scholarly journals Neuromuscular sonography detects changes in muscle echotexture and nerve diameter in ICU patients within 24 h

2021 ◽  
Author(s):  
Catherine Bulinski ◽  
Maxime Viard ◽  
Alexander Vlazak ◽  
Kathrin Habig ◽  
Martin Juenemann ◽  
...  
Keyword(s):  
Patient Group ◽  
Tibialis Anterior ◽  
Peroneal Nerve ◽  
Time Course ◽  
Tibial Nerve ◽  
Rectus Femoris ◽  
Rectus Abdominis ◽  
Cross Sectional ◽  
Icu Patients ◽  
Difficult Weaning

Abstract Purpose During an ICU stay, changes in muscles and nerves occur that is accessible via neuromuscular sonography. Methods 17 patients recruited from the neurological and neurosurgical ICU (six women; 66 ± 3 years) and 7 healthy controls (three women, 75 ± 3 years) were included. Muscle sonography (rectus abdominis, biceps, rectus femoris and tibialis anterior muscles) using gray-scale values (GSVs), and nerve ultrasound (peroneal, tibial and sural nerves) analyzing the cross-sectional area (CSA) were performed on days 1 (t1), 3 (t2), 5 (t3), 8 (t4), and 16 (t5) after admission. Results Time course analysis revealed that GSVs were significantly higher within the patient group for all of the investigated muscles (rectus abdominis: F = 7.536; p = 0.011; biceps: F = 14.761; p = 0.001; rectus femoris: F = 9.455; p = 0.005; tibialis anterior: F = 7.282; p = 0.012). The higher GSVs were already visible at t1 or, at the latest, at t2 (tibialis anterior muscles). CSA was enlarged in all of the investigated nerves in the patient group (peroneal nerve: F = 7.129; p = 0.014; tibial nerve: F = 28.976, p < 0.001; sural nerve: F = 13.051; p = 0.001). The changes were visible very early (tibial nerve: t1; peroneal nerve: t2). The CSA of the motor nerves showed an association with the ventilation time and days within the ICU (t1 through t4; p < 0.05). Discussion We detected very early changes in the muscles and nerves of ICU-patients. Nerve CSA might be a useful parameter to identify patients who are at risk for difficult weaning. Therefore our observations might be severity signs of neuromuscular suffering for the most severe patients.

scholarly journals Patterns of whole-body muscle activations following vertical perturbations during standing and walking

2020 ◽  
Author(s):  
Desiderio Cano Porras ◽  
Jesse V. Jacobs ◽  
Rivka Inzelberg ◽  
Yotam Bahat ◽  
Gabriel Zeilig ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Muscle Activation ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Visual Input ◽  
Rectus Abdominis ◽  
Whole Body ◽  
Eyes Closed ◽  
Postural Responses ◽  
Muscle Activations

Abstract Background: Falls commonly occur due to losses of balance associated with vertical body movements (e.g. reacting to uneven ground, street curbs). Research, however, has focused on horizontal perturbations, such as forward and backward translations of the standing surface. This study describes and compares muscle activation patterns following vertical and horizontal perturbations during standing and walking, and investigates the role of vision during the standing postural responses. Methods: Fourteen healthy participants (ten males; 27±4 years-old) responded to downward, upward, forward, and backward perturbations while standing and walking in a virtual reality (VR) facility containing a moveable platform with an embedded treadmill; participants were also exposed to visual perturbations in which only the virtual scenery moves. We collected bilateral surface electromyography (EMG) signals from 8 muscles (tibialis anterior, rectus femoris, rectus abdominis, external oblique, gastrocnemius, biceps femoris, paraspinals, deltoids). Parameters included onset latency, duration of activation, and activation magnitude. Standing perturbations comprised dynamic-camera (congruent), static-camera (incongruent) and eyes-closed sensory conditions. ANOVAs were used to compare the effects of perturbation direction and sensory condition across muscles. Results: Vertical perturbations induced longer onset latencies and durations of activation with lower activation magnitudes in comparison to horizontal perturbations (p<0.0001). Downward perturbations while standing generated earlier activation of anterior muscles to facilitate flexion (for example, p=0.0005 and p=0.0021 when comparing the early activators, rectus femoris and tibialis anterior, to a late activator, the paraspinals), whereas upward perturbations generated earlier activation of posterior muscles to facilitate extension (for example, p<0.0001 and p=0.0004, when comparing the early activators, biceps femoris and gastrocnemius, to a late activator, the rectus abdominis). Static-camera conditions induced longer onset latencies (p=0.0085 and p<0.0001 compared to eyes-closed and dynamic-camera conditions, respectively), whereas eyes-closed conditions induced longer durations of activation (p=0.0001 and p=0.0008 compared to static-camera and dynamic-camera, respectively) and larger activation magnitudes. During walking, downward perturbations promptly activated contralateral trunk and deltoid muscles (e.g., p=0.0036 for contralateral deltoid versus a late activator, the ipsilateral tibialis anterior), and upward perturbations triggered early activation of trunk flexors (e.g., p=0.0308 for contralateral rectus abdominis versus a late activator, the ipsilateral gastrocnemius). Visual perturbations elicited muscle activation in 67.7% of trials.Conclusion: Our results demonstrate that vertical (vs. horizontal) perturbations generate unique balance-correcting muscle activations, which were consistent with counteracting vertical body extension induced by downward perturbations and vertical body flexion induced by upward perturbations. Availability of visual input appears to affect response efficiency, and incongruent visual input can adversely affect response triggering. Our findings have clinical implications for the design of robotic exoskeletons (to ensure user safety in dynamic balance environments) and for perturbation-based balance and gait rehabilitation.

scholarly journals Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

2011 ◽  
Vol 470 (3) ◽  
pp. 779-790 ◽  
Author(s):  
Jennifer L. Giuffre ◽  
Allen T. Bishop ◽  
Robert J. Spinner ◽  
Bruce A. Levy ◽  
Alexander Y. Shin
Keyword(s):  
Nerve Injury ◽  
Tibialis Anterior ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Nerve Transfer ◽  
Motor Branch ◽  
Peroneal Nerve Injury ◽  
Knee Trauma

scholarly journals Cadaveric Study of the Mode of Termination of the Sciatic Nerve in a Malian Population: Cases of Trifurcation and Hexafurcation

2021 ◽  
Author(s):  
Tata Touré ◽  
Babou Ba ◽  
Adoul Kader Moussa ◽  
Abdoulaye Kanté ◽  
Falé Traoré ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Artery Aneurysm ◽  
Common Peroneal Nerve ◽  
Anatomical Variations ◽  
Popliteal Fossa ◽  
Terminal Branch ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The sciatic nerve is the largest nerve in body. It is the only terminal branch of the sacral plexus. It emerges under the piriformis muscle, descends into the gluteal region, then into the posterior compartment of the thigh. It ends in the popliteal fossa by dividing into the tibial and common peroneal nerve. It is the most frequently injured nerve. The aim of this work was to study the mode of termination of the sciatic nerve by cadaveric dissection in a Malian population.Materials and methods: This was a cross-sectional study, carried out at the anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako, ranging from December 2019 to April 2021. The sciatic nerve was dissected 74 times in 37 cadaveric subjects (29 men and 8 women).Results: The classic termination mode (the sciatic nerve terminates giving the tibial nerve and common peroneal nerve) was most frequently encountered with a prevalence of 82.43%. Anatomical variations were noted in 17.57%. Among these variations, trifurcation (termination in three branches) of the sciatic nerve was observed in 16.22%. Hexafurcation (six-branch termination) of the sciatic nerve was observed in 1.35%. The termination mode showed a significant difference being more frequently bilateral than unilateral (P˂0.05)Conclusion: Anatomical variations in the mode of termination of the sciatic nerve are not uncommon. The most common of these variations is the trifurcation in which the sciatic nerve ends up giving the tibial nerve, the common peroneal nerve and a third branch which is variable. Knowledge of these variations is important for surgeons when treating popliteal artery aneurysm, popliteal vessel fistula and popliteal fossa cysts.

Changes in Crossed Spinal Reflexes After Peripheral Nerve Injury and Repair

2002 ◽  
Vol 87 (4) ◽  
pp. 1763-1771 ◽  
Author(s):  
Antoni Valero-Cabré ◽  
Xavier Navarro
Keyword(s):  
Sciatic Nerve ◽  
Action Potential ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Tibialis Anterior ◽  
Tibial Nerve ◽  
Spinal Reflexes ◽  
Injury And Repair

We investigated the changes induced in crossed extensor reflex responses after peripheral nerve injury and repair in the rat. Adults rats were submitted to non repaired sciatic nerve crush (CRH, n = 9), section repaired by either aligned epineurial suture (CS, n = 11) or silicone tube (SIL4, n = 13), and 8 mm resection repaired by tubulization (SIL8, n = 12). To assess reinnervation, the sciatic nerve was stimulated proximal to the injury site, and the evoked compound muscle action potential (M and H waves) from tibialis anterior and plantar muscles and nerve action potential (CNAP) from the tibial nerve and the 4th digital nerve were recorded at monthly intervals for 3 mo postoperation. Nociceptive reinnervation to the hindpaw was also assessed by plantar algesimetry. Crossed extensor reflexes were evoked by stimulation of the tibial nerve at the ankle and recorded from the contralateral tibialis anterior muscle. Reinnervation of the hindpaw increased progressively with time during the 3 mo after lesion. The degree of muscle and sensory target reinnervation was dependent on the severity of the injury and the nerve gap created. The crossed extensor reflex consisted of three bursts of activity (C1, C2, and C3) of gradually longer latency, lower amplitude, and higher threshold in control rats. During follow-up after sciatic nerve injury, all animals in the operated groups showed recovery of components C1 and C2 and of the reflex H wave, whereas component C3 was detected in a significantly lower proportion of animals in groups with tube repair. The maximal amplitude of components C1 and C2 recovered to values higher than preoperative values, reaching final levels between 150 and 245% at the end of the follow-up in groups CRH, CS, and SIL4. When reflex amplitude was normalized by the CNAP amplitude of the regenerated tibial nerve, components C1 (300–400%) and C2 (150–350%) showed highly increased responses, while C3 was similar to baseline levels. In conclusion, reflexes mediated by myelinated sensory afferents showed, after nerve injuries, a higher degree of facilitation than those mediated by unmyelinated fibers. These changes tended to decline toward baseline values with progressive reinnervation but still remained significant 3 mo after injury.

scholarly journals Application of Botulinum Neurotoxin Injections in TRAM Flap for Breast Reconstruction: Intramuscular Neural Arborization of the Rectus Abdominis Muscle

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 269
Author(s):  
Kyu-Ho Yi ◽  
Hyung-Jin Lee ◽  
Ji-Hyun Lee ◽  
Kyle K. Seo ◽  
Hee-Jin Kim
Keyword(s):  
Breast Reconstruction ◽  
Botulinum Neurotoxin ◽  
Rectus Abdominis ◽  
Tram Flap ◽  
Rectus Abdominis Muscle ◽  
Cross Sectional ◽  
Transverse Rectus Abdominis Myocutaneous ◽  
Intramuscular Nerves ◽  
The Ideal

Breast reconstruction after mastectomy is commonly performed using transverse rectus abdominis myocutaneous (TRAM) flap. Previous studies have demonstrated that botulinum neurotoxin injections in TRAM flap surgeries lower the risk of necrosis and allow further expansion of arterial cross-sectional diameters. The study was designed to determine the ideal injection points for botulinum neurotoxin injection by exploring the arborization patterns of the intramuscular nerves of the rectus abdominis muscle. A modified Sihler’s method was performed on 16 rectus abdominis muscle specimens. Arborization of the intramuscular nerves was determined based on the most prominent point of the xyphoid process to the pubic crest. All 16 rectus abdominis muscle specimens were divided into four muscle bellies by the tendinous portion. The arborized portions of the muscles were located on the 5–15%, 25–35%, 45–55%, and 70–80% sections of the 1st, 2nd, 3rd, and 4th muscle bellies, respectively. The tendinous portion was located at the 15–20%, 35–40%, 55–60%, and 90–100% sections. These results suggest that botulinum neurotoxin injections into the rectus abdominis muscles should be performed in specific sections.

scholarly journals Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application

2021 ◽  
Vol 10 (12) ◽  
pp. 2721
Author(s):  
Nobuto Nakanishi ◽  
Shigeaki Inoue ◽  
Rie Tsutsumi ◽  
Yusuke Akimoto ◽  
Yuko Ono ◽  
...  
Keyword(s):  
Measurement Accuracy ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Phantom Model ◽  
Ultrasound Measurements ◽  
Ultrasound Phantom

Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

Decline of contractility during ischemia-reperfusion injury: actin glutathionylation and its effect on allosteric interaction with tropomyosin

2006 ◽  
Vol 290 (3) ◽  
pp. C719-C727 ◽  
Author(s):  
Frank C. Chen ◽  
Ozgur Ogut
Keyword(s):  
Reperfusion Injury ◽  
Posttranslational Modifications ◽  
Actin Polymerization ◽  
Time Course ◽  
Troponin I ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
High Concentration ◽  
Cross Sectional ◽  
The Impact

The severity and duration of ischemia-reperfusion injury is hypothesized to play an important role in the ability of the heart subsequently to recover contractility. Permeabilized trabeculae were prepared from a rat model of ischemia-reperfusion injury to examine the impact on force generation. Compared with the control perfused condition, the maximum force (Fmax) per cross-sectional area and the rate of tension redevelopment of Ca2+-activated trabeculae fell by 71% and 44%, respectively, during ischemia despite the availability of a high concentration of ATP. The reduction in Fmax with ischemia was accompanied by a decline in fiber stiffness, implying a drop in the absolute number of attached cross bridges. However, the declines during ischemia were largely recovered after reperfusion, leading to the hypothesis that intrinsic, reversible posttranslational modifications to proteins of the contractile filaments occur during ischemia-reperfusion injury. Examination of thin-filament proteins from ischemic or ischemia-reperfused hearts did not reveal proteolysis of troponin I or T. However, actin was found to be glutathionylated with ischemia. Light-scattering experiments demonstrated that glutathionylated G-actin did not polymerize as efficiently as native G-actin. Although tropomyosin accelerated the time course of native and glutathionylated G-actin polymerization, the polymerization of glutathionylated G-actin still lagged native G-actin at all concentrations of tropomyosin tested. Furthermore, cosedimentation experiments demonstrated that tropomyosin bound glutathionylated F-actin with significantly reduced cooperativity. Therefore, glutathionylated actin may be a novel contributor to the diverse set of posttranslational modifications that define the function of the contractile filaments during ischemia-reperfusion injury.

Lower-Extremity Muscle Activity During Aquatic and Land Treadmill Running at the Same Speeds

2014 ◽  
Vol 23 (2) ◽  
pp. 107-122 ◽  
Author(s):  
W. Matthew Silvers ◽  
Eadric Bressel ◽  
D. Clark Dickin ◽  
Garry Killgore ◽  
Dennis G. Dolny
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
Muscle Activity ◽  
Tibialis Anterior ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Swing Phase ◽  
Treadmill Running ◽  
Vastus Medialis ◽  
Lower Extremity Muscle

Context:Muscle activation during aquatic treadmill (ATM) running has not been examined, despite similar investigations for other modes of aquatic locomotion and increased interest in ATM running.Objectives:The objectives of this study were to compare normalized (percentage of maximal voluntary contraction; %MVC), absolute duration (aDUR), and total (tACT) lower-extremity muscle activity during land treadmill (TM) and ATM running at the same speeds.Design:Exploratory, quasi-experimental, crossover design.Setting:Athletic training facility.Participants:12 healthy recreational runners (age = 25.8 ± 5 y, height = 178.4 ± 8.2 cm, mass = 71.5 ± 11.5 kg, running experience = 8.2 ± 5.3 y) volunteered for participation.Intervention:All participants performed TM and ATM running at 174.4, 201.2, and 228.0 m/min while surface electromyographic data were collected from the vastus medialis, rectus femoris, gastrocnemius, tibialis anterior, and biceps femoris.Main Outcome Measures:For each muscle, a 2 × 3 repeated-measures ANOVA was used to analyze the main effects and environment–speed interaction (P ≤ .05) of each dependent variable: %MVC, aDUR, and tACT.Results:Compared with TM, ATM elicited significantly reduced %MVC (−44.0%) but increased aDUR (+213.1%) and tACT (+41.9%) in the vastus medialis, increased %MVC (+48.7%) and aDUR (+128.1%) in the rectus femoris during swing phase, reduced %MVC (−26.9%) and tACT (−40.1%) in the gastrocnemius, increased aDUR (+33.1%) and tACT (+35.7%) in the tibialis anterior, and increased aDUR (+41.3%) and tACT (+29.2%) in the biceps femoris. At faster running speeds, there were significant increases in tibialis anterior %MVC (+8.6−15.2%) and tACT (+12.7−17.0%) and rectus femoris %MVC (12.1−26.6%; swing phase).Conclusion:No significant environment–speed interaction effects suggested that observed muscle-activity differences between ATM and TM were due to environmental variation, ie, buoyancy (presumed to decrease %MVC) and drag forces (presumed to increase aDUR and tACT) in the water.

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