Muscle Thickness Ratio Research Articles

The relationship between the ratio of the supraspinatus muscle thickness measured by ultrasound imaging and glenohumeral subluxation in stroke patients: a cross-sectional study.

Glenohumeral subluxation (GHS) is a common complication in stroke patients with hemiplegia, occurring in approximately 17-81% of cases. This study aims to evaluate the relationship between shoulder muscle thickness and the degree of subluxation using ultrasound imaging. A cross-sectional study of 61 stroke patients with hemiplegia was conducted, measuring supraspinatus muscle thickness, deltoid muscle thickness, and acromion-greater tuberosity (AGT). Logistic regression and ROC analyses were used. ROC curves, calibration plots, and decision curves were drawn on the training and validation sets. According to logistic regression analysis, the ratio of supraspinatus muscle thickness was statistically significant (OR: 0.80; 95% CI: 0.70-0.92; p < 0.01), and it was an independent factor for evaluating the presence or absence of GHS. An AUC of 0.906 (95% CI, 0.802-1.000) was found in the training set; meanwhile, the AUC in the validation set was 0.857 (95% CI, 0.669-1.000), indicating good performance. According to the training set ROC curve, the most effective statistical threshold was 93%, with a sensitivity of 84% and a specificity of 96%. The ratio of supraspinatus muscle thickness is a valuable criterion for evaluating GHS risk, supporting targeted rehabilitation interventions.

Dextrose neuroprolotherapy and occlusal splint treatment outcomes in occlusal trauma: Evaluation through ultrasound imaging.

Occlusal trauma has become a common phenomenon among individuals today. Its primary source is bruxism, which involves unusual activities such as clenching and grinding during the day or sleep. The hypothesis is that with 5% dextrose neuroprolotherapy, both the trigger points and affected nerves will be healed, and the muscle will be relieved by eliminating the pain. This study aimed to compare the short-term ultrasonographic results of patients treated with occlusal splint and 5% dextrose neuroprolotherapy for bruxism. Patients were divided into two groups: the dextrose neuroprolotherapy group and the occlusal splint group. In the first group, patients were administered 5% dextrose three times at one-week intervals using the dextrose neuroprolotherapy method. Impressions for both jaws were made using a high-viscosity irreversible hydrocolloid impression material in the second group. An occlusal splint was tailored to fit the upper jaw. Patients were assessed for masseter muscle thickness and strain ratio using ultrasonography before and 3 months after the treatment. No statistically significant differences were found between the two groups for all measures. Statistically significant differences were observed in the strain ratio of the left musculus massetericus in the resting position and the thickness of the left musculus massetericus in the contracted position exclusively in the neuroprolotherapy group (p=0.001, p=0.011, respectively). Differences in the strain ratio of both sides of the contracted musculus massetericus were demonstrated in both groups (neuroprolotherapy group: right side p<0.001, left side p=0.007, splint group: right side p=0.005, left side p=0.012). This study demonstrates that 5% dextrose neuroprolotherapy is an effective treatment comparable to an occlusal splint. Objectively visualizing changes in the masseter muscle through ultrasound provides clear results in the context of occlusal trauma and bruxism.

Correlation of Measurable Body Fat and Muscle Composition Parameters and Visceral Adipose Tissue on Computed Tomography with COVID-19 Severity

Background/Aims: Obesity increases the risk of having COVID-19. To evaluate the relationship between body fat, muscle composition, and visceral adipose tissue on computed tomography (CT) with COVID-19 outcome. Materials and Methods: 149 patients were included who had chest CT and a positive reverse transcriptase-polymerase chain reaction test. We measured the epicardial adipose tissue thickness (EAT) and liver density (LD), thoracic subcutaneous adipose tissue /pectoralis major (TSAT/PMJ), abdominal subcutaneous adipose tissue /psoas major muscle (ASAT/PSM), abdominal subcutaneous adipose tissue/erector spina muscle (ASAT/ESM) thickness ratios from thorax CT. Lymphocyte, platelet, neutrophil count, lymphocyte/neutrophil ratio, and CRP were recorded. Results: The mean EAT was high in the patients with a poor clinical course (in severe patients: 7.06±2.39 mm, in critical patients: 7.89±2.08 mm). The mean EAT of the ICU group was 7.70±2.14 mm, it was 8.50±2.10 mm in the deceased patients. TSAT/PMJ was lower in deceased patients (0.90±0.36, p=0.038). ASAT/PSM and ASAT/ESM were also higher in the moderate group (2,27±1,60 and 0,51±0,25) (p=0.003. and p=0.019) than mild one (1.59±1.80, and 0.40±0.26). There was no difference in terms of DM, malignancy, or gender. Conclusion: EAT was high in ICU-admitted and deceased patients and can be used as a predictor of poor prognosis.

Эхографические параметры век в различных возрастных группах европеоидного взрослого населения

Most of the literature data on eyelid structures are based on the measurements in cadavers or histological samples. Nonetheless, such data can differ from the living tissues with interstitial fluid and filled vessels. In clinical work, specialists sometimes need to be aware of in vivo parameters of eyelids tissue structures. Purpose. To measure thickness of normal eyelid structures with echographic method and establish normal ranges of these parameters in various age groups in Caucasians. Methods. This prospective observational study comprised 37 patients with a mean age of 46±13.13 years (aged 27–79 years; 28 women). All subjects were divided into 4 groups with an interval of 10 years from 20 to 60 years and a group aged above 60 years. Same operator took measurements of skin, circular eye muscle, conjunctiva, tarsus and their composition of both eyelids with B-scan ultrasonography. Results. We established some age-related trends for all parameters, but two of them change most significantly. The lower eyelid skin thickness in the group of 31–40 years old people (1.2 [1.0; 1.4] mm) significantly differed from the values in the groups of people aged 41–50 (1.65 [1.45; 1.85] mm, p=0.052) and 51–60 years (2.05 [1.73; 2.7] мм, p=0.05). Upper eyelid conjunctiva at the level of tarsal plate upper margin also tends to be thicker in people over 60 years (0.97 [0.8; 1.2] mm) than in younger adults, especially at the age of 21–30 (0.49 [0.44; 0.55], p=0.053) and 41–50 years (0.58 [0.50; 0.65] mm, p=0.053). In addition, it was found that the thicknesses of the upper eyelid structures differ significantly from similar structures of the lower eyelid. The ratio of orbicularis oculi muscle thickness to the thickness of the muscles lifting the upper eyelid is 1:2.1 in average, which ensures their good mobility and protective function. Conclusion. The study provides data about normal eyelid structures thickness in various age groups of Caucasians. The revealed differences between the upper and the lower eyelids are due to their different functionality. Key words: orbicularis oculi muscle; levator; blepharoplasty; aging; blinking; protective function of the eyelids; supportive function of the eyelids

Influence of individual quadriceps and hamstrings muscle architecture and quality on knee adduction and flexion moment in gait

The purpose of this study was to investigate the relationship between muscular parameters of quadriceps/hamstrings and knee joint kinetics in gait. Muscle architecture (thickness, pennation angle, and fascicle length), and quality (echo intensity) of individual quadriceps and hamstrings of 30 healthy participants (16 males and 14 females) was measured using ultrasound. Peak knee flexion moment (KFM), KFM impulse, peak knee adduction moment (KAM), and KAM impulse during walking were obtained at preferred speed. Pearson’s correlation coefficient and multiple regression analyses were performed at significance level of 0.05, and Cohen’s f2 values were calculated to examine the effect sizes of multiple regression. The hamstring-to-quadriceps muscle thickness ratio (r = 0.373) and semitendinosus echo intensity (r = − 0.371) were predictors of first peak KFM (R2 = 0.294, P = 0.009, f2 = 0.42), whereas only vastus medialis (VM) echo intensity was a significant predictor of second peak KFM (r = 0.517, R2 = 0.267, P = 0.003, f2 = 0.36). Only the VM thickness was the predictor of first (r = 0.504, R2 = 0.254, P = 0.005, f2 = 0.34) and second peak KAM (r = 0.581, R2 = 0.337, P = 0.001, f2 = 0.51), and KAM impulse (r = 0.693, R2 = 0.480, P < 0.001, f2 = 0.92). In conclusion, the greater hamstring-to-quadriceps muscle thickness ratio and the muscle architecture and quality of medial quadriceps/hamstring play an important role in KFM and KAM, and may have implications in knee osteoarthritis.

Reliability of Ultrasound Measurements of the Lumbar Multifidus and Transversus Abdominis Muscles during Lying and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain

The reliability studies are limited to support ultrasound usage during dynamic conditions; for example, unstable sitting position. This study aims to examine the reliability of ultrasound measurements of the lumbar multifidus and transversus abdominis during lying and unstable sitting positions in individuals with chronic low back pain (CLBP) and asymptomatic individuals considering abnormal lumbar lordosis. In this observational study, intrarater within-day and between-day reliability of muscle thickness and contraction ratio of the lumbar multifidus and transversus abdominis muscles were assessed using ultrasound imaging. In total, 40 participants (27 with CLBP, 13 asymptomatic individuals) with abnormal lumbar lordosis were recruited. The degree of lumbar lordosis has been measured by a flexible ruler. The muscle thickness was assessed at lying and sitting on a gym ball for both muscles in three sessions. Both groups had well to high ICCs of thickness measurement and contraction ratio in the transversus abdominis and lumbar multifidus muscles during both static (ICC=0.71-0.99) and semi-dynamic conditions (ICC=0.73-0.98). The standard error of measurements and minimal detectable changes were rather small in both groups. Ultrasound imaging is a highly reliable method to assess muscle thicknesses and contraction ratio of the transversus abdominis and lumbar multifidus during different conditions, even in patients with CLBP and abnormal lumbar lordosis.

Association Between the Medial-Lateral Quadriceps and Hamstring Muscle Thickness and the Knee Kinematics and Kinetics During Single-Leg Landing.

Muscle thickness can influence the joint kinematics and/or kinetics during dynamic activities. The relationship between the muscle thickness of individual quadriceps and hamstrings or medial-to-lateral thigh muscle thickness ratio and the knee kinematics/kinetics with respect to anterior cruciate ligament (ACL) injury risk remains unclear. Higher medial-to-lateral thigh muscle thickness ratio would be associated with lower knee valgus angle/moment and lower tibial internal rotation angle/moment during single-leg landing. Cross-sectional. Level 4. Muscle thickness of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST) of 30 healthy participants (16 males and 14 females) were measured using ultrasound. Knee joint kinematics and kinetics during single-leg landing were obtained. Stepwise multiple regression analysis, a follow-up Fisher's r to z test to examine the sex as a moderator, and independent t tests to evaluate sex difference were performed. Both knee valgus moment (R2 = 0.466, P < 0.001) and tibial external rotation moment (R2 = 0.330, P < 0.001) at peak anterior tibial shear force during single-leg landing were negatively correlated with medial-to-lateral (ie, (VM+ST):(VL+BF)) thickness ratio regardless of sex, whereas medial-to-lateral thigh muscle thickness ratio was not correlated with knee valgus and tibial external rotation angles. Male participants exhibited higher (VM+ST):(VL+BF) thickness ratio than female participants (P = 0.005), and lower knee valgus moment (P = 0.04) and tibial external rotation moment (P = 0.05), as well. The knee joint moments in frontal and transverse planes during single-leg landing were associated with the medial-to-lateral thigh muscle thickness ratio; thus, the medial-lateral thigh muscle thickness could be a potential contributor to frontal and transverse plane knee joint loading during dynamic movement. Strength training that aims to selectively strengthen the medial/lateral thigh muscles might be considered in a new ACL injury prevention training program to alter the biomechanical parameters associated with ACL injuries.

Usefulness of muscle ultrasound in appendicular skeletal muscle mass estimation for sarcopenia assessment.

The measurement of skeletal muscle mass is essential for the diagnosis of sarcopenia. Muscle ultrasonography has emerged as a useful tool for evaluating sarcopenia because it can be used to assess muscle quality and quantity. This study investigated whether muscle ultrasonography is effective for estimating appendicular skeletal muscle mass (ASM) and screening for sarcopenia. This study prospectively enrolled 212 healthy volunteers aged 40-80 years. ASM was measured using the bioelectrical impedance analysis. Muscle thickness (MT) and echo-intensity (EI) were measured in four muscles (biceps brachii, BB; triceps brachii, TB; rectus femoris, RF; biceps femoris, BF) on the dominant hand. A hold-out cross-validation method was used to develop and validate the ASM prediction equation. In the model development group, the ASM prediction equations were deduced as follows: estimated ASM for men (kg) = 0.167 × weight (kg) + 0.228 × height (cm) + 0.143 × MT of BF (mm)- 0.822 × EI to MT ratio of BB- 28.187 (R2 = 0.830) and estimated ASM for women (kg) = 0.115 × weight + 0.215 × height (cm) + 0.139 × MT of RF-0.638 × EI to MT ratio of BB- 23.502 (R2 = 0.859). In the cross-validation group, the estimated ASM did not significantly differ from the measured ASM in both men (p = 0.775; intraclass correlation coefficient [ICC] = 0.948) and women (p = 0.516; ICC = 0.973). In addition, multiple logistic regression analysis revealed that the ratios of EI to MT in the BF and RF muscles in men and MT in the BB muscle in women could be valuable parameters for sarcopenia screening. Therefore, our study suggests that muscle ultrasound could be an effective tool for estimating ASM and screening sarcopenia.

COVID-19 Pozitif ve Negatif Hastalar Arasında Toraks Bilgisayarlı Tomografi Tabanlı Vücut Kompozisyon Parametrelerinin Karşılaştırılması: Kesitsel Bir Çalışma

Objective: To compare body fat-muscle and visceral obesity indices that can be measured with thorax computed tomography (CT) between reverse transcriptase-polymerase chain reaction (RTPCR) positive and negative patients. Material and Methods: This retrospective, comparative study included 141 PCR (+) and 150 PCR (-) patients who applied to our hospital with flu-like symptoms without having the comorbid diseases and undergone thoracic CT between April 1, 2020-July 1, 2020. For the each patient, the ratio of thoracic subcutaneous adipose tissue thickness to pectoralis major muscle thickness (TSAT/PMJ), epicardial adipose tissue thickness (EAT), liver density (LD), abdominal subcutaneous adipose tissue thickness to psoas major muscle thickness ratio (ASAT/ PSM), subcutaneous abdominal adipose tissue thickness to erector spinae muscle thickness ratio (ASAT/ESM) was measured. The comparison was made between the subgroups in terms of age, gender, and measured parameters. Results: Statistically significant difference was found between PCR (+) and (-) individuals in terms of EAT mean (p0.05) in terms of TSAT/PMJ, ASAT/PSM, LD, ASAT/ESM. Conclusion: Higher EAT values can increase the risk of getting coronavirus disease-2019 (COVID-19) infection. Peripheral fat-muscle indices don't increase the risk of contracting COVID-19 infection.

Persistent intolerable abdominal pain in patients with Parkinson’s disease

ObjectivesIn Parkinson’s disease (PD), pain is common, increases motor disability, and makes daily life unpleasant. Few patients reportedly have a low prevalence of abdominal pain. The pathophysiology of such abdominal pain has not been confirmed. We clinically studied patients with PD and persistent intolerable abdominal pain to determine the pathophysiology and effective therapy. Materials and MethodsWe obtained detailed clinical information from medical records, including the disease course before and after the onset of abdominal pain. The maximal thickness of the rectus muscle at the L4 and L5 corpus vertebral level of the abdomen on axial computed tomography was calculated, and the relative muscle thickness ratio was calculated by dividing the maximal thickness by the distance from the fascia between the bilateral rectus muscles of the abdomen and the dorsal part of the corpus vertebrae. ResultsIn six patients with PD (three men, age range 71–85 years), the Hoehn–Yahr stage, disease duration, and daily levodopa equivalent dose were 3.1 ± 0.7, 107 ± 44 months, and 636.7 ± 451.4 mg/day, respectively. The pain occurred daily and often during the night and was not related to the timing of food intake. The pain in two patients was related to wearing-off. One patient showed constant hypertonic activity in the rectus abdominis on surface electromyography. The rectus abdominis showed that the maximal thickness and relative muscle thickness ratio of patients with abdominal pain were significantly higher than those of patients without pain. Therapeutic usefulness of antiparkinsonian medications was short and limited. ConclusionsAlthough intolerable abdominal pain is likely to be infrequent, it alleviates the quality of life of patients with PD. The pathophysiology seems to vary, and our observations found wearing-off of related pain and muscle contraction, suggesting dystonia. Among persistent abdominal pain, organic abnormalities, such as the precursor state of megacolon, may be lurking.

Knee alignment and individual quadriceps femoris muscle thicknesses and their relationships with postnatal motor development and subcutaneous fat thickness: A cross-sectional study in Japanese infants

BackgroundPostnatal changes in individual quadriceps femoris muscle thicknesses and the relationships between knee alignment and quadriceps thicknesses, postnatal motor development, and subcutaneous fat thickness are unclear. This study investigated knee alignment and individual quadriceps thickness ratios in Japanese infants and investigated their relationships with postnatal motor development and subcutaneous fat thickness. MethodsOne-year-old (n = 28), 2-year-old (n = 26), and 3-year-old infants (n = 22) were included. Postnatal months when the infants began crawling, standing, and walking were assessed. The intercondylar distance was measured, and the individual quadriceps and subcutaneous fat thicknesses at the right mid-thigh were measured using ultrasonography. The individual quadriceps:total quadriceps muscle thickness ratios were calculated. Analysis of variance tests in the 3 groups were conducted for the intercondylar distances and individual quadriceps thickness ratios, and correlation coefficients between the parameters were evaluated in each group. FindingsIntercondylar distance was longer in 1-year-old infants than in 2-year-old infants (p < 0.001), without significant differences between 2-year-old and 3-year-old infants (p = 0.33). The rectus femoris thickness ratio was higher in 1-year-old infants than in 3-year-old infants (p = 0.013), whereas the vastus medialis thickness ratio was higher in 3-year-old infants than in 2-year-old infants (p = 0.024). In 3-year-old infants, a larger subcutaneous fat thickness, but not postnatal motor development, was correlated with a longer intercondylar distance and a lower vastus medialis thickness ratio (rs = 0.53, p = 0.012; rs = −0.46, p = 0.032, respectively). InterpretationFurther studies on the relationships between subcutaneous fat and knee alignment and vastus medialis in juveniles, adolescents, young adults, and elderly people are expected.

Effect of direct vibration on the activity of deep trunk muscles of patients with non-specific chronic low back pain.

Vibration training is an adjuvant to muscle-strengthening exercises. To investigate the short-term effects of direct vibration on the deep trunk muscles of patients with non-specific chronic low back pain (CLBP). Participants with non-specific CLBP were randomly placed into two groups: the vibration-plus stabilization exercise (VSE) group (n= 31) and the conventional stabilization exercise (CSE) group (n= 31). The groups underwent 12 sessions of an exercise program. The thickness and activity of the trunk muscles were measured using ultrasonography and surface electromyography. Ultrasonography revealed that the ratio of muscle thickness to contraction and relaxation was statistically increased after exercise in the bilateral transversus abdominis (TrA) and lumbar multifidus (LM) muscles in the CSE group (p= 0.031), and in the bilateral TrA, LM, and internal oblique (IO) muscles in the VSE group (p< 0.001). The LM/lumbar erector spinae (LES) ratio in the CSE group (p= 0.037), and the IO/rectus abdominis (RA), TrA/RA, and LM/LES ratios in the VSE group (p= 0.019) were statistically increased. Multiple regression analysis showed that symptom improvement was related to increased activity of the deep trunk muscles in the VSE group (p< 0.001). Direct vibration can increase the selective activity of contracting deep trunk muscles.

Persistent quadriceps muscle atrophy after anterior cruciate ligament reconstruction is associated with alterations in exercise-induced myokine production

PurposePersistent quadriceps muscle atrophy is observed in a subset of patients following anterior cruciate ligament reconstruction (ACLR) despite the completion of comprehensive rehabilitation. Critically, quadriceps muscle atrophy correlates with muscle weakness and quadriceps strength deficits. The aim of this study was to examine the effect of resistance exercise on myokine levels and muscle atrophy status in ACLR patients with persistent quadriceps muscle atrophy. MethodsSixteen participants between the ages of 18–39 with a Tegner score of >6 and who had undergone ACLR with hamstring graft were recruited for the study. Quadriceps muscle thicknesses were ascertained by ultrasonography and isokinetic strength assessments were made prior to commencing a single bout of resistance exercise training (RET). Blood samples were taken before and after RET and assayed for myokine expression. Self-reported activity level and knee function questionnaires were completed and recorded. ResultsClustering by quadriceps muscle size measurements created a non-atrophy group of 9 subjects and an atrophy group of 7 subjects. There were no significant between-group differences in anthropometric measurements, time post operation and knee function questionnaires, but the atrophic group comprised of patients with lower pre-injury sporting levels. The atrophy group exhibited significant lower side-to-side muscle thickness ratios and a decreasing trend in quadriceps strength deficits. Serum brain-derived neurotrophic factor (BDNF) was up-regulated in response to RET in non-atrophy group, but a negative fold change was detected in the atrophy group. ConclusionThe dysregulation in myokines plays an important role in patients failing to regain muscle mass after ACLR leading to persistent quadriceps muscle atrophy, which may potentiate greater strength deficits and poor functional recovery.

Long-Term Weaning of Mechanical Ventilation After Lung Transplantation: Patient Characteristics and Impact on Survival

<h3>Purpose</h3> Following lung transplantation (LTx), some recipients may require a prolonged postoperative course including long-term weaning of mechanical ventilation, raising concerns regarding transplant benefit. The aim of this study was to characterize this subgroup of patients, identify risk factors of prolonged mechanical ventilation (PMV), and determine impact on survival. <h3>Methods</h3> We retrospectively reviewed all adult LTx procedures performed at our center between January 2008 and January 2019 (n=1138). Logistic regression analysis of baseline characteristics and peri-operative variables was utilized to identify risk factors for PMV. The subgroup with PMV > 60 days was then compared to a random sample of patients of equal size with short MV (< 48 hr). <h3>Results</h3> Fifty-eight patients (5%) underwent PMV > 60 days (median 99.5, IQR 71-152 days). Independent risk factors for PMV > 60 days were bridging on MV, double (versus single) LTx, concomitant cardiac procedure, re-exploration for bleeding, and primary graft dysfunction higher grades. At time of LTx listing, the group with PMV > 60 days had higher lung allocation score (72 [44-89] vs 40 [35-48], p < .01), greater chest wall soft tissue to pectoralis muscle thickness ratio (3 ± 1 vs 2 ± 1, p = .02), lower 6-minute walk test distance (873 [680-1058] vs 1003 [821-1183], p = .03), increased bridging on MV (72% vs 53%, p = .03) or ECMO (29% vs 0%, p < .01), compared to patients with short MV (< 48 hr). The group with PMV > 60 days underwent more double LTx (93% vs 48%, p < .01), cardiopulmonary bypass utilization (93% vs 45%, p < .01), concomitant cardiac procedures (29% vs 5%, p < .01), re-exploration for bleeding (36% vs 3%, p < .01), delayed chest closure (52% vs 2%, p < .01), post-LTx ECMO (24% vs 0%, p < .01), and had higher primary graft dysfunction grade 3 (48% vs 2%, p < .01). Additionally, patients with PMV > 60 days had higher hospital mortality (15% vs 3%, p = 0.02) and lower 1-year survival (59% vs 86%, p < .01); however, there was no difference in 3- or 5-year survival. <h3>Conclusion</h3> LTx recipients who undergo long-term weaning of MV have unique baseline characteristics prior to listing that influence the likelihood of a prolonged perioperative course and worse short-, but not long-, term survival. Understanding the specific predictors of PMV, and which are potentially modifiable, would contribute to optimal recipient selection.

Effect of acupotomy intervention on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis

To observe the effect of acupotomy on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis and to reveal the possible therapeutic mechanism involved in the effect of acupotomology on the treatment of knee osteoarthritis(KOA). Twenty-four male New Zealand rabbits aged 6 months and weighed (2.0±0.5) kg were randomly divided into blank group, model group and acupotomy group, 8 rabbits in each group. KOA model was established by modified Videman method with left hind limb extended plaster immobility for 6 weeks. In acupotomy group, the transfascial focal points of quadriceps femoris muscle were released by acupotomy under the guidance of Jingjin theory for 4 times and once a week, and the treatment points include Hedingci, Binwaixia, Binneixia. Blank group and model group were fed normally without intervention. One week after the end of the intervention, the pennation angle(PA), muscle thickness(MT), cross-sectional area(CSA) and strain ratio(SR) of rectus femoris were measured by ultrasound. HE staining was used to observe the changes of the tissue morphology, the number of muscle fibers and the average area of muscle fibers. The myofibril of rectus femoris, sarcomere and myofilament were observed by transmission electron microscope. The PA of rectus femoris muscle in the blank group was (9.05±0.21)°. The MT was(1.09±0.09) cm and the CSA was(1.30±0.01) cm2. The PA of rectus femoris muscle in the model group was (3.06±0.15)°. The MT was (0.71±0.02) cm and the CSA was(0.77±0.02) cm2. The PA of rectus femoris muscle in the acupotomy group was (6.94±0.28)°. The MT was (0.80±0.05) cm and the CSA was(0.94±0.03) cm2. The muscle PA, MT and CSA of rectus femoris in the model group were significantly smaller than those in the blank group (P<0.05). Those in acupotomy group were significantly increased compared with those in model group (P<0.05). The SR of rectus femoris muscle was 1.19±0.02 in the blank group, 3.50±0.05 in the model group and 1.99±0.07 in the acupotomy group. The elastic SR of the model group was significantly higher than that of the blank group (P<0.05). These in acupotomy group was significantly lower than that in model group(P<0.05). The results of HE staining showed:in blank group, the fascicles of rectus femoris were arranged neatly, the number of beam of muscle fibers within the fixed visual field was 94.38±3.50 and the average CSA was(0.75±0.22) mm2. In model group, the fascicles of rectus femoris with different sizes were disorganized with a small amount of inflammatory cell infiltration, the number of beam of muscle fibers within the fixed visual field was 196.63±2.62 and the average CSA was(0.26±0.03) mm2. Compared to the blank group, a significant increase in the number of muscle fibers in the fixed field in the model group (P<0.05) and the average CSA decreased significantly(P<0.05). In acupotomy group, the rectus femoris fascicles in the acupotomy group tended to be arranged in a more orderly manner, with the inflammatory cells decreased, the number of beam of muscle fibers within the fixed visual field was 132.88±4.61 and the average CSA was(0.70±0.07) mm2. Compared to the model group, a significant decrease in the number of muscle fibers in the fixed field in the model group(P<0.05) and the average CSA increased significantly(P<0.05). The results of transmission electron microscope showed:compared with the blank group, the overall arrangement of the myofibrils of the rectus femoris in the model group was less structured. There was fracture between the muscle fibers and the sarcomere, the myofilaments were disordered, and the fracture of the Z line was discontinuous. Compared with the model group, the myofibrillar texture of rectus femoris in acupotomy group was clearer, and the Z line was more continuous. Based on the jingjin theory, the release of quadriceps femoris by acupotomy can effectively improve the morphology and structure of rectus femoris, and promote the repair and reconstruction of chronic skeletal muscle injury in rabbits with KOA, which may be one of the mechanisms of acupotomy in the treatment of KOA.

Functional and morphological changes in shoulder girdle muscles after repeated climbing exercise

ABSTRACT This study aimed to investigate the acute effect of repeated climbing actions on functional and morphological measures of the shoulder girdle. Fifteen male indoor climbers participated in this study. All the climbers declared route level 6a+, as the best climbing grade (French climbing grade scale). Functional (range of motion – ROM and muscle strength), and morphological measurements (muscle/tendon stiffness and thickness) after a repeated climbing exercise protocol were analysed. The ROM and muscle strength showed significant decreases from baseline to Immediate-Post (IA) as well as significant increases from IA to 1 h-Post for all movements (p ≤ .001 for all). Muscle stiffness showed significant increases from baseline to IA after as well as significant decreases from IA to 1 h-Post for all muscles (p ≤ .001 for all). However, the thickness showed significant increases from baseline to IA for supraspinatus tendon and muscle thickness and occupation ratio (p ≤ .001 for all), while a significant decrease was observed in acromiohumeral distance (p ≤ .001). Significant decreases from IA to 1 h-Post were found for muscles/tendons and occupation ratio (p ≤ .001 for all), while a significant increase for AHD (p ≤ .001). Our data demonstrated acute alterations in tendon thickness due to acute signs of implement symptom in climbers.

Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial

BackgroundFacial expression muscles atrophy is one kind of sequelae after peripheral facial paralysis. It causes critical problems in facial appearance of patient as well as social and psychological problems. This study aims to evaluate the efficacy and safety of Thread-embedding acupuncture (TEA) for the management of facial expression muscles atrophy after peripheral facial paralysis.MethodsThis is a patient-assessor blinded, randomized, sham-controlled trial. A total of fifty-six eligible patients will be randomly divided into TEA (n=28) and sham TEA (STEA) (n=28) groups. Both groups will receive TEA or STEA treatment at the frontal muscle and the depressor anguli oris muscle, at one predefined points once a week for eight weeks. Additionally, both groups will receive traditional acupuncture treatment at ten acupoints (GB20, LI4, LR3, GB12, ST7, SI18, LI20, BL2, SJ23, ST4) twice a week for eight weeks as a concurrent treatment. B-mode ultrasonography will be used to assess the changes in facial expression muscle thickness ratio of the affected/healthy side at baseline and at 10 weeks after screening, as the primary outcome. House-Brackmann Grade and lip mobility score will be measured and analyzed at baseline and 4, 8, 10, and 12 weeks after screening, as secondary outcomes.DiscussionThe study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis.Trial registrationChinese Clinical Trial Registry, ChiCTR1900027170. Registered on 3 November 2019, http://www.chictr.org.cn/edit.aspx?pid=45173&htm=4

MOTOR NEURON DISORDERS AND NEUROPATHIES: EP.242 Fraction ratio of muscle thickness as ultrasonographic biomarker in patients with amyotrophic lateral sclerosis

MOTOR NEURON DISORDERS AND NEUROPATHIES: EP.242 Fraction ratio of muscle thickness as ultrasonographic biomarker in patients with amyotrophic lateral sclerosis

Relationship between glenohumeral internal rotation deficit and shoulder conditions in professional baseball pitchers

Previous studies have reported that glenohumeral internal rotation deficit (GIRD) may increase the risk of throwing-shoulder injuries. The purpose of this study was to analyze the conditions of the throwing shoulder in professional baseball pitchers with GIRD by comparing with those in pitchers without GIRD. In total, 26 male professional baseball pitchers participated in this study. We evaluated passive range of motion (ROM) and isometric muscle strength at internal rotation (IR) and external rotation (ER) at 90° of abduction, as well as the muscle thickness of the supraspinatus (SSP) and infraspinatus (ISP) by ultrasound. The pitchers were divided into 2 groups: those who exhibited a loss of IR of ≥20° in the throwing shoulder (GIRD group) and those who did not (non-GIRD group). In the GIRD group, the total ROM deficit (throwing side - non-throwing side) (P < .001), the muscle thickness ratio (throwing to non-throwing) of the SSP and ISP (P = .017 and P = .014, respectively), and the muscle strength ratio (throwing to non-throwing) of ER (P = .028) were significantly lower than those in the non-GIRD group. In contrast, the muscle strength ratio (throwing to non-throwing) of IR was significantly higher in the GIRD group than in the non-GIRD group (P = .0064). We have shown that GIRD has significant correlations with several conditions, such as atrophy of the SSP and ISP, weakness of ER strength, enhancement of IR strength, limitation of total ROM, and throwing side, all of which could be important factors for throwing-shoulder injuries.

STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia.

The aim of the study was to explore an individualized sonographic muscle thickness ratio and its cutoff values in the diagnosis of sarcopenia. A total of 326 community-dwelling adults were included in this cross-sectional study. Total skeletal muscle mass was evaluated by bioelectrical impedance analysis, and nine-site muscle thickness measurements using ultrasound. Isometric handgrip and knee extension strengths were assessed. Physical performance was evaluated by usual Gait Speed, Chair Stand Test, and Timed Up and Go Test. Because the anterior thigh muscle thickness was the most significantly decreasing measurement with aging and the most significantly related value with body mass and height; sonographic thigh adjustment ratio was calculated by dividing it with body mass index. Using the two standard deviation values of our healthy young adults, sonographic thigh adjustment ratio cutoff values were found as 1.4 and 1.0 for male and female subjects, respectively. Sonographic thigh adjustment ratio values were negatively correlated with Chair Stand Test and Timed Up and Go Test in both sexes (all P < 0.05) and positively correlated with gait speed in female subjects and knee extension strength in male subjects (both P < 0.05). Our results imply that regional (rather than total) muscle mass measurements should be taken into consideration for the diagnosis of sarcopenia.