Muscle Bulging Research Articles

Classification of forearm and finger motions using electromyogram and arm-shape-changes.

Robot arms for humanoid are widely developed for medical, welfare and education use. Surface electromyogram (sEMG) signals which are the electrical signals obtained from surface of human skin using electrodes have been mainly used for classification of hand motions. However, it is difficult to classify detailed motions such as finger motions and wrist pronation or supination. Moreover, Kinect is an integration sensor device which can capture human joints movement. It also has been widely used for recognition of body motions in many fields. However, it has some problems such as setting of camera and restriction of detection range. In this study, we propose an advanced method of motion classification by combining arm-shape-changes with sEMG to classify the detailed motions. Arm-shape-changes are forearm deformation caused by a bulge of muscle when subjects move an arm or a finger. Experimental results showed classification accuracies of 90% or more in wrist pronation and supination which are difficult to classify using only sEMG signals. As the result, our method could classify the detailed motions and contribute to expansion of classifiable hand motions.

Three-dimensional geometrical changes of the human tibialis anterior muscle and its central aponeurosis measured with three-dimensional ultrasound during isometric contractions.

Background. Muscles not only shorten during contraction to perform mechanical work, but they also bulge radially because of the isovolumetric constraint on muscle fibres. Muscle bulging may have important implications for muscle performance, however quantifying three-dimensional (3D) muscle shape changes in human muscle is problematic because of difficulties with sustaining contractions for the duration of an in vivo scan. Although two-dimensional ultrasound imaging is useful for measuring local muscle deformations, assumptions must be made about global muscle shape changes, which could lead to errors in fully understanding the mechanical behaviour of muscle and its surrounding connective tissues, such as aponeurosis. Therefore, the aims of this investigation were (a) to determine the intra-session reliability of a novel 3D ultrasound (3DUS) imaging method for measuring in vivo human muscle and aponeurosis deformations and (b) to examine how contraction intensity influences in vivo human muscle and aponeurosis strains during isometric contractions.Methods. Participants (n = 12) were seated in a reclined position with their left knee extended and ankle at 90° and performed isometric dorsiflexion contractions up to 50% of maximal voluntary contraction. 3DUS scans of the tibialis anterior (TA) muscle belly were performed during the contractions and at rest to assess muscle volume, muscle length, muscle cross-sectional area, muscle thickness and width, fascicle length and pennation angle, and central aponeurosis width and length. The 3DUS scan involved synchronous B-mode ultrasound imaging and 3D motion capture of the position and orientation of the ultrasound transducer, while successive cross-sectional slices were captured by sweeping the transducer along the muscle.Results. 3DUS was shown to be highly reliable across measures of muscle volume, muscle length, fascicle length and central aponeurosis length (ICC ≥ 0.98, CV < 1%). The TA remained isovolumetric across contraction conditions and progressively shortened along its line of action as contraction intensity increased. This caused the muscle to bulge centrally, predominantly in thickness, while muscle fascicles shortened and pennation angle increased as a function of contraction intensity. This resulted in central aponeurosis strains in both the transverse and longitudinal directions increasing with contraction intensity.Discussion. 3DUS is a reliable and viable method for quantifying multidirectional muscle and aponeurosis strains during isometric contractions within the same session. Contracting muscle fibres do work in directions along and orthogonal to the muscle’s line of action and central aponeurosis length and width appear to be a function of muscle fascicle shortening and transverse expansion of the muscle fibres, which is dependent on contraction intensity. How factors other than muscle force change the elastic mechanical behaviour of the aponeurosis requires further investigation.

What are the complications and complication rates of cosmetic Botox injections?

Evidence-based answer Complications from cosmetic Botox injections depend on the location of treatment; they include headache (2%-17%), brow ptosis (3.1%), blepharoptosis (2.5%), muscle imbalance (6.9%), muscle bulge (5.9%), and bruising (9.2%-25%). Complications may last from several hours (headache) up to 1 month (some nerve paralysis) (SOR: A, systematic review of RCTs and subsequent RCT). Treatment applied to the upper and periocular regions of the face have the highest complication rates (4%-8%) (SOR: C, case series).

Clinico laboratory determinants of outcome among babies with perinatal asphyxia in Osogbo, Southwestern Nigeria

Background: Many clinical, pathological, biochemical and metabolic changes occur as a result of perinatal asphyxia. These changes affect many organ and systems like central nervous system, cardiovascular system, pulmonary, renal, adrenal, gastrointestinal tract, skin and haemopoetic systems. The aim of the study was to identify various clinical and biochemical determinants of outcome in perinatal asphyxia so as to institute proactive the management of such babies. Methods: All newborn infants with birth asphyxia over 5 year period (2009-2013) were retrospectively studied. The data studied included place of birth, gestational age, Apgar score, mode of resuscitation, details of complete physical examination especially as regard each of the system. Results of investigations like haematocrit, serum electrolytes and urea, blood glucose done in the first 24 hours of life and also other investigations like lumbar puncture, full blood count, cultures were noted. The outcome studied was survival and death of the babies. Results: One thousand, six hundred and seven babies were admitted into special care baby’s unit over the 5 year period, between 2009 and 2013. Nine hundred and seventy nine (60.9%) of them were males while 628 (39.1%) were females, M:F ratio was 1.6:1. Of the 1607 babies, 563 (35.0%) were asphyxiated. Of 1607 admitted during the period of study, 304 (18.9%) died while 128 (22.7%) of 563 babies with perinatal asphyxia died. Therefore, perinatal asphyxia accounted for 42.1% of the total mortality. 22 (7.8%) of the 280 babies who suffered moderate asphyxia compared with 106 (37.9%) of 283 babies who suffered severe asphyxia died. (χ2 = 72.4, p=0.000). Many of the asphyxiated babies had multisystemic adverse features. Significantly more babies who were out born, low birth weight, macrosomic and hypothermic than otherwise died. Also more babies with cyanosis, respiratory distress, apnoea, abdominal distension, feed intolerance, oliguria/anuria, bleeding disorder, abnormal muscle tone, seizures, bulging frontannel, and coma died, p ≥ 0.001. Also, mean haematocrit, plasma potassium and urea was significantly lower while plasma sodium was significantly higher among the babies who survived (p ≥0.001). Conclusions: Our findings have highlighted the major role of asphyxia in neonatal mortality and multisystemic morbidities or complications which contributed to death. It is therefore, likely that efforts at preventing perinatal asphyxia will be more rewarding. Such efforts include free and compulsory antenatal care, training of more skilled labour attendants and women empowerment.

Three-dimensional muscle bulging and its implications for muscle force generation

Three-dimensional muscle bulging and its implications for muscle force generation

MRI Features of Psoas Major Muscles in Patients with Paraspinal Muscle Atrophy

Introduction Maintaining both lumbar lordosis and paraspinal muscle function is important for prevention of sagittal imbalance. We previously reported that the cross-sectional area of the paraspinal muscles tends to decrease with age. To quantify the depth of the groove between the paraspinal muscles, we have developed our own parameter, the T-back value, which indicates the length of the bulge of muscle on the attachment of the spinous process. The T-back value is strongly correlated with the CSA of the paraspinal muscles. The occurrence of T-back value of 0 or less shows a marked increase in individuals aged 60 years or older. The CSA of the paraspinal and psoas muscles shows a similar decreasing trend with age, but fat infiltration of the paraspinal muscles is far more prominent than that of the psoas muscles in the elderly. The aims of this study are to investigate the CSA and fat infiltration of the psoas muscles in patients with paraspinal muscle atrophy, and to compare the findings with those in patients having a T-back value above 0. Methods Among 704 patients who underwent MRI of the lumbar spine at our hospital during 2010, 141 patients had a T-back value of 0 or less. Of these 141 patients, there were 120 patients, 40 men and 80 women, aged 60 years or older. We defined these as T-back − group. The control group included 120 age- and sex-matched individuals with a T-back value above0. We defined them as T-back + group. We compared their data from the two groups. The body mass index (BMI) of participants was calculated. Lumbar lordosis was measured on sagittal T2-weighted MR images. Axial T2-weighted MR images and a digital image analysis technique were used to measure the cross-sectional area and the percentage of fat infiltration of the paraspinal and psoas muscles at the intervertebral disc levels from L1/2 to L4/5 bilaterally. Then the mean values of both sides were used as CSA and the percentage of fat respectively Results The T-back − group had a significantly lower BMI than the T-back + group. Lumbar lordosis was significantly smaller in the T-back − group than in the T-back + group. In addition, the CSA of the paraspinal muscles was significantly smaller in the T-back − group than the T-back + group. The %Fat of the paraspinal muscles was significantly higher in the T-back − group than the T-back + group. When the CSA of the psoas muscles was compared across all spinal levels, there was no significant difference between the two groups. The %Fat of the psoas muscles also showed no significant difference between the two groups. Conclusion The patients in this study were divided into two groups according to the T-back value. The T-back − group had a smaller BMI, less lumbar lordosis, and the advanced atrophy of the paraspinal muscles than the T-back + group. However, MRI features of the psoas muscles were similar in the two groups. This study demonstrates that the psoas muscles are less susceptible to atrophy than the paraspinal muscles.

Flank muscle volume changes after open and laparoscopic partial nephrectomy.

To determine the occurrence of flank symptoms, flank muscle atrophy, bulge, and hernia formation after open and laparoscopic partial nephrectomy (LPN). Our prospective Institutional Review Board-approved database was queried to identify 50 consecutive patients who were treated with open partial nephrectomy (OPN) and 50 consecutive patients who were treated with LPN between September 2006 and May 2008. Study patients had: Solitary clinical T1 renal tumor, preoperative and ≥6 month postoperative CT scan performed at our institution, and a confirmed renal-cell carcinoma on the final pathology report. Patients with previous abdominal surgery and neuromuscular disorders were excluded. Oncocare software was used to measure abdominal wall musculature on preoperative and postoperative CT scan. Bilateral flanks were compared for muscle volume, bulge, and hernia. Patients were administered a phone questionnaire to assess postoperative flank symptoms. No statistical significant difference was found in the demographics between the two groups. Median age (range) was 59.9 years (20.6-80.7) in the OPN group and 57.5 years (25-78) in the LPN group (P=0.89). Median (range) body mass index and American Society of Anesthesiologists scores were similar between the two groups. On CT scans, median percent variation (range) in abdominal wall muscle volume was significantly greater in the OPN group: -1.03% (-31.4-1.5) vs-0.39% (-5.2-1.8) (P=0.006). The median extent of flank bulge on CT scans (range) was also greater in the OPN group: 0.75 cm (-1.9-7.6) vs 0 cm (-2.7-2.8) (P=0.0004). The OPN group was also more symptomatic, including paresthesia 48% vs 8% (P=0.0053); numbness 44% vs 0% (P=0.002); and flank bulge 57% vs 12% (P=0.007). Minimally invasive partial nephrectomy has lesser deleterious impact on flank muscle volume compared with OPN with fewer symptoms of flank bulge, paresthesia, and numbness.

3P2-J04 動力義手制御に向けた筋隆起位置変化に基づく関節角度の推定(看護とメカトロニクス)

As for today's powered prosthesis, only on-off control is available. The control that quantity of movement is proportional to depending on input signal is not realized for characteristic of EMG. The function that is required by amputees include accurate control of wrist joint angle. We proposed the muscle bulge movement that we could measure on the forearm skin as new signal to estimate wrist angle. We analyzed the feasibility of muscle bulge movement for accurate control of wrist angle. There were two results, the first was that relationship between wrist angle and muscle bulge movement have uniqueness. The second was variability of proposed method, because RMSE among the angle estimated by proposed method and the measured angle was within RMSE of the joint angle control by human. As a future work, we will apply this result to the control method of powered prosthesis.

Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy

BackgroundTemporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients.MethodsBetween August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs.ResultsThe symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery.ConclusionsThe orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.

Capture and Statistical Modeling of Arm‐Muscle Deformations

AbstractWe present a comprehensive data‐driven statistical model for skin and muscle deformation of the human shoulder‐arm complex. Skin deformations arise from complex bio‐physical effects such as non‐linear elasticity of muscles, fat, and connective tissue; and vary with physiological constitution of the subjects and external forces applied during motion. Thus, they are hard to model by direct physical simulation. Our alternative approach is based on learning deformations from multiple subjects performing different exercises under varying external forces. We capture the training data through a novel multi‐camera approach that is able to reconstruct fine‐scale muscle detail in motion. The resulting reconstructions from several people are aligned into one common shape parametrization, and learned using a semi‐parametric non‐linear method. Our learned data‐driven model is fast, compact and controllable with a small set of intuitive parameters – pose, body shape and external forces, through which a novice artist can interactively produce complex muscle deformations. Our method is able to capture and synthesize fine‐scale muscle bulge effects to a greater level of realism than achieved previously. We provide quantitative and qualitative validation of our method.

Variable gearing in a biologically inspired pneumatic actuator array

A fundamental feature of pennate muscles is that muscle fibers are oriented at an angle to the line of action and rotate as they shorten, becoming more oblique throughout a contraction. This change in fiber orientation (pennation angle) can amplify the shortening velocity of a fiber and increase output velocity of the muscle. The velocity advantage resulting from dynamic changes in pennation angle can be characterized as a gear ratio (muscle velocity/fiber velocity). A recent study has shown that a pennate muscle's gear ratio varies automatically depending on the load such that a muscle operates with a high gear during rapid contractions and low gear during forceful contractions. We examined whether this variable gearing behavior can be replicated in a pennate array of artificial muscles. We used McKibben type pneumatic actuators, which shorten in tension when filled with compressed gas. Similar to muscle fibers, the actuators expand radially during shortening, a feature thought to be a critical part of the variable gearing mechanism in pennate muscles. We arranged McKibben actuators in an array oriented to mimic a pennate muscle, and quantified the system's gear ratio during contraction against a range of loads. Video was used to measure the gear ratio during each contraction. We find that similar to pennate muscles, the gear ratio decreases significantly with increasing load and that variable gearing results from load-dependent variation in the amount of actuator rotation. These results support the idea that variable gearing in pennate muscles is mediated by difference is fiber rotation and the direction of muscle bulging. The behavior of our artificial muscle array also highlights the potential benefits of bio-inspired architectures in artificial muscle arrays, including the ability to vary force and speed automatically in response to variable loading conditions.

Temporal Bone Arrangements in Turtles: An Overview

The temporal region of turtles is characterized by significant anatomical diversity. Turtles show a pure anapsid morphotype that exhibits various different marginal reductions known as emarginations. As a result of this diversity, turtles can be taken as a model by which to understand the processes that may have resulted in the highly debated anatomy of the amniote temporal region in general. In this review on almost forgotten literature, I summarize ten potential factors that may act on the skull to shape the temporal region of turtles. These are: (1) phylogenetic constraints, (2) skull weights, (3) type of food, (4) skull dimensions, (5) muscle bulging, (6) ear anatomy and jaw muscle bending mechanisms, (7) extent and nature of muscle attachment sites, (8) internal forces within the jaw adductor chamber, (9) environmental pressure, and (10) neck bending mechanisms. Particular focus is laid on the interrelationship of the jaw musculature and the dermatocranial armour, which were assumed to influence each other to a certain degree. In the literature, cranial dimensions were assumed to influence temporal bone formation within major tetrapod groups. Among these, turtles seem to represent a kind of intermixture, a phenomenon that may be reflected in their specific anatomy. The references presented should be understood as product of the scientific environment in which they developed and the older literature does not always insist current empirical demands. However, the intuitive and creative ideas and the comprehensive anatomical considerations of these authors may inspire future studies in several fields related to this topic.

Detail‐aware spatial deformation transfer

ABSTRACTIn this paper, we propose a deformation transfer method that is applicable to multi‐component objects and is able to transfer fine‐scale deformations. To accomplish our goal, we combine surface‐based and space‐based deformation transfers. Our system enhances the result of space deformation transfer, which is applicable to multi‐component objects but loses details, by using surface‐based deformation transfer to add fine‐scale deformations. Self‐collisions are handled by approximating spatial relationships between surfaces, from the result of space deformation. Experimental results show that our method can transfer fine‐scale deformations such as motions of a skirt and muscle bulging. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature

BackgroundMuscle herniation of the leg is a rare clinical entity. Yet, knowing this condition is necessary to avoid misdiagnosis and delayed treatment. In the extremities, muscle herniation most commonly occurs as a result of an acquired fascial defect, often due to trauma. Different treatment options for symptomatic extremity muscle herniation in the extremities, including conservative treatment, fasciotomy and mesh repair have been described.Case presentationWe present the case of a patient who presented with prolonged symptoms after an ankle sprain. The clinical picture showed a fascial insufficiency with muscle bulging under tension. Ultrasound and MRI imaging confirmed the diagnosis of muscle hernia of the medial gastrocnemius on the right leg. Conservative treatment did not lead to success. Therefore, the fascial defect was treated surgically by repairing the muscle herniation using a synthetic vicryl propylene patch.ConclusionsMuscle hernias should be taken into consideration as a rare differential diagnosis whenever patients present with persisting pain or soft tissue swelling after ankle sprain. Diagnosis is mainly based on clinical aspect and physical examination, but can be confirmed by radiologic imaging techniques, including (dynamic) ultrasound and MRI. If conservative treatment fails, we recommend the closure with mesh patches for large fascial defects.

Paradoxical bulging of muscle after injection of botulinum neurotoxin type A into hypertrophied masseter muscle

Paradoxical bulging of muscle after injection of botulinum neurotoxin type A into hypertrophied masseter muscle

Pose Space Surface Manipulation

Example-based mesh deformation techniques produce natural and realistic shapes by learning the space of deformations from examples. However, skeleton-based methods cannot manipulate a global mesh structure naturally, whereas the mesh-based approaches based on a translational control do not allow the user to edit a local mesh structure intuitively. This paper presents an example-driven mesh editing framework that achieves both global and local pose manipulations. The proposed system is built with a surface deformation method based on a two-step linear optimization technique and achieves direct manipulations of a model surface using translational and rotational controls. With the translational control, the user can create a model in natural poses easily. The rotational control can adjust the local pose intuitively by bending and twisting. We encode example deformations with a rotation-invariant mesh representation which handles large rotations in examples. To incorporate example deformations, we infer a pose from the handle translations/rotations and perform pose space interpolation, thereby avoiding involved nonlinear optimization. With the two-step linear approach combined with the proposed multiresolution deformation method, we can edit models at interactive rates without losing important deformation effects such as muscle bulging.

Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft

ABSTRACT Introduction Distal biceps tendon ruptures are a rare injury and surgical reconstruction is typically recommended for chronic ruptures. There is no consensus regarding the most appropriate reconstruction technique. We present our experience with fascia lata autograft reconstructions of chronic distal biceps tendon ruptures using a modified single incision technique and distal fixation with suture anchors. Materials and methods We retrospectively reviewed the outcome of 12 male patients with chronic distal biceps tendon ruptures who had reconstruction using a fascia lata autograft through a single anterior approach. The age ranged from 29 to 62 years. The average delay to surgery was 26.5 weeks (range 6-68 weeks). A modified single anterior incision was utilized for all patients. Fascia lata autograft was attached distally to the bicipital tuberosity using suture anchors. Tension was set with the elbow in 50° of flexion. The average follow-up was 14.5 months (range 1.5-66 months). All patients were treated by the senior author (MSM). Results Eleven patients (92%) reported subjective improvement in elbow flexion and supination strength, as well as painless range of motion. The average elbow flexion/ extension arc was 126° (5° flexion to 131° flexion) and the average supination/pronation arc was 167 degrees (87° pronation to 80° supination). Five patients underwent isokinetic flexion strength testing which revealed a restoration of 86% of strength when compared to the uninvolved side. Four patients underwent supination isokinetic strength testing which revealed a restoration of 87% of strength when compared to uninvolved side. Four patients reported numbness in the superficial radial nerve distribution that recovered within 12 months. There were no cases of heterotopic ossification or graft rupture. There was one case of wound dehiscence at the elbow that required local flap coverage and went on to heal uneventfully. Aside from a small muscle bulge at the donor site, there were no donor site complications. Conclusion To our knowledge, this is the largest case series of patients undergoing distal biceps tendon reconstruction using fascia lata autograft. Our study has demonstrated a low complication rate with functional results similar to those reported in the literature utilizing a similar technique. We conclude that this technique offers a surgical treatment alternative that yields satisfactory functional outcomes with a low risk of complication. Morrell NT, Mercer DM, Moneim MS. Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft. The Duke Orthop J 2012;2(1):55-59.

The Mechanical Significance of the Temporal Fasciae in Macaca fascicularis: An Investigation Using Finite Element Analysis

Computational finite element analyses (FEAs) of the skull predict structural deformations under user specified loads and constraints, with results normally presented as stress and strain distributions over the skull's surface. The applied loads are generally a representation of the major adductor musculature, with the skull constrained at bite positions and at the articulating joints. However, virtually all analyses ignore potentially important anatomical structures, such as the fasciae that cover the temporalis muscle and attach onto the zygomatic arch. In vivo experimental studies have shown that removal of the temporal fasciae attachment onto the zygomatic arch in Cebus monkeys results in significant bone adaptation and remodeling in this region, suggesting the fasciae play an important role in stabilising the arch during biting. Here we investigate this potential stabilising role by carrying out FEAs of a macaque skull with and without temporal fasciae included. We explore the extent to which the zygomatic arch might be stabilized during biting by a synchronized tensioning of the temporal fasciae, acting to oppose masseteric contraction forces. According to our models, during temporalis muscle bulging the forces generated within the tensioned temporal fasciae are large enough to oppose the pull of the masseter. Further, a near bending-free state of equilibrium within the arch can be reached, even under forceful biting. We show that it is possible to eliminate the high strain gradients in and around the zygomatic arch that are present in past computational studies, with strains being more uniform in magnitude than previously thought.

肩甲舌骨筋症候群例

Omohyoid muscle syndrome (OMS) featuring marked omohyoid muscle bulging during swallowing, not present at rest, was first reported by R.B. Zachary in 1969. We report a case of this condition. A 41-year-old woman reporting right neck discomfort during swallowing was found to have bulging corresponding to the omohyoid muscle course, diagnosed as OMS. We excised the muscle, found to be of normal size, at the central tendon under general anesthesia. No recurrence has been seen in the 12 months post operative. Pathological findings included omohyoid muscle degeneration, hypertrophy, and atrophy. Cases reported in Japan numbered 22 since 1983, 10 of which were treated surgically and remedied satisfactorily. No common features were seen, although normal and abnormal findings were present in macroscopic and pathological intra- or postoperative examination. OMS is benign, and warrants surgery only in cases of severe subjective symptoms or at the subject's request.

Technique for repair of suprarenal and thoracoabdominal aortic aneurysms

Suprarenal and thoracoabdominal aortic aneurysms represent significant surgical challenges. For patients with associated aortic dissections, current endovascular technology has not been matured to address branch reconstructions that derive from separate lumens, making open surgical reconstruction the only proven method for repair. The required exposures of the thoracoabdominal aorta are expansive, and the extent of aortic replacement mandates efficient technique. Furthermore, a well-orchestrated team of surgeons, nurses, anesthesiologists, and perfusionists are all integral to achieving good outcomes and keeping operative courses tightly managed. Techniques to address extensive aneurysms of the thoracoabdominal aorta are reviewed in detail here, and videos are provided on The Journal website to show relevant anatomical features.