Measure Muscle Tone Research Articles

Objective Methods of Muscle Tone Diagnosis and Their Application-A Critical Review.

"Muscle tone" is a clinically important and widely used term and palpation is a crucial skill for its diagnosis. However, the term is defined rather vaguely, and palpation is not measurable objectively. Therefore, several methods have been developed to measure muscle tone objectively, in terms of biomechanical properties of the muscle. This article aims to summarize these approaches. Through database searches, we identified those studies related to objective muscle tone measurement in vivo, in situ. Based on them, we described existing methods and devices and compared their reliability. Furthermore, we presented an extensive list of the use of these methods in different fields of research. Although it is believed by some authors that palpation cannot be replaced by a mechanical device, several methods have already proved their utility in muscle biomechanical property diagnosis. There appear to be two issues preventing wider usage of these objective methods in clinical practice. Firstly, a high variability of their reliability, and secondly, a lack of valid mathematical models that would provide the observed mechanical characteristics with a clear physical significance and allow the results to be compared with each other.

Analysis of the Relationship Between Muscle Tones and Abnormal Postures in a Computational Model.

Patients with Parkinson's disease (PD), a neurodegenerative disorder, exhibit a characteristic posture known as a forward flexed posture. Increased muscle tone is suggested as a possible cause of this abnormal posture. For further analysis, it is necessary to measure muscle tone, but the experimental measurement of muscle tone during standing is challenging. The aim of this study was to examine the hypothesis that "In patients with PD, abnormal postures are those with a small sway at increased muscle tones" using a computational model. The muscle tones of various magnitudes were estimated using the computational model and standing data of patients with PD. The postures with small sway at the estimated muscle tones were then calculated through an optimization method. The postures and sway calculated using the computational model were compared to those of patients with PD. The results showed that the differences in posture and sway between the simulation and experimental results were small at higher muscle tones compared to those considered plausible in healthy subjects by the simulations. This simulation result indicates that the reproduced sway at high muscle tones is similar to that of actual patients with PD and that the reproduced postures with small sway locally at high muscle tones in the simulations are similar to those of patients with PD. The result is consistent with the hypothesis, reinforcing the hypothesis.Clinical relevance- This study implies that improving the increased muscle tone in patients with PD may lead to an improved abnormal posture.

Quantitative assessment of biceps brachii muscle stiffness by using Young's modulus-Angle curve during passive stretching in stroke patients.

Purpose: This study aims to use shear wave elastography (SWE) to dynamically describe the characteristics of biceps brachii muscle stiffness during passive stretching in healthy participants, investigate changes in the Young's modulus-angle curve under various states of muscle tone in stroke patients, and develop a new method for measuring muscle tone quantitatively. Methods: In total, 30 healthy volunteers and 54 stroke patients were evaluated for elbow flexor muscle tone on both sides using passive motion examination and were divided into groups based on their muscle tone status. The real-time SWE video of the biceps brachii and the Young's modulus data were recorded during the passive straightening of the elbow. The Young's modulus-elbow angle curves were created and fitted using an exponential model. The parameters yielded from the model were subjected to further intergroup analysis. Results: The repeatability of the Young's modulus measurement was generally good. During passive elbow extension, the Young's modulus of the biceps brachii steadily increased as muscle tone increased, and it increased faster when the modified Ashworth scale (MAS) score got higher. The exponential model's fitness was generally good. The curvature coefficient was significantly different between the MAS 0 group and the hypertonia groups (MAS 1, 1+, and 2 groups). Conclusion: The passive elastic characteristics of the biceps brachii are consistent with the exponential model. The Young's modulus-elbow angle curve of the biceps brachii changes in distinct ways depending on the muscle tone status. SWE can be used to quantify muscular stiffness during passive stretching as a new way of muscle tone evaluation, allowing for quantitative muscle tone evaluation and mathematical assessment of muscle mechanical properties in stroke patients.

Intra-Rater and Inter-Rater Reliability Analysis of Muscle-Tone Evaluation Using a Myotonometer for Children with Developmental Disabilities.

Assessing muscle tone is an essential component of the diagnosis, prognosis, and treatment planning of developmental disabilities (DD) in children and is of great help in developing clinical diagnosis patterns. The purpose of this study was to investigate intra-rater and inter-rater reliability using the myotonometer, which is an assessment tool to measure muscle tone in children with DD. This study included 26 children diagnosed with DD. Two physical therapists measured the children's muscle tone using a myotonometer. For all the muscles measured, reliability was determined using the intra-class correlation coefficient (ICC), the standard measurement error (SEM), and the minimal detectable change (MDC). The intra-rater reliability for all muscles was excellent (ICC = 0.75~0.78), except for the biceps brachii (ICC = 0.68). The inter-rater reliability was also excellent for all muscles (ICC = 0.75~0.95), and the SEM and MDC showed small measurement errors. Therefore, the intra-rater and inter-rater reliability of measurements by the myotonometer was found to be good or excellent. This suggests that the myotonometer is a tool that can objectively assess muscle tone, and it can be utilized in clinical practice to quickly and conveniently measure muscle tone in children with DD.

지지면 변화에 따른 네발기기 자세 운동이 뭇갈래근과 척추세움근의 두께 및 근 긴장도에 미치는 영향

The purpose of this study is to investigate the effect of quadruped exercise according to the change of the support surface on the muscle thickness and muscle tone of the multifidus and erector spinae muscles. Thity healthy adults (16 males and 14 females) voluntarily participated in the experiment. The Q (Quadruped) and Q-L (Quadruped-Lifting right leg) exercises were performed on a stable support surface; whereas the Q-LT (Quadruped-Lifting right leg using TOGU dynamic airchusion) and Q-LS (Quadruped-Lifting right leg using Sling) exercises were performed on an unstable support surface. Outcome measurement included muscle thickness and muscle tone measurement using ultrasound equipment and Myoton, respectively. Repeated measures ANOVA was used for data analysis. The result of the study showed that in Q-L, Q-LT, and Q-LS, the muscle thickness of the multifidus and erector spinae was significantly increased compared to Q (p<.05). The muslce tone of the multifidus in Q-LT and Q-LS, increased compared to Q (p<.05). The muscle tone of the erector spinae muscle was significantly increased in Q-L, Q-LT and Q-LS compared to Q (p<.05). The muscle thickness was significantly increased in the unstable support surfaces in Q-LT and Q-LS compared to the stable support surfaces of Q and Q-L (p<.05). However, a significant difference between Q-LT and Q-LS was absent, which were the unstable support surfaces. Therefore, the results of this study showed that the quadruped exercise was more effective on an unstable support surface. This result can be used as useful data for the prescription and application of various exercises in clinical practice.

α-Subunit Tyrosine Phosphorylation Is Required for Activation of the Large Conductance Ca2+-Activated Potassium Channel in the Rabbit Sphincter of Oddi

Large conductance Ca2+-activated potassium (BKCa) channels are regulated by intracellular free Ca2+ concentrations ([Ca2+]i) and channel protein phosphorylation. In hypercholesterolemia (HC), motility impairment of the sphincter of Oddi (SO) is associated with abnormal [Ca2+]i accumulation in smooth muscle cells of the rabbit SO (RSOSMCs), which is closely related to BKCa channel activity. However, the underlying mechanisms regulating channel activity remain unclear. In this study, an HC rabbit model was generated and used to investigate BKCa channel activity of RSOSMCs via SO muscle tone measurement invitro and manometry invivo, electrophysiological recording, intracellular calcium measurement, and Western blot analyses. BKCa channel activity was decreased, which correlated with [Ca2+]i overload and reduced tyrosine phosphorylation of the BKCa α-subunit in the HC group. The abnormal [Ca2+]i accumulation and decreased BKCa channel activity were partially restored by Na3VO4 pretreatment but worsened by genistein in RSOSMCs in the HC group. This study suggests that α-subunit tyrosine phosphorylation is required for [Ca2+]i to activate BKCa channels, and there is a negative feedback between the BKCa channel and the L-type voltage-dependent Ca2+ channel that regulates [Ca2+]i. This study provides direct evidence that tyrosine phosphorylation of BKCa α-subunits is required for [Ca2+]i to activate BKCa channels in RSOSMCs, which may be the underlying physiological and pathologic mechanism regulating the activity of BKCa channels in SO cells.

A multi-parameter approach to measurement of spontaneous myogenic contractions in human stomach: Utilization to assess potential modulators of myogenic contractions

Electrical slow waves, generated by interstitial cells of Cajal (ICC), cause spontaneous contractions of human stomach. Software was developed to measure muscle tone and eleven different parameters defining these contractions in human stomach, displaying data as radar plots. A pilot study assessed the effects of potential modulators, selected from among compounds known to influence ICC activity; n = 4–7 each concentration tested/compound. Human distal stomach (corpus-antrum) muscle strips were suspended in tissue baths for measuring myogenic (non-neuronal) contractions in the presence of tetrodotoxin (10-6 M). Initial characterization: Contractions (amplitude 4 ± 0.4mN, frequency 3 ± 0.1 min-1, n = 49) were unchanged by ꭃ-conotoxin GVIA (10-7 M) or indomethacin (10-6 M) but abolished by nifedipine (10-4 M). Carbachol (10-7 M) increased contraction rate and amplitude; 10-6-10-5 M increased tone and caused large, irregular contractions. [Ca2+]imodulators: Ryanodine (10-5-10-4 M) increased muscle tone accompanied by inhibition of myogenic contractions. Xestospongin-C (10-6 M; IP3 channel inhibitor) had no effects. SERCA pump inhibitors, 2-APB and cycloplazonic acid (10-5-10-4 M) increased tone and myogenic contraction amplitude before abolishing contractions; thapsigargin was weakly active. CaCC blockers: MONNA and CaCCinh-A01 had little-or-no effects on tone but reduced myogenic contractions; MONNA (10-4 M) was more effective, reducing amplitude (77.8 ± 15.2%) and frequency. CaV3.1/3.2/3.3 channel block: Mibefradil reduced tone and myogenic contraction amplitude (pIC50 4.8 ± 0.9). Inward-rectifying K+-channel inhibitor: E-4031 (10-4 M) increased contraction duration (17.4 ± 5.8%). Conclusions: (1) Measurement of multiple parameters of myogenic contractions identified subtle differences between compounds, (2) only E-4031 and CaCC blockers influenced myogenic contractions, not muscle tone, (3) studies are needed with compounds with known and/or improved selectivity/potency for human targets affecting ICC functions.

Effects of a Bio-Electromagnetic Energy Regulation Blanket on Thoracolumbar Epaxial Muscle Pain in Horses

Back pain and inflammation of the epaxial musculature is a significant problem in all equine athletes. Treatment of back pain can be challenging and often requires a multimodal approach. In humans, bio-electromagnetic energy regulation therapy (BEMER) has been reported to be effective in pain modulation. With its increased use in people comes a similar robust application in veterinary medicine unfortunately, there is unsubstantiated evidence for this type of therapy in horses.Objectives of this study were to assess analgesic responses and biomechanical outcome variables using a bio-electromagnetic energy regulation therapy blanket, and to evaluate serum biomarkers as a method to monitor the treatment effects in horses with thoracolumbar epaxial muscle pain.Cohort study of 8 horses treated for 3 consecutive days.Horses with naturally-occurring thoracolumbar epaxial muscle pain were used in this study. Objective outcome variables were recorded daily for 5 days, which included spinal evaluation, mechanical nociceptive thresholds, electromyography, kinematics, kinetics, and serum biomarkers.BEMER blanket therapy significantly improved thoracolumbar epaxial muscle nociceptive thresholds. Center of pressure displacement as a measure of postural stability was significantly improved as well as significant gains in spinal flexibility were demonstrated at study completion. A significant treatment effect was not appreciated in measures of muscle tone, ground reaction forces or serum biomarkers.Limitations include the lack of a control group and a definitive structural diagnosis of thoracolumbar epaxial muscle pain.The BEMER blanket produced significant clinical and biomechanical effects in horses with back pain.

Sharp Changes in Muscle Tone in Humans Under Simulated Microgravity

A decrease in muscle tone induced by space flight requires a standardized assessment of changes to control the state of the neuromuscular system. This study is a step toward the development of a unified protocol, aimed at determining the initial effect of the presence or withdrawal of support on muscle tone, the effects of a 2-h supportlessness in Dry Immersion (DI) experiments, and the changes in muscle tone depending on the site of measurement. To perform measurements of changes in muscle tone, we used a MyotonPRO device. The list of muscles that we assessed includes: trunk – mm. deltoideus posterior, trapezius, erector spinae; leg – mm. biceps femoris, rectus femoris, tibialis anterior, soleus, gastrocnemius; foot – m. flexor digitorum brevis, tendo Achillis, aponeurosis plantaris. The study involved 12 healthy volunteers (6 men, 6 women) without musculoskeletal disorders and aged 32.8 ± 1.6 years. At the start of DI, there was a significant decrease in muscle tone of the following muscles: mm. tibialis anterior (−10.9%), soleus (−9.6%), erector spinae (−14.4%), and the tendo Achillis (−15.3%). The decrease continued to intensify over the next 2 h. In contrast, the gastrocnemius muscle demonstrated an increase in muscle tone (+7.5%) 2 h after the start of DI compared to the immediate in-bath baseline. Muscle tone values were found to be site-dependent and varied in different projections of mm. erector spinae and soleus. In previous experiments, we observed a high sensitivity of the myotonometry technique, which was confirmed in this study. To make it possible to compare data from different studies, a standardized protocol for measuring muscle tone for general use in gravitational physiology needs to be developed.

The Effects of Extracorporeal Shock Wave Therapy on Spastic Muscle of the Wrist Joint in Stroke Survivors: Evidence From Neuromechanical Analysis.

Background: This study combined neuromechanical modeling analysis, muscle tone measurement from mechanical indentation and electrical impedance myography to assess the neural and peripheral contribution to spasticity post stroke at wrist joint. It also investigated the training effects and explored the underlying mechanism of radial extracorporeal shock wave (rESW) on spasticity.Methods: People with first occurrence of stroke were randomly allocated to rESW intervention or control group. The intervention group received one session of rESW therapy, followed by routine therapy which was the same frequency and intensity as the control group. Outcome measures were: (1) NeuroFlexor method measured neural component (NC), elastic component (EC) and viscosity component (VC), and (2) myotonometer measured muscle tone (F) and stiffness (S), (3) electrical impedance myography measured resistance (R), reactance (X) and phase angle (θ); (4) modified Asworth scale; (5) Fugl Meyer Upper limb scale. All outcome measures were recorded at baseline, immediately post rESW and at 1-week follow-up. The differences between the paretic and non-paretic side were assessed by t-test. The effectiveness of rESW treatment were analyzed by repeated-measures one-way analysis of variance (ANOVA) at different time points.Results: Twenty-seven participants completed the study. NC, EC, and VC of the Neuroflexor method, F and S from myotonometer were all significantly higher on the paretic side than those from the non-paretic side. R, X, and θ from electrical impedance were significantly lower on the paretic side than the non-paretic side. Immediately after rESW intervention, VC, F, and S were significantly reduced, and X was significantly increased. The clinical scores showed improvements immediate post rESW and at 1-week follow-up.Conclusions: The observed changes in upper limb muscle properties adds further support to the theory that both the neural and peripheral components play a role in muscle spasticity. ESW intervention may be more effective in addressing the peripheral component of spasticity in terms of muscle mechanical properties changes. The clinical management of post stroke spasticity should take into consideration of both the neural and non-neural factors in order to identify optimal intervention regime.

The Relationship Between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study.

The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

Comparison between Erigo tilt-table exercise and conventional physiotherapy exercises in acute stroke patients: a randomized trial

BackgroundStroke is a common, serious, and disabling health-care problem throughout the world. Although great advances have been made in acute stroke management, the most of post-stroke care to reduce a patient’s dependency relies on rehabilitation.PurposeTo compare the effectiveness of exercises using an Erigo tilt-table and conventional physiotherapy in the rehabilitation of acute stroke patients.MethodsA total of 110 acute stroke patients (age 51.08 ± 7.48 years, 8.69 ± 4.62 days after stroke) were assigned randomly into two groups, 55 in each for 30 days of conventional physiotherapy (Group A) or Erigo tilt-table (Group B) rehabilitation. The National Institutes of Health Stroke Scale (NIHSS), Mini-Mental Scale Examination (MMSE), Modified Ashworth Scale were used to measure muscle tone, quality of life (QOL) and muscle strength (MMT), Affected upper (UE) and lower limb (LE) outcomes were assessed at baseline (day 0), after day 30 of the intervention and on 90th day of follow up. Repeated measures ANOVA followed by a Bonferroni post-hoc test and independent Student’s t-test were used for statistical analysis to evaluate the improvement in outcome variables within and between the groups.ResultsBoth the treatments were effective. Notably, Group B patients showed a significant improvement in both QOL (p < 0.001) and lower limb strength (p = 0.030) at day 90 and muscle tone (p = 0.011) at day 30 compared to Group A.ConclusionBoth the groups improved with time but the Erigo tilt-table group experienced greater improvement in QOL, NIHSS and muscle strength of the lower limb. Thus, Erigo tilt-table can be used for early rehabilitation of acute hemiplegic patients and improving their quality of life and motor system, resulting in better functional performances.

Establishment of an animal model of underactive bladder induced by obstruction in rats

Objective To establish and evaluate a rat modle of bladder outlet obstruction (BOO) induced underactive bladder (UAB). Methods Male Sprague-Dawley rats were randomly divided into sham operation group, BOO6 week group and BOO12 week group. The UAB animal model was constructed by ligation of the bladder outlet by compression. At 6 and 12 weeks, animal models were evaluated by urodynamics, muscle tone measurement and Masson staining. Results 2 rats died after operation. The incidence of UAB was 43% and 100% at 6 and 12 weeks after operation. At the 6th week, the maximum bladder capacity (MBC), post-void residual urine volume (PVR), and micturition time (MT) of UAB rats were (2.52±0.16) ml, (0.87±0.08) ml, (109.59±1.00) s, respectively, which were higher than that of sham group (0.98±0.08) ml, (0.01±0.01) ml, (50.19±0.19) s, and the maximum pressure (Pmax) was (39.83±0.85) cmH2O (1 cmH2O=0.098 kPa), which was lower than that of sham group [(61.53±0.68) cmH2O]. The difference was statistically significant (t=21.221, 25.721, 101.001, 34.531, P<0.05). At the 12th week, the MBC, PVR and MT of UAB rats were (3.87±0.05) ml, (1.33±0.14) ml, (154.44±1.99) s, respectively, which were higher than that of the sham group (1.33±0.08) ml, (0.01±0.01) ml, (50.80±0.29) s. The Pmax was (27.68±0.83) cmH2O less than sham group [(66.53±1.68) cmH2O], and the difference was statistically significant (t=27.041, 23.741, 89.261, 35.891, 60.891, P<0.05). At 6 and 12 weeks, the bladder detrusor contractility of UAB rats was significantly lower than that of sham group. The wet weight of bladder at 6 and 12 weeks was (356.67±42.74) mg and (464.67±7.58) mg, respectively, which was significantly higher than that of sham group [(166.67±22.51) mg and (183.83±8.38) mg]. The collagen deposition rate was significantly higher than that of sham group, and the difference was statistically significant (t=9.635, 60.891, P<0.05). Conclusion UAB animal models can be successfully established by ligation of the bladder outlet and can be assessed using urodynamics, muscle strip tension measurements, and Masson staining. Key words: Bladder outlet obstruction; Underactive bladder; Urodynamics; Muscle tone

Measuring muscle tone with isokinetic dynamometer technique in stroke patients

Summary Study aim: Increased muscle tone, a common consequence of stroke, has neural and non-neural components. Spasticity is related to the neural component. Non-neural resistance arises from passive stiffness. This study was designed to assess the feasibility of using isokinetic dynamometry to evaluate wrist flexor muscle spasticity in stroke patients. Materials and methods: Twenty-six patients with hemiplegia in the subacute phase of stroke participated in this study. An isokinetic dynamometer was used to stretch wrist flexor muscles at four velocities of 5, 60, 120 and 180°/s on both the paretic and non-paretic sides. Peak torque at the lowest speed (5°/s) and reflex torque at the three higher speeds were quantified. Peak torque at the lowest speed was attributed to the non-neural component of muscle tone, and was subtracted from the torque response at higher velocities to estimate reflex torque (spasticity). Data from the two sides were compared. Results: There was no significant difference in peak torque between the paretic (2.47 ± 0.22 N·m) and non-paretic side (2.41 ± 0.28 N·m) at the lowest velocity of 5°/s (p=0.408). However, compared to the non-paretic side, the paretic side showed higher reflex torque (p&lt;0001), and reflex torque increased rapidly with increasing velocity (p &lt; 0.05). Conclusion: The isokinetic dynamometer distinguished spasticity from the non-neural component and showed higher reflex torque on the paretic side compared to the non-paretic side. This instrument is potentially useful to assess the efficacy of therapeutic interventions aimed at modifying spasticity.

Is Pelvic Floor sEMG a Measure of Women’s Sexual Response?

IntroductionPelvic floor surface electromyography (sEMG) is often used in the assessment and treatment of individuals with pelvic floor abnormalities to measure muscle tone and neural control of the pelvic floor muscles (PFM); however, little is known about the role of the PFM in sexual arousal. AimThe aim of this pilot study was to examine whether changes in deep and superficial PFM activity—assessed with sEMG—can be observed during the presentation of sexual stimuli. MethodsDeep PFM sEMG activity was assessed with a vaginal probe. Superficial PFM activity was assessed with sEMG electrodes placed over the bulbocavernosus and perianal muscles. 15 sexually healthy women (mean age 27 years) watched a series of neutral, anxiety-evoking, and sexually explicit films. Continuous subjective sexual arousal was measured using a handheld arousometer. Main Outcome MeasureChanges in microvolts were measured by sEMG sensors, from neutral to anxiety-evoking and neutral to sexually explicit films. ResultsThere was an increase in intravaginal and perianal sEMG for both the erotic and anxiety films. Bulbocavernosus sEMG responses did not differ among the 3 films. Concordance between self-reported continuous sexual arousal for the erotic film and bulbocavernosus sEMG (r = 0.349) was not significantly different than concordance using intravaginal sEMG (r = 0.293) or perianal sEMG (r = 0.236). Clinical ImplicationsUnderstanding more about which parts of the PFM respond specifically to sexual stimuli may have implications for measuring the effects of treatments aimed at improving sexual response in women. Strength & LimitationsThe results of this pilot study provide a preliminary understanding of which pelvic floor muscles respond to sexual stimuli. A limitation of this study was the small sample size. ConclusionTaken together, these findings suggest that intravaginal and perianal sEMG respond to erotic stimuli, whereas bulbocavernosal sEMG responses do not.Hannan-Leith MN, Dayan M, Hatfield G, et al. Is Pelvic Floor Surface Electromyography a Measure of Women’s Sexual Response? A Pilot Study. J Sex Med 2019;16:70–82.

Effect of Postural Changes on Leg Muscle Tone and Arterial Blood Pressure in Able‑Bodied People and People after Chronic Spinal Cord Injury

Research background and hypothesis. Following spinal cord injury part of sympathetic nervous system is disrupted from the brain stem control, which results in cardiovascular system regulation disorders. Impaired cardiovascular regulation may cause orthostatic hypotension or other negative impacts on persons’ health. However, there are adaptive mechanisms which may change cardiovascular regulation and compensate these cardiovascular disorders. One of the mechanisms that may affect the occurrence of orthostatic hypotension may be changes in muscle tone after spinal cord injury.The aim of research was to ascertain the effect of muscle tone changes on blood pressure in persons with spinal cord injury through ortho-clinostatic test.Research methods. During passive ortho-clinostatic test, non-invasive blood pressure was continuously measured using the vital signs tracking monitor and leg muscle tone measurement was performed using myotonometer.Research results. In control group muscle tone is characterized as constant wave – it decreases in orthostasis and increases in clinostasis. In paraplegic group muscle tone changes are as similar to those in controls, except that dynamics is not so constant and numeric values are lower. In tetraplegics we can see that muscle tone changes rapidly and tone in thigh muscles has a tendency to decrease through all the test. Discusion and conclusions: 1. Leg muscle tone changes are important for blood pressure compensating mechanisms when the body position changes: it increases during orthostasis and decreases during clinostasis.2. Blood pressure varies differently among able-bodied persons and persons with spinal cord injury. The degree of the breach has a significant impact on the occurrence of compensatory peripheral regulation mechanisms. Characteristics of blood pressure fluctuations during body position changes in paraplegics are similar to those of reactions as in the able-bodied controls, while in tetraplegia case, possibilities of homeostatic blood pressure compensation during body posture changes are significantly reduced.Keywords: blood pressure, muscle tone, paraplegia, tetraplegia.

Evaluation of a toolkit for standardizing clinical measures of muscle tone

Objective: To evaluate a new portable toolkit for quantifying upper and lower extremity muscle tone in patients with upper motor neuron syndrome (UMNS). Approach: Cross-sectional, multi-site, observational trial to test and validate a new technology. Setting: Neurorehabilitation clinics at tertiary care hospitals. Participants: Four cohorts UMNS patient, >6 mo post acquired brain injury, spinal cord injury, multiple sclerosis and cerebral palsy, and a sample of healthy age-matched adult controls. Measures: Strength: grip, elbow flexor and extensor, and knee extensor; range of motion (ROM): passive ROM (contracture) and passive-active ROM (paresis); objective spasticity: stretch-reflex test for elbow, and pendulum test for knee; subjective spasticity: modified Ashworth scale scores for elbow and knee flexors and extensors. Results: Measures were acquired for 103 patients from three rehabilitation clinics. Results for patient cohorts were consistent with the literature. Grip strength correlated significantly with elbow muscle strength and all patient populations were significantly weaker in upper- and lower-extremity compared to controls. Strength and paresis were correlated for elbow and knee but neither correlated with contracture. Elbow spasticity correlated with strength and paresis but not contracture. Knee spasticity correlated with strength, and subjective spasticity correlated with contracture. Significance: The BioTone™ toolkit provided comprehensive objective measures for assessing muscle tone in patients with UMNS. The toolkit could be useful for standardizing outcomes measures in clinical trials and for routine practice.

Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients.

[Purpose] The purpose of this study was to examine the effects of extracorporeal shock wave therapy (ESWT) on upper extremity muscle tone in chronic stroke patients. [Subjects and Methods] For this study, 30 stroke patients participated in this study and they were divided into ESWT group and sham-ESWT group, each group consisted of 15 patients. ESWT and sham-ESWT was performed by the patients for two times a week, for eight weeks. MyotonPRO was used to measure muscle tone. [Results] According to the results of the comparisons between the groups, after intervention, upper extremity muscle tone were significantly higher in the ESWT group than in the sham-ESWT group. [Conclusion] This study showed that ESWT is effective for improving decrease of muscle tone in chronic stroke patients.

Pengaruh Penambahan Electrical Muscle Stimulation (EMS) Peningkatan Tonus Otot Pada Penderita DD

Delayed Development (DD) is the classification of characteristics of children which is showeda significant delay in one or more domains of cognitive development, emotional or physical. The problemsthat arise in the DD are hypotonus of the muscles that cause delays in functional abilities ofchildren.The purpose of this study was to determine the influence of Electrical Muscle Stimulation(EMS)to increase muscle tone of DD patients. Quasi-experimental research method using two pre andpost-testgroup design. Sample of this research was 12 children 1-3 years of age. Measurement ofmuscletone using a sphygmomanometer before and after treatment for 4 weeks. The effect measuredusing Wilcoxon tes and the different effect measured using Mann Whitney test. Wilcoxon test resultshowedthat the effect of electrical muscle stimulation on muscle tone was seen from the right quadricepsp value (p = 0.026), the left quadriceps (p = 0.024), right tibialis anterior (p = 0.024) and left tibialisanterior(p = 0.024). It can be concluded that there is an effect of Electrical Muscle stimulation onincreasingthe muscle tone in people with DD.

Multi-System Deconditioning in 3-Day Dry Immersion without Daily Raise.

Dry immersion (DI) is a Russian-developed, ground-based model to study the physiological effects of microgravity. It accurately reproduces environmental conditions of weightlessness, such as enhanced physical inactivity, suppression of hydrostatic pressure and supportlessness. We aimed to study the integrative physiological responses to a 3-day strict DI protocol in 12 healthy men, and to assess the extent of multi-system deconditioning. We recorded general clinical data, biological data and evaluated body fluid changes. Cardiovascular deconditioning was evaluated using orthostatic tolerance tests (Lower Body Negative Pressure + tilt and progressive tilt). Metabolic state was tested with oral glucose tolerance test. Muscular deconditioning was assessed via muscle tone measurement.Results: Orthostatic tolerance time dropped from 27 ± 1 to 9 ± 2 min after DI. Significant impairment in glucose tolerance was observed. Net insulin response increased by 72 ± 23% on the third day of DI compared to baseline. Global leg muscle tone was approximately 10% reduced under immersion. Day-night changes in temperature, heart rate and blood pressure were preserved on the third day of DI. Day-night variations of urinary K+ diminished, beginning at the second day of immersion, while 24-h K+ excretion remained stable throughout. Urinary cortisol and melatonin metabolite increased with DI, although within normal limits. A positive correlation was observed between lumbar pain intensity, estimated on the second day of DI, and mean 24-h urinary cortisol under DI. In conclusion, DI represents an accurate and rapid model of gravitational deconditioning. The extent of glucose tolerance impairment may be linked to constant enhanced muscle inactivity. Muscle tone reduction may reflect the reaction of postural muscles to withdrawal of support. Relatively modest increases in cortisol suggest that DI induces a moderate stress effect. In prospect, this advanced ground-based model is extremely suited to test countermeasures for microgravity-induced deconditioning and physical inactivity-related pathologies.