Limitation of Knee Flexion by a Fibrotic Band of a Fifth Component of the Quadriceps Muscle in a Child

2017 ◽  
Vol 7 (4) ◽  
pp. e87-e87 ◽  
Author(s):  
Carlos Sarassa ◽  
Verónica Sarassa ◽  
Rodrigo Restrepo ◽  
Luz Ángela Angarita ◽  
Ana Milena Herrera
Keyword(s):  
Knee Flexion ◽  
Quadriceps Muscle ◽  
Fibrotic Band

scholarly journals Quadriceps Strength Symmetry Does Not Modify Gait Mechanics After Anterior Cruciate Ligament Reconstruction, Rehabilitation, and Return-to-Sport Training

2020 ◽  
pp. 036354652098007
Author(s):  
Elanna K. Arhos ◽  
Jacob J. Capin ◽  
Thomas S. Buchanan ◽  
Lynn Snyder-Mackler
Keyword(s):  
Knee Flexion ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Sport Training ◽  
Gait Biomechanics ◽  
Peak Knee

Background: After anterior cruciate ligament (ACL) reconstruction (ACLR), biomechanical asymmetries during gait are highly prevalent, persistent, and linked to posttraumatic knee osteoarthritis. Quadriceps strength is an important clinical measure associated with preoperative gait asymmetries and postoperative function and is a primary criterion for return-to-sport clearance. Evidence relating symmetry in quadriceps strength with gait biomechanics is limited to preoperative and early rehabilitation time points before return-to-sport training. Purpose/Hypothesis: The purpose was to determine the relationship between symmetry in isometric quadriceps strength and gait biomechanics after return-to-sport training in athletes after ACLR. We hypothesized that as quadriceps strength symmetry increases, athletes will demonstrate more symmetric knee joint biomechanics, including tibiofemoral joint loading during gait. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Of 79 athletes enrolled in the ACL-SPORTS Trial, 76 were participants in this study after completing postoperative rehabilitation and 10 return-to-sport training sessions (mean ± SD, 7.1 ± 2.0 months after ACLR). All participants completed biomechanical walking gait analysis and isometric quadriceps strength assessment using an electromechanical dynamometer. Quadriceps strength was calculated using a limb symmetry index (involved limb value / uninvolved limb value × 100). The biomechanical variables of interest included peak knee flexion angle, peak knee internal extension moment, sagittal plane knee excursion at weight acceptance and midstance, quadriceps muscle force at peak knee flexion angle, and peak medial compartment contact force. Spearman rank correlation (ρ) coefficients were used to determine the relationship between limb symmetry indexes in quadriceps strength and each biomechanical variable; alpha was set to .05. Results: Of the 76 participants, 27 (35%) demonstrated asymmetries in quadriceps strength, defined by quadriceps strength symmetry <90% (n = 23) or >110% (n = 4) (range, 56.9%-131.7%). For the biomechanical variables of interest, 67% demonstrated asymmetry in peak knee flexion angle; 68% and 83% in knee excursion during weight acceptance and midstance, respectively; 74% in internal peak knee extension moment; 57% in medial compartment contact force; and 74% in quadriceps muscle force. There were no significant correlations between quadriceps strength index and limb symmetry indexes for any biomechanical variable after return-to-sport training ( P > .129). Conclusion: Among those who completed return-to-sport training after ACLR, subsequent quadriceps strength symmetry was not correlated with the persistent asymmetries in gait biomechanics. After a threshold of quadriceps strength is reached, restoring strength alone may not ameliorate gait asymmetries, and current clinical interventions and return-to-sport training may not adequately target gait.

Relationship between muscle volume and contractile properties of the human knee extensors

2016 ◽  
Vol 41 (1) ◽  
pp. 110-113 ◽  
Author(s):  
Martin Behrens ◽  
Niklas Brown ◽  
Robert Bollinger ◽  
Dieter Bubeck ◽  
Anett Mau-Moeller ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Femoral Nerve ◽  
Quadriceps Muscle ◽  
Muscle Volume ◽  
Contractile Properties ◽  
Knee Extensors ◽  
Resonance Imaging ◽  
Human Knee ◽  
The Relationship ◽  
Stimulation Of

The present study was designed to investigate the relationship between volume and electrically evoked twitch properties of the quadriceps muscle. Supramaximal single and doublet stimulation of the femoral nerve was used to assess contractile properties at 45° and 80° knee flexion. Muscle volume was measured using a 1.5-Tesla magnetic resonance imaging scanner. Quadriceps muscle volume was only significantly correlated (r = 0.629) with peak twitch torque induced by doublet stimulation at 80° but not at 45° knee flexion.

scholarly journals The Comparison of Different Stretching Intensities on the Range of Motion and Muscle Stiffness of the Quadriceps Muscles

2021 ◽  
Vol 11 ◽  
Author(s):  
Masatoshi Nakamura ◽  
Shigeru Sato ◽  
Yuta Murakami ◽  
Ryosuke Kiyono ◽  
Kaoru Yahata ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Range Of Motion ◽  
Knee Flexion ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Quadriceps Muscle ◽  
Muscle Stiffness ◽  
Static Stretching ◽  
Muscle Strain ◽  
Shear Elastic Modulus

Muscle strain is one of the most frequent sports injuries, having the rectus femoris (RF) muscle as the reported preferred site of quadriceps muscle strain. The decrease muscle stiffness could be an effective RF muscle strain prevention. In recent studies, a high-intensity static stretching intervention decreased passive stiffness, though no study has investigated on the effect of the different static stretching intervention intensities on quadriceps muscle stiffness. The purpose of this study was to investigate the three different quadriceps muscle stiffness intensities (120 vs. 100 vs. 80%). Eighteen healthy, sedentary male volunteers participated in the study and randomly performed three intensities. The static stretching intervention was performed in knee flexion with 30° hip extension. Three 60-second stretching intervention with a 30-second interval were performed at each stretching intensity. We measured knee flexion range of motion and shear elastic modulus of the RF muscle used by ultrasonic shear-wave elastography before and after the static stretching intervention. Our results showed that the knee flexion range of motion was increased after 100% (p &lt; 0.01) and 120% intensities (p &lt; 0.01) static stretching intervention, not in 80% intensity (p = 0.853). In addition, our results showed that the shear elastic modulus of the RF muscle was decreased only after 100% intensity static stretching intervention (p &lt; 0.01), not after 80% (p = 0.365), and 120% intensities (p = 0.743). To prevent the quadriceps muscle strain, especially the RF muscle, 100%, not 120% (high) and 80% (low), intensity stretching could be beneficial in sports setting application.

Effects of hot pack application before high-intensity stretching on the quadriceps muscle

2021 ◽  
Vol 28 (10) ◽  
pp. 1-10
Author(s):  
Masatoshi Nakamura ◽  
Shigeru Sato ◽  
Futaba Sanuki ◽  
Yuta Murakami ◽  
Ryosuke Kiyono ◽  
...  
Keyword(s):  
Range Of Motion ◽  
High Intensity ◽  
Knee Flexion ◽  
Shear Wave Elastography ◽  
Quadriceps Muscle ◽  
Muscle Stiffness ◽  
Static Stretching ◽  
Significant Difference ◽  
Before And After ◽  
Hot Pack

Background/aims High-intensity static stretching is assumed to increase the range of motion and/or decrease muscle stiffness; however, the effects of high-intensity static stretching on the quadriceps muscle have been debated. Hot pack application before high-intensity static stretching was assumed to decrease stretching pain, which is the main problem in high-intensity static stretching, and decrease quadriceps muscle stiffness. This study aimed to examine hot pack application before high-intensity static stretching on stretching pain, knee flexion range of motion, and quadriceps muscle stiffness. Methods In total, 21 healthy sedentary male participants randomly performed two interventions: high-intensity static stretching and hot pack application before stretching. Static stretching was performed at three 60-second stretching interventions with a 30-second interval. Then, a 20-minute hot pack was applied before high-intensity static stretching. The knee flexion range of motion and shear elastic modulus of the quadriceps muscle were measured by ultrasonic shear-wave elastography before and after the static stretching intervention. Results Stretching pain after hot pack application before stretching was lower than high-intensity static stretching alone. Significant increases were also found in knee flexion range of motion after both stretching interventions, but no significant difference was noted in the increase in the knee flexion range of motion with or without hot pack application. No significant change was found in quadriceps muscle stiffness in either intervention. Conclusions The results suggest that hot pack application before high-intensity static stretching could decrease stretching pain, but no significant difference in knee flexion range of motion increase was found.

Determining the Force-Length-Velocity Relations of the Quadriceps Muscles: I. Anatomical and Geometric Parameters

1999 ◽  
Vol 15 (2) ◽  
pp. 182-190 ◽  
Author(s):  
John W. Chow ◽  
Warren G. Darling ◽  
James C. Ehrhardt
Keyword(s):  
Magnetic Resonance ◽  
Knee Flexion ◽  
Vastus Lateralis ◽  
Quadriceps Muscle ◽  
Vastus Lateralis Muscle ◽  
Moment Arm ◽  
Anatomical Position ◽  
Moment Arms ◽  
Effective Moment

The purpose of this study was to determine the coordinates of the origin and insertion, muscle volumes, lengths, lines of action, and effective moment arm of the quadriceps muscles in vivo using magnetic resonance imaging (MRI) and radiography for a pilot study involving musculoskeletal modeling. Two magnetic resonance scans were performed, and axial images were obtained for the left thigh of a female subject in the anatomical position to measure muscle volume, coordinates of the origin and insertion, and muscle belly length at the anatomical position of each quadriceps muscle. Six knee radiographs were used to determine the effective moment arm of the quadriceps force at different knee flexion angles. A combination of MRI and radiography data was used to compute the muscle lengths at different knee flexion angles. The coordinates of the vastus lateralis, muscle volumes of individual quadriceps muscles, and effective moment arms were clearly different from the corresponding values from cadaver data reported in the literature. These comparisons demonstrate the advantages of using personalized muscle parameters instead of those collected from cadavers and dry-bone specimens.

scholarly journals Effect of Blood Flow Restriction Training on Quadriceps Muscle Strength, Morphology, Physiology, and Knee Biomechanics Before and After Anterior Cruciate Ligament Reconstruction: Protocol for a Randomized Clinical Trial

2019 ◽  
Vol 99 (8) ◽  
pp. 1010-1019 ◽  
Author(s):  
Lauren N Erickson ◽  
Kathryn C Hickey Lucas ◽  
Kylie A Davis ◽  
Cale A Jacobs ◽  
Katherine L Thompson ◽  
...  
Keyword(s):  
Blood Flow ◽  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Knee Biomechanics ◽  
Flow Restriction ◽  
Anterior Cruciate

Abstract Background Despite best practice, quadriceps strength deficits often persist for years after anterior cruciate ligament reconstruction. Blood flow restriction training (BFRT) is a possible new intervention that applies a pressurized cuff to the proximal thigh that partially occludes blood flow as the patient exercises, which enables patients to train at reduced loads. This training is believed to result in the same benefits as if the patients were training under high loads. Objective The objective is to evaluate the effect of BFRT on quadriceps strength and knee biomechanics and to identify the potential mechanism(s) of action of BFRT at the cellular and morphological levels of the quadriceps. Design This will be a randomized, double-blind, placebo-controlled clinical trial. Setting The study will take place at the University of Kentucky and University of Texas Medical Branch. Participants Sixty participants between the ages of 15 to 40 years with an ACL tear will be included. Intervention Participants will be randomly assigned to (1) physical therapy plus active BFRT (BFRT group) or (2) physical therapy plus placebo BFRT (standard of care group). Presurgical BFRT will involve sessions 3 times per week for 4 weeks, and postsurgical BFRT will involve sessions 3 times per week for 4 to 5 months. Measurements The primary outcome measure was quadriceps strength (peak quadriceps torque, rate of torque development). Secondary outcome measures included knee biomechanics (knee extensor moment, knee flexion excursion, knee flexion angle), quadriceps muscle morphology (physiological cross-sectional area, fibrosis), and quadriceps muscle physiology (muscle fiber type, muscle fiber size, muscle pennation angle, satellite cell proliferation, fibrogenic/adipogenic progenitor cells, extracellular matrix composition). Limitations Therapists will not be blinded. Conclusions The results of this study may contribute to an improved targeted treatment for the protracted quadriceps strength loss associated with anterior cruciate ligament injury and reconstruction.

scholarly journals Muscle Endurance Testing Using an Isokinetic Dynamometer and A Recumbent Stepper: A Correlation Study

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Pepin Marie-Eve ◽  
Thornton Alyssa ◽  
Gasperoni Vittoria ◽  
Kosky Jillian ◽  
Lowrey Laura ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Objective Measure ◽  
Quadriceps Muscle ◽  
Knee Extension ◽  
Correlation Study ◽  
Muscle Endurance ◽  
Isokinetic Dynamometer ◽  
Average Force ◽  
Endurance Testing ◽  
Clinical Measures

Purpose: A lack of objective and validated clinical measures to assess Quadriceps muscle endurance (ME) currently exists. The Transitt model of the NuStep recumbent stepper has the capability to measure ME but has not been validated. Therefore, the aim of this study was to investigate the association between ME measures on the NuStep and the isokinetic dynamometer (ID). Methods: 30 healthy individuals were recruited to participate. On both the NuStep (70°/90° knee flexion) and ID (70° knee flexion), the participants were instructed to hold a submaximal isometric unilateral knee extension contraction until exhaustion. Descriptive statistics, inferential statistics and correlation analyses were used with significance set at p<0.05. Results: There was excellent correlation (r between 0.813 to 0.840, p<0.001) between the average force generated by the individuals on the ID and the NuStep. There was a fair correlation (r between 0.331 to 0.413, p<0.05) for the ME measures between the ID and the NuStep. Conclusions: The NuStep shows excellent agreement for average force measurements. Future studies are needed to validate the NuStep as an objective measure of ME in both healthy and clinical populations.

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