scholarly journals Are Leg Muscle, Tendon and Functional Characteristics Associated with Medial Tibial Stress Syndrome? A Systematic Review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Joshua P. M. Mattock ◽  
Julie R. Steele ◽  
Karen J. Mickle
Keyword(s):  
Shear Modulus ◽  
Soleus Muscle ◽  
Muscle Activity ◽  
Treatment Options ◽  
Neuromuscular Control ◽  
The Body ◽  
Medial Tibial Stress Syndrome ◽  
Specific Information ◽  
Leg Muscles ◽  
Stress Syndrome

Abstract Background Medial tibial stress syndrome (MTSS) is a common overuse injury that lacks effective evidence-based treatment options. Reduced leg girth has been associated with MTSS development because it is hypothesised to impair the ability of the leg to modulate tibial loading generated during foot–ground contact. Measuring total leg girth, however, does not provide specific information about the structural composition or functional capacity of individual leg muscles. Consequently, uncertainty remains as to which specific muscles are compromised and contribute to MTSS development. Therefore, this paper aimed to systematically review the body of literature pertaining to how the structure and function of the leg muscles are thought to be associated with MTSS injury. Methods The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Medline, PubMed, SCOPUS, SPORTDiscus with Full-texts and Web of Science were searched until March 2021 to identify articles in which lower limb muscle structural or functional variables associated with MTSS injury were investigated. Results Seventeen studies, which were predominately case–control in design and captured data from 332 individuals with MTSS symptoms and 694 control participants, were deemed appropriate for review. The average Downs and Black Quality Assessment score was 71.7 ± 16.4%, with these articles focussing on leg girth, tendon abnormalities, muscle strength and endurance, shear modulus and neuromuscular control. Of the risk factors assessed in the 17 studies, decreased lean leg girth and higher peak soleus muscle activity during propulsion were most strongly correlated with MTSS development. Individuals with MTSS also displayed deficits in ankle plantar flexor endurance, greater isokinetic concentric eversion strength, increased muscle shear modulus and altered neuromuscular recruitment strategies compared to asymptomatic controls. Conclusions Future prospective studies are required to confirm whether decreased lean leg girth and higher peak soleus muscle activity during propulsion are associated with MTSS development and to elucidate whether these structural and functional differences in the leg muscles between MTSS symptomatic and asymptomatic controls are a cause or effect of MTSS.

Shear Modulus of the Lower Leg Muscles in Patients with Medial Tibial Stress Syndrome

2016 ◽  
Vol 42 (8) ◽  
pp. 1779-1783 ◽  
Author(s):  
Kei Akiyama ◽  
Ryota Akagi ◽  
Kuniaki Hirayama ◽  
Norikazu Hirose ◽  
Hideyuki Takahashi ◽  
...  
Keyword(s):  
Shear Modulus ◽  
Lower Leg ◽  
Medial Tibial Stress Syndrome ◽  
Leg Muscles ◽  
Stress Syndrome

scholarly journals The Effects of Stochastic Galvanic Vestibular Stimulation on Body Sway and Muscle Activity

2020 ◽  
Vol 14 ◽  
Author(s):  
Akiyoshi Matsugi ◽  
Kosuke Oku ◽  
Nobuhiko Mori
Keyword(s):  
Soleus Muscle ◽  
Muscle Activity ◽  
Center Of Pressure ◽  
Vestibular Stimulation ◽  
Galvanic Vestibular Stimulation ◽  
The Body ◽  
Lower Limbs ◽  
Body Sway ◽  
Eyes Open ◽  
Significant Increment

Objective: This study aimed to investigate whether galvanic vestibular stimulation with stochastic noise (nGVS) modulates the body sway and muscle activity of the lower limbs, depending on visual and somatosensory information from the foot using rubber-foam.Methods: Seventeen healthy young adults participated in the study. Each subject maintained an upright standing position on a force plate with/without rubber-foam, with their eyes open/closed, to measure the position of their foot center of pressure. Thirty minutes after baseline measurements under four possible conditions (eyes open/closed with/without rubber-foam) performed without nGVS (intensity: 1 mA, duration: 40 s), the stimulation trials (sham-nGVS/real-nGVS) were conducted under the same conditions in random order, which were then repeated a week or more later. The total center of pressure (COP) path length movement (COP-TL) and COP movement velocity in the mediolateral (Vel-ML) and anteroposterior (Vel-AP) directions were recorded for 30 s during nGVS. Furthermore, electromyography activity of the right tibial anterior muscle and soleus muscle was recorded for the same time and analyzed.Results: Three-way analysis of variance and post-hoc multiple comparison revealed a significant increment in COP-related parameters by nGVS, and a significant increment in soleus muscle activity on rubber. There was no significant effect of eye condition on any parameter.Conclusions: During nGVS (1 mA), body sway and muscle activity in the lower limb may be increased depending not on the visual condition, but on the foot somatosensory condition.

Atrophy and Depigmentation After Pretibial Corticosteroid Injection for Medial Tibial Stress Syndrome: Two Case Reports

2016 ◽  
Vol 25 (4) ◽  
pp. 380-381 ◽  
Author(s):  
Miette F. Loopik ◽  
Marinus Winters ◽  
Maarten H. Moen
Keyword(s):  
Conservative Treatment ◽  
Physical Examination ◽  
Case Reports ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Medial Tibial Stress Syndrome ◽  
Case Presentation ◽  
Stress Syndrome ◽  
Local Injections ◽  
Corticosteroid Injections

Introduction:No reports have been published on the results of corticosteroid injections for medial tibial stress syndrome (MTSS).Case Presentation:The authors present 2 cases of women with MTSS who showed atrophy and depigmentation of the skin after pretibial corticosteroid injections. Case 1 is an 18-y-old woman presenting with pain in her lower leg for 12 mo. No improvement was noticed after conservative treatment, so she received local injections with corticosteroids. Five months later physical examination showed tissue atrophy and depigmentation around the injection sites. Case 2 is a 22-y-old woman who presented with pain in both lower legs for 24 mo. Several conservative treatment options failed, so she received local injections with corticosteroids. Physical examination revealed tissue atrophy and depigmentation around the injection sites.Conclusion:No positive effect of injections with corticosteroids was found in 2 cases of MTSS. Furthermore, considerable tissue atrophy and hypopigmentation of the skin was observed.

Abnormally Decreased Regional Bone Density in Athletes with Medial Tibial Stress Syndrome

2001 ◽  
Vol 29 (6) ◽  
pp. 712-715 ◽  
Author(s):  
Håkan I. Magnusson ◽  
Nils E. Westlin ◽  
Fredrik Nyqvist ◽  
Per Gärdsell ◽  
Ego Seeman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
The Body ◽  
Medial Tibial Stress Syndrome ◽  
Mineral Density ◽  
Male Athletes ◽  
Tibial Bone ◽  
Control Subjects ◽  
Stress Syndrome ◽  
Regional Bone Mineral Density

Medial tibial stress syndrome, a common condition of uncertain origin found in athletes, is characterized by pain in the distal posteromedial aspect of the tibia during exercise, with or without increased scintigraphic uptake in the affected region. To determine whether medial tibial stress syndrome with increased scintigraphic uptake is associated with a change in tibial bone mineral density confined to the site of the increased uptake, we measured bone mineral density (in grams per square centimeter) in 18 adult male athletes with long-standing medial tibial stress syndrome and compared the measurements with those of 16 age-and sex-matched control subjects and with those of 18 athletes without medial tibial stress syndrome who had a comparable training regimen. Tibial bone mineral density in the region corresponding to the pain was 15% ± 9% lower in the patients than in control subjects and 23% ± 8% lower than in the athletic control subjects (both significant differences). Bone mineral densities in most other regions of the body were higher than in the control subjects but lower than in the athletic controls at the corresponding sites. In summary, medial tibial stress syndrome is associated with low regional bone mineral density.

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

Changes in muscle activities and kinematics due to simulated leg length inequalities

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hannah Lena Siebers ◽  
Jörg Eschweiler ◽  
Filippo Migliorini ◽  
Valentin Michael Quack ◽  
Markus Tingart ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Rectus Femoris ◽  
Knee Extension ◽  
Pelvic Obliquity ◽  
Lateral Flexion ◽  
Leg Length ◽  
Joint Angles ◽  
Leg Muscles ◽  
Compensation Mechanisms ◽  
Musculoskeletal Problems

Abstract Muscle imbalances are a leading cause of musculoskeletal problems. One example are leg length inequalities (LLIs). This study aimed to analyze the effect of different (simulated) LLIs on back and leg muscles in combination with kinematic compensation mechanics. Therefore, 20 healthy volunteers were analyzed during walking with artificial LLIs (0–4 cm). The effect of different amounts of LLIs and significant differences to the reference condition without LLI were calculated of maximal joint angles, mean muscle activity, and its symmetry index. While walking, LLIs led to higher muscle activity and asymmetry of back muscles, by increased lumbar lateral flexion and pelvic obliquity. The rectus femoris showed higher values, independent of the amount of LLI, whereas the activity of the gastrocnemius on the shorter leg increased. The hip and knee flexion of the long leg increased significantly with increasing LLIs, like the knee extension and the ankle plantarflexion of the shorter leg. The described compensation mechanisms are explained by a dynamic lengthening of the short and shortening of the longer leg, which is associated with increased and asymmetrical muscle activity. Presenting this overview is important for a better understanding of the effects of LLIs to improve diagnostic and therapy in the future.

scholarly journals Liquid Biopsy Analysis in Clinical Practice: Focus on Lung Cancer

2021 ◽  
Vol 2 (3) ◽  
pp. 241-254
Author(s):  
Pasquale Pisapia ◽  
Francesco Pepe ◽  
Antonino Iaccarino ◽  
Roberta Sgariglia ◽  
Mariantonia Nacchio ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Liquid Biopsy ◽  
Treatment Options ◽  
Molecular Testing ◽  
Specific Information ◽  
Sample Collection ◽  
Timely Manner ◽  
Oncology Practice ◽  
Nsclc Patients ◽  
To Receive

Lung cancer is the leading cause of cancer death worldwide. Despite the emergence of highly effective targeted therapies, up to 30% of advanced stage non-small cell lung cancer (NSCLC) patients do not undergo tissue molecular testing because of scarce tissue availability. Liquid biopsy, on the other hand, offers these patients a valuable opportunity to receive the best treatment options in a timely manner. Indeed, besides being much faster and less invasive than conventional tissue-based analysis, it can also yield specific information about the genetic make-up and evolution of patients’ tumors. However, several issues, including lack of standardized protocols for sample collection, processing, and interpretation, still need to be addressed before liquid biopsy can be fully incorporated into routine oncology practice. Here, we reviewed the most important challenges hindering the implementation of liquid biopsy in oncology practice, as well as the great advantages of this approach for the treatment of NSCLC patients.

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