Function Of Muscle Groups Research Articles

Rehabilitation Training Combined with Jiaji Electroacupuncture Can Promote the Recovery of Muscle Group Function and Improve the Quality of Life in Patients with Upper Limb Peripheral Nerve Injury.

This study was designed to probe into the improvement of rehabilitation training combined with Jiaji electroacupuncture intervention on patients with upper limb peripheral nerve injury. A total of 114 patients with peripheral nerve injury of upper limbs in our hospital from August 2017 to November 2019 were collected as the research participants. Among them, 59 in the control group (CG) received rehabilitation training alone, while 65 in the observation group (OG) received rehabilitation training combined with Jiaji electroacupuncture intervention. The therapeutic efficacy, Barthel index, and Fugl–Meyer assessment score, motor nerve conduction velocity, sensory nerve conduction velocity and amplitude, and quality of life (score SF-36) were compared between the two groups before and after treatment. The total effective rate of the OG was markedly higher than that of the CG. After treatment, the Barthel index, Fugl–Meyer assessment score, motor nerve conduction velocity, and sensory nerve conduction velocity and amplitude of the OG were obviously higher than those of the CG, and the SF-36 scores of the OG were higher than those of the CG in 8 dimensions. Rehabilitation training combined with Jiaji electroacupuncture intervention can dramatically promote the recovery of muscle group function and improve the quality of life of patients with upper limb peripheral nerve injury.

S2034 Wrong Tube: A Mysterious Case of Dysphagia in a Patient with Tracheostomy

Introduction: Dysphagia simply means difficulty swallowing. It occurs in 11% to 93% of patients following tracheostomy and is therefore one of the most common side effects seen after the procedure [1]. We present a case of dysphagia following tracheostomy with unusual endoscopic findings. Case Description/Methods: An 83-year-old male with a past medical history of laryngeal cancer treated with partial laryngectomy followed by complete laryngectomy and permanent tracheostomy. Complete laryngectomy and tracheostomy were performed 15 years prior to his presentation. He presented with a chief complaint of dysphagia. Patient had dysphagia to both solids and liquids associated with weight loss for 6 months’ duration. Patient was in no acute distress. A diagnostic upper endoscopy was done which showed a trachea-esophageal fistula through which the tracheostomy tube was seen penetrating the esophageal wall. Patient was subsequently referred to ENT for possible removal of tracheostomy and consideration of esophageal stenting in an attempt to heal the trachea-esophageal fistula. Discussion: Some of the proposed hypotheses for dysphagia after tracheostomy include loss of hypomandibular muscle group function and a delayed trigger in the swallowing response [1-2]. More commonly it is seen with esophageal compression which can sometimes cause excessive pressure on the posterior wall of the esophagus leading to tracheoesophageal fistula as well [3]. In our case, the tracheostomy tube was seen penetrating the wall of the esophagus. We propose this likely occurred due to excessive pressure by the tracheostomy tube eventually causing necrosis, tissue breakdown and fistula formation through which the tube slowly migrated into the esophagus, presenting with symptoms of dysphagia. Fortunately the patient was stable from a respiratory perspective with adequate gas exchange thought to be secondary to the fenestrated tracheostomy which allowed for air ventilation despite misplaced position. To our knowledge this is one of the first reported cases of such a complication which makes this a unique case. It gives us ground for early endoscopy to rule out any structural defects similar to this in a patient with a tracheostomy presenting with dysphagia.Figure 1.: Tracheostomy penetrating esophageal wall visualized during endoscopy.

Effect of rehabilitation robot rehabilitation training synchronizing acupuncture exercise therapy on postoperative rehabilitation with hip fracture

To compare the therapeutic effect between rehabilitation robot rehabilitation training synchronizing acupuncture exercise therapy and simple acupuncture exercise therapy on lower limb function and life activity ability for postoperative patients with hip fracture. A total of 50 elderly postoperative patients with hip fracture were randomly divided into an observation group and a control group, 25 cases in each group. Both groups were treated with acupuncture at hip three points of the affected side and lateral line 1 of vertex, anterior oblique parietotemporal line of the healthy side, hip three needles were retained for 30 min. The scalp acupuncture needles were continue retained, the observation group was given acupuncture exercise therapy to synchronize lower limb rehabilitation robot rehabilitation training, and the control group was given acupuncture exercise therapy. The two groups were treated once a day, 7 times as a course of treatment, and totally 4 courses were required. The Harris score, Barthel index score and quadriceps femoris isokinetic muscle strength indexes [peak torque (PT), average power (AP), flexor peak torque/extensor peak torque (F/E)] were compared between the two groups before and after treatment. After treatment, the Harris score, Barthel index score, PT and AP were higher than those before treatment (P<0.05), and F/E was lower than that before treatment in the two groups (P<0.05). After treatment, the Harris score, Barthel index score, PT and AP in the observation group were higher than those in the control group (P<0.05), and the F/E in the observation group was lower than that in the control group (P<0.05). Rehabilitation robot rehabilitation training of lower limbs synchronizing acupuncture exercise therapy could enhance the hip joint activity function and quadriceps muscle group function of elderly postoperative patients with hip fracture, and effectively improve the lower limb function and life activity ability.

Syndrome of hypotension-hyperkinesia. Chorea or chorea like syndrome?

One of the varieties of hyperkinesia, characterized by rapid, involuntary, disordered movements in the limbs and trunk, is chorea. With this disease, a nonrhythmic contraction of the different in location and function of muscle groups occurs. The term chorea is used to refer to both independent diseases in which choreic hyperkinesis is the leading manifestation, and a number of syndromes that arise in various diseases.Chorea as a syndrome can be in the composition of such hereditary extrapyramidal diseases as hepatocerebral dystrophy (Wilson Konovalov's disease), Lesch Nichin syndrome, and paroxysmal choreoathetosis. Therefore, in order to establish such diagnoses, attention should be paid to the presence of other clinico paraclinical manifestations inherent in these pathologies, that is, the patient needs differential diagnosis

Spectral analysis of knee isokinetic extension curves of osteoarthritic patients

Isokinetic assessment of knee extensors muscle group function in patients suffering from knee osteoarthritis has exclusively been achieved using time-domain based variables. While useful, these analyses do not quantify the conspicuously irregular moment-time pattern exhibited by the involved knee when compared to the contralateral knee. The purpose of this investigation was to assess whether the frequency content of the isokinetic curve can quantify this latter phenomenon. Thirty two patients with knee osteoarthritis participated in this study. Each participant performed 5 maximal concentric knee extensions bilaterally at 60 � /s using an isokinetic dynamometer. For each time-domain extension curve, the power spectrum was calculated via Fast Fourier Transform and the maximum frequency content value contained within 99% of total signal power was extracted. Of the 32 participants, 26 exhibited higher frequency contents in the isokinetic curves obtained from their involved knee (p = 0.002, effect size = 0.35). The results suggest that the frequency content of iso kinetic moment-time curves may provide useful quantitative information regarding the smoothness of moment production, and as such, may be used in conjunction with traditional time-domain variables in the assessment of knee extensors function in patients suffering from knee osteoarthritis.

Functional Impact of Relative Versus Absolute Sarcopenia in Healthy Older Women

To determine whether adjustment of muscle mass for height(2) or for body mass represents a more-relevant predictor of physical performance. Cross-sectional study, using baseline data from a trial comparing upper- and lower-body training. Women recruited from the community and gynecological practices in Connecticut. One hundred eighty-nine healthy older (aged 67.5 +/- 4.8), active women receiving estrogen for osteoporosis over 2 years. Total and appendicular skeletal muscle (ASM) and fat mass (AFM) were determined using dual x-ray absorptiometry. Physical performance, muscle strength, and fitness measures were obtained at baseline. Adjusting ASM for height(2) identifies lean women who are sarcopenic according to published standards yet fails to identify overweight and obese women whose ASM adjusted for body mass is low. ASM divided by body mass (ASM/body mass) is a stronger physical performance predictor, explaining 32.5%, 13.5%, 11.6%, 6.3%, and 6.8% of the variance in maximum time on treadmill, 6-minute walk, gait speed, 8-foot walk, and single leg stance, respectively, whereas ASM divided by height in m(2) (ASM/height(2)) explained only 2.9%, 0.2%, 2.0%, 0.04%, and 0.1%. Multivariate modeling demonstrated considerable overlap in aspects of ASM/body mass and AFM/body mass associated with performance, with ASM/body mass dominant. In contrast, ASM/height(2) is a much stronger predictor of leg press 1 repetition maximum and maximum power. The results suggest that relative sarcopenia with ASM adjusted for body mass is a better mobility predictor, with absolute sarcopenia a better indicator of isolated muscle group function in healthy postmenopausal women receiving estrogen replacement.

Rectus femoris surface myoelectric signal cross-talk during static contractions

The clinical application of EMG requires that the recorded signal is representative of the muscle of interest and is not contaminated with signals from adjacent muscles. Some authors report that surface EMG is not suitable for obtaining information on a single muscle but rather reflects muscle group function [J. Perry, C.S. Easterday, D.J. Antonelli, Surface versus intramuscular electrodes for electromyography of superficial and deep muscles. Physical Therapy 61 (1981) 7–15]. Other authors report however, that surface EMG is adequate to determine individual muscle function, once guidelines pertaining to data acquisition are followed [D.A. Winter, A.J. Fuglevand, S.E. Archer. Cross-talk in surface electromyography: theoretical and practical estimates. Journal of Electromyography and Kinesiology 4 (1994) 15–26]. The aim of this study was to determine whether surface EMG was suitable for monitoring rectus femoris (RF) activity during static contractions. Five healthy subjects, having given written informed consent, participated in this trial. Surface and fine wire EMG from the rectus femoris and the vastus lateralis (VL) muscles were recorded simultaneously during a protocol of static contractions consisting of knee extensions and hip flexions. Ratios were used to quantify the relationship between the surface EMG amplitude value and the fine wire EMG amplitude value for the same contraction. The results showed that hip flexion contractions elicited RF activation only and that knee extension contractions elicited fine wire activity in VL only. When the relationship between RF surface and RF fine wire electrodes was compared for hip flexion and knee extension contractions, it was observed that for all subjects, there was a tendency for increased RF surface activity in the absence of RF fine wire activity during knee extensions. It was concluded that the activity recorded by the RF surface electrode arrangement during knee extension consisted of EMG from the vastii, i.e., cross-talk and that vastus intermedius was the most likely origin of the erroneous signal. Therefore it is concluded that for accurate EMG information from RF, fine wire electrodes are necessary during a range of static contractions.

Physiological coxa varus?genu valgus influences internal knee and ankle joint moments in females during crossover cutting

This study evaluated the ankle and knee electromyographic, kinematic, and kinetic differences of 20 nonimpaired females with either neutral (group 1) or coxa varus-genu valgus (group 2) alignment during crossover cutting stance phase. Two-way mixed model ANOVA (group, session) assessed mean differences ( p<0.05) and correlation analysis further delineated relationships. During impact absorption, group 2 displayed earlier peak horizontal braking (anterior-posterior) ground reaction force timing, decreased and earlier peak internal knee extension moments (eccentric function), and earlier peak internal ankle dorsiflexion moment timing (eccentric function). During the pivot phase, group 2 displayed later and eccentrically-biased peak ankle plantar flexion moments, increased peak internal knee flexion moments (eccentric function), and later peak knee internal rotation timing. Correlation analysis revealed that during impact absorption, subjects with coxa varus-genu valgus alignment (group 2) displayed a stronger relationship between knee internal rotation velocity and peak internal ankle dorsiflexion moment onset timing ( r= -0.64 vs r = -0.26) and between peak horizontal braking ground reaction forces and peak internal ankle dorsiflexion moment onset timing ( r= 0.61 vs r= 0.24). During the pivot phase these subjects displayed a stronger relationship between peak horizontal braking ground reaction forces and peak internal ankle plantar flexion moment onset timing ( r= -0.63 vs r= -0.09) and between peak horizontal braking forces and peak internal ankle plantar flexion moments ( r= -0.72 vs r= -0.26). Group differences suggest that subjects with coxa varus-genu valgus frontal-plane alignment have an increased dependence on both ankle dorsiflexor and plantar flexor muscle group function during crossover cutting. Greater dependence on ankle muscle group function during the performance of a task that requires considerable 3D dynamic knee joint control suggests a greater need for frontal and transverse plane weight bearing tasks that facilitate eccentric ankle muscle group function to optimize injury prevention conditioning and post-surgical rehabilitation programs.

Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention.

Neuropathies involving the brachial plexus, phrenic, recurrent laryngeal, and saphenous nerves, as well as the sympathetic chain are complications of cardiac surgery. The reported frequency of nerve injuries varies from 1.5% to 24% for the brachial plexus and 10% to 60",,6 for the phrenic nerve (1-5). Neuropathies of the recurrent laryngeal, lower limb (saphenous) nerves, and the sympathetic chain are less frequent.

Muscle group-specific regulation of GLUT 4 glucose transporters in control, diabetic, and insulin-treated diabetic rats

Insulin resistance in diabetic rats involves pretranslational suppression of the GLUT 4 glucose transporter in muscle. Because the capacity for insulin-mediated glucose transport varies as a function of muscle group, we hypothesized that GLUT 4 was differentially expressed and regulated by diabetes in a muscle-specific manner. We studied control (C), streptozocin (STZ)-induced diabetic (D), and insulin-treated diabetic (Tx) rats and examined the following muscles that vary in fiber composition: soleus (type I fibers), gastrocnemius (mixed type IIa > IIb), vastus lateralis and rectus abdominis (type IIb > IIa), and cardiac muscle. In C animals, these muscles exhibited significant differences in the baseline expression of GLUT 4. Relative GLUT 4 content was highest in cardiac muscle, intermediate in soleus, and significantly lower in gastrocnemius, rectus abdominis, and vastus lateralis (1.8:1.0:0.6). The impact of diabetes and insulin therapy on GLUT 4 expression also varied as a function of muscle group. After four weeks of diabetes, GLUT 4 levels were reduced by approximately 50% in cardiac muscle, soleus, and gastrocnemius. In contrast, GLUT 4 content in rectus abdominis and vastus lateralis was similar to that in control rats. Exogenous insulin treatment of diabetic rats increased GLUT 4 content in soleus, cardiac muscle, and gastrocnemius, but had no effect in either vastus lateralis or rectus abdominis. Temporal effects of diabetes and insulin treatment were also examined in different skeletal muscle. Soleus showed a significant decrease in GLUT 4 content as early as 2 days with a further decrease at 4 weeks; rectus abdominis showed little change at either time point. In conclusion, (1) skeletal muscle groups that vary in fiber composition exhibit different levels of GLUT 4 expression in C rats and differential regulation of GLUT 4 content by diabetes and insulin treatment; (2) relative baseline GLUT 4 expression is greatest in cardiac muscle, intermediate in soleus, and lower in gastrocnemius, vastus lateralis, and rectus abdominis; and (3) GLUT 4 depletion in diabetes and the increase in levels following insulin therapy are most profound in cardiac muscle, soleus, and gastrocnemius, whereas effects in vastus lateralis and rectus abdominis are minimal or nonexistent. These results should be considered in evaluating previous studies that have tested for effects in total hindlimb musculature, and have major implications relevant to reported data in non-insulin-dependent diabetes mellitus (NIDDM).

Perceived Exertion in Isometric Muscular Contractions Related to Age, Muscle, Force Level and Duration

This research was concerned with studying the development and growth of perceived effort of long-term isometric contractions as a function of muscle group (biceps vs quadriceps), of subjects with different age groups (20–29 vs. 50–59 years old) on long-term muscular isometric contractions (5 minutes) at different levels of %MVC (20, 40, 60, 80 and 100 %MVC). An experiment testing 20 subjects each performing 10 conditions (two muscle groups × five levels of %MVC) showed that the older age group reported Significantly higher perceived exertion at higher levels of %MVC and across time. Furthermore, subjects experienced a higher and faster increase in their perceived exertion when the level of %MVC and time increased.

Correlating Anatomy and Roentgenology

THE student of medicine, whether undergraduate or practising physician, although he may have no interest in clinical roentgenology, is vitally concerned with the living body; and, therefore, dependent upon the technics of roentgenology which teach us so much about the living. In human anatomy we desire to know the living structure and the gross function of the body, and anatomy has been pursued in the classical way to gain this knowledge. This desire agrees with the best anatomical tradition, beginning with Vesalius, yet in most medical schools, no matter what the pronouncements about inadequacies of dead anatomy, the terms “anatomy” and “dissecting” are still synonymous. Obviously, fabrics of the body may be learned in the dissecting room but the topographic anatomy of the living must be learned from the living. That part of physiology which the physiologists do not claim and which has, therefore, remained with anatomy—the function of muscle groups, the action of joints, the mechanics of the chest—is likewise not a cadaver study. Anatomy to medical students and to physicians should mean a study of the living body by any means. Naturally dissection has played a significant rôle in this study and must continue to do so, but it should not be emphasized at the expense of exclusion of other methods. I explain to my students that in anatomy we study the body by any technic which yields knowledge. Certain facts may be obtained only by dissection but many of these facts are useless unless vitalized. In the vitalization, the radiologic laboratory helps us most. I have taught first-year medical students and first-year dental students and I am now teaching graduate doctors, preparing for special fields of practice. I have excellent opportunity to obtain a bird's-eye view of the results of medical school teaching in anatomy and I am more convinced than ever that the teaching of anatomy must be in fact the teaching of the anatomy of the living. In the following remarks, I shall draw on my experiences, especially those obtained in the Department of Anatomy in the University of Cincinnati, where, by trial and error, I developed certain teaching methods which enabled me, even in the crowded medical curriculum, to present the anatomy of the living. This technic, as it concerns the use of the radiologic laboratory, will be described in some detail, because I find that the teaching value of the fluoroscopic screen and the roentgen film varies with the aptness of the presentation. My ideas about the use of roentgenologic facilities in anatomy were gradually shaped during five years of experimentation with the x-ray as a teaching aid. In this trial period, I found that it was not profitable to put view boxes into the corridors or into the dissecting rooms, with films changing from week to week. As long as the instructor looked at the films, the student looked. I think that the reason for this is obvious: the student did not understand how to see.