our laboratory, the gait parameters of 131 young subjects walking as usual speed were acquired, and 14 young subjects of the total were specially analyzed. We then provided reference data for the walking gait database of young people, including time parameters, space parameters and plantar pressure parameters. We also obtained the line of geometry center and pressure center under the foot. We found that the differences existed in normal people's geometric center line and the pressure center line. The center of pressure trajectory revealed foot movement stability. The length and lateral changes of the center line of the plantar pressure could be applied to analysis of the plantar pressure of all kinds of people. The results in this paper are useful in clinical foot disease diagnosis and evaluation of surgical effect.

  11. Can foot anthropometric measurements predict dynamic plantar surface contact area?

    Directory of Open Access Journals (Sweden)

    Collins Natalie

    2009-10-01

    Full Text Available Abstract Background Previous studies have suggested that increased plantar surface area, associated with pes planus, is a risk factor for the development of lower extremity overuse injuries. The intent of this study was to determine if a single or combination of foot anthropometric measures could be used to predict plantar surface area. Methods Six foot measurements were collected on 155 subjects (97 females, 58 males, mean age 24.5 ± 3.5 years. The measurements as well as one ratio were entered into a stepwise regression analysis to determine the optimal set of measurements associated with total plantar contact area either including or excluding the toe region. The predicted values were used to calculate plantar surface area and were compared to the actual values obtained dynamically using a pressure sensor platform. Results A three variable model was found to describe the relationship between the foot measures/ratio and total plantar contact area (R2 = 0.77, p R2 = 0.76, p Conclusion The results of this study indicate that the clinician can use a combination of simple, reliable, and time efficient foot anthropometric measurements to explain over 75% of the plantar surface contact area, either including or excluding the toe region.

  12. Femoral Neck Strain during Maximal Contraction of Isolated Hip-Spanning Muscle Groups

    Directory of Open Access Journals (Sweden)

    Saulo Martelli

    2017-01-01

    Full Text Available The aim of the study was to investigate femoral neck strain during maximal isometric contraction of the hip-spanning muscles. The musculoskeletal and the femur finite-element models from an elderly white woman were taken from earlier studies. The hip-spanning muscles were grouped by function in six hip-spanning muscle groups. The peak hip and knee moments in the model were matched to corresponding published measurements of the hip and knee moments during maximal isometric exercises about the hip and the knee in elderly participants. The femoral neck strain was calculated using full activation of the agonist muscles at fourteen physiological joint angles. The 5%±0.8% of the femoral neck volume exceeded the 90th percentile of the strain distribution across the 84 studied scenarios. Hip extensors, flexors, and abductors generated the highest tension in the proximal neck (2727 με, tension (986 με and compression (−2818 με in the anterior and posterior neck, and compression (−2069 με in the distal neck, respectively. Hip extensors and flexors generated the highest neck strain per unit of joint moment (63–67 με·m·N−1 at extreme hip angles. Therefore, femoral neck strain is heterogeneous and muscle contraction and posture dependent.

  13. Muscle area of knee O.A

    International Nuclear Information System (INIS)

    Suzuki, Nobuharu; Onozawa, Toshihiro; Shibata, Minoru; Yamasita, Izumi; Kitsunai, Isamu; Asano, Akira

    1983-01-01

    The cross sectional area of the thigh muscles were studied by means of C.T. scan. Twelve normal knees, twelve primary knee O.A. knees, and six R.A. knees were examined. The cross sectional area of the Quadriceps femoris decreased significantly in the patient of the knee O.A. although flexors did not decrease. We discussed the etiology of the knee O.A. from this result. (author)

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

    Science.gov (United States)

    Schomacher, Jochen; Falla, Deborah

    2013-10-01

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

  15. The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

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    Jung, Hyun Jin; Lee, Sheen Woo; Jeong, Yu Mi; Choi, Hye Young; Kim, Hyung Sik [Dept. of Radiology, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of); Park, Hong Gi; Kwak, Ji Hoon [Dept. of Orthopedic Surgery, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of)

    2012-02-15

    The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation. Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings. There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions. MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

  16. The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

    International Nuclear Information System (INIS)

    Jung, Hyun Jin; Lee, Sheen Woo; Jeong, Yu Mi; Choi, Hye Young; Kim, Hyung Sik; Park, Hong Gi; Kwak, Ji Hoon

    2012-01-01

    The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation. Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings. There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions. MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

  17. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    Science.gov (United States)

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  18. A muscle-driven approach to restore stepping with an exoskeleton for individuals with paraplegia.

    Science.gov (United States)

    Chang, Sarah R; Nandor, Mark J; Li, Lu; Kobetic, Rudi; Foglyano, Kevin M; Schnellenberger, John R; Audu, Musa L; Pinault, Gilles; Quinn, Roger D; Triolo, Ronald J

    2017-05-30

    -driven exoskeleton was a feasible intervention to restore stepping in individuals with paraplegia due to SCI. The untethered hybrid system was capable of adjusting to different individuals' needs to appropriately coordinate exoskeletal constraints with muscle activation using a sensor-driven FSM for stepping. Further improvements for out-of-the-laboratory use should include implantation of plantar flexor muscles to improve walking speed and power assist as needed at the hips and knees to maintain walking as muscles fatigue.

  19. How plantar exteroceptive efficiency modulates postural and oculomotor control: inter-individual variability

    Directory of Open Access Journals (Sweden)

    Arnaud eFoisy

    2016-05-01

    Full Text Available In a previous experiment, we showed that among young and healthy subjects, thin plantar inserts improve postural control and modify vergence amplitudes. In this experiment, however, significant inter-individual variability was observed. We hypothesize that its origin could be attributed to a different reliance upon feet cutaneous afferents. In order to test this hypothesis, we re-analyzed the data relative to 31 young (age 25,7±3,8 and healthy subjects who participated in the first experiment after having classified them into two groups depending on their Plantar Quotient (PQ = Surface area of CoP foam / Surface area of CoP firm ground x100. Foam decreases the information arising from the feet, normally resulting in a PQ>100. Hence, the PQ provides information on the weight of plantar cutaneous afferents used in postural control. Twelve people were Plantar-Independent Subjects, as indicated by a PQ<100. These individuals did not behave like the Normal Plantar Quotient Subjects: they were almost insensitive to the plantar stimulations in terms of postural control and totally insensitive in terms of oculomotor control. We conclude that the inter-individual variability observed in our first experiment is explained by the subjects’ degree of plantar reliance. We propose that plantar independence is a dysfunctional situation revealing an inefficiency in plantar cutaneous afferents. The