scholarly journals Motor Point Heatmap of the Calf

2021 ◽  
Author(s):  
Elias Schriwer ◽  
Robin Juthberg ◽  
Johanna Flodin ◽  
Paul W. Ackermann
Keyword(s):  
Neuromuscular Electrical Stimulation ◽  
Lower Limbs ◽  
Electrode Placement ◽  
Anatomical Landmarks ◽  
Motor Point ◽  
Heat Map ◽  
Improve Compliance ◽  
To Receive ◽  
Search Program ◽  
Healthy Participants

Abstract Background: Contractions of muscles in the calf induced by neuromuscular electrical stimulation (NMES) may prevent venous thromboembolism. However, compliance to NMES-treatment is limited by the use of suboptimal stimulation points which may cause discomfort. Knowledge of where one is most likely to find muscle motor points (MP) could improve NMES comfort and compliance.Aims: To anatomically map the MPs of the calf as well as to calculate the probability of finding a MP in different areas of the calf. Material and Methods: On 30 healthy participants (mean age 37 years) anatomical landmarks on the lower limbs were defined. The location of the four most responsive MPs on respectively the medial and lateral calf muscle bellies were determined in relation to these anatomical landmarks using a MP search pen and a pre-set MP search program with 3 Hz continuous stimulation. The anatomy of the calves was normalized and subdivided into a matrix of 48 (6x8) smaller areas (3x3cm), from upper medial to lower lateral, in order to calculate the probability of finding a MP in one of these areas. The probability of finding a MP was then calculated for each area and presented with a 95% confidence interval.Results: The MP heat map displayed a higher concentration of MPs proximally and centrally on the calf. However, there were wide inter-individual differences in the location of the MPs. The highest probability of finding a MP was in area 4, located proximally and medially, and in area 29, located centrally and around the maximum circumference, both with 50% probability (95% CI: 0.31-0.69). The second highest probability of finding MPs was in areas 9, 10, 16, proximally and medially, all with 47% probability (95% CI: 0.28-0.66). These areas 4, 9, 10, 16 and 29 exhibited significantly higher probability of finding motor points than all areas with a mean probability of 27% and lower (p<0.05) The lateral and distal outskirts exhibited almost zero probability of finding MPs. Conclusions: This MP heat map of the calf could be used to expedite electrode placement and to improve compliance in order to receive consistent and enhanced results of NMES treatments.

Fronto-striatal network activation leads to less fatigue in multiple sclerosis

2017 ◽  
Vol 24 (9) ◽  
pp. 1174-1182 ◽  
Author(s):  
Ekaterina Dobryakova ◽  
Hanneke E Hulst ◽  
Angela Spirou ◽  
Nancy D Chiaravalloti ◽  
Helen M Genova ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Goal Attainment ◽  
Functional Neuroimaging ◽  
Network Activation ◽  
Healthy Control ◽  
Neuroimaging Study ◽  
To Receive ◽  
Monetary Gain ◽  
Healthy Participants ◽  
Stimulation Of

Background: The fronto-striatal network has been implicated in both fatigue, a common multiple sclerosis (MS) symptom, and goal attainment, which has been shown to reduce fatigue in healthy individuals. Objectives: To investigate whether stimulation of the fronto-striatal network through goal attainment (potential monetary gain) leads to fatigue reduction in MS and healthy control (HC) participants. Methods: In all, 14 healthy and 19 MS participants performed a gambling task during functional magnetic resonance imaging (fMRI). Participants were presented with an opportunity to receive monetary reward during the outcome condition of the task but not during the no outcome condition. Self-reported fatigue measures were obtained after each condition and outside of the scanner. Structural alterations were also examined. Results: A significant decrease in fatigue was observed after the outcome condition compared to the no outcome condition in both groups. Significantly greater activation was observed in the ventral striatum in association with the outcome condition compared to the no outcome condition in both groups. Ventromedial prefrontal cortex showed significantly greater activation during the no outcome condition compared to the outcome condition with greater difference between conditions in the HC group. Conclusion: This is the first functional neuroimaging study showing that stimulation of the fronto-striatal network through goal attainment leads to decreased on-task fatigue in MS and healthy participants.

The Relationship of Transepicondylar Width with the Distal and Posterior Femoral Condyles and Its Clinical Implications: A Three-Dimensional Study

2020 ◽  
Author(s):  
Merrill Lee ◽  
Jade Pei Yuik Ho ◽  
Jerry Yongqiang Chen ◽  
Chung Kia Ng ◽  
Seng Jin Yeo ◽  
...  
Keyword(s):  
Three Dimensional ◽  
3D Models ◽  
Ct Images ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Lower Limbs ◽  
Anatomical Landmarks ◽  
Medial Condyle ◽  
Lateral Epicondyle ◽  
Femoral Condyles

Abstract Background Restoration of the anatomical joint line, while important for clinical outcomes, is difficult to achieve in revision total knee arthroplasty (rTKA) due to distal femoral bone loss. The objective of this study was to determine a reliable method of restoring the anatomical joint line and posterior condylar offset in the setting of rTKA based on three-dimensional (3D) reconstruction of computed tomography (CT) images of the distal femur. Methods CT scans of 50 lower limbs were analyzed. Key anatomical landmarks such as the medial epicondyle (ME), lateral epicondyle, and transepicondylar width (TEW) were determined on 3D models constructed from the CT images. Best-fit planes placed on the most distal and posterior loci of points on the femoral condyles were used to define the distal and posterior joint lines, respectively. Statistical analysis was performed to determine the relationships between the anatomical landmarks and the distal and posterior joint lines. Results There was a strong correlation between the distance from the ME to the distal joint line of the medial condyle (MEDC) and the distance from the ME to the posterior joint line of the medial condyle (MEPC) (p < 0.001; r = 0.865). The mean ratio of MEPC to MEDC was 1.06 (standard deviation [SD]: 0.07; range: 0.88–1.27) and that of MEPC to TEW was 0.33 (SD: 0.03; range: 0.25–0.38). Conclusions Our findings suggest that the fixed ratios of MEPC to TEW (0.33) and that of MEPC to MEDC (1.06) provide a reliable means for the surgeon to determine the anatomical joint line when used in combination.

scholarly journals The Quality of Recovery after Dexamethasone, Ondansetron, or Placebo Administration in Patients Undergoing Lower Limbs Orthopedic Surgery under Spinal Anesthesia Using Intrathecal Morphine. A Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Eduardo Toshiyuki Moro ◽  
Miguel Antônio Teixeira Ferreira ◽  
Renyer dos Santos Gonçalves ◽  
Roberta Costa Vargas ◽  
Samira Joverno Calil ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Orthopedic Surgery ◽  
Intrathecal Morphine ◽  
Controlled Trial ◽  
Lower Limbs ◽  
Postanesthesia Care Unit ◽  
Quality Of Recovery ◽  
Pain Scores ◽  
To Receive

Intrathecal morphine is widely and successfully used to prevent postoperative pain after orthopedic surgery, but it is frequently associated with side effects. The aim of this study was to evaluate the effect of dexamethasone or ondansetron when compared to placebo to reduce the occurrence of these undesirable effects and, consequently, to improve the quality of recovery based on patient’s perspective. Methods. One hundred and thirty-five patients undergoing lower extremity orthopedic surgery under spinal anesthesia using bupivacaine and morphine were randomly assigned to receive IV dexamethasone, ondansetron, or saline. On the morning following surgery, a quality of recovery questionnaire (QoR-40) was completed. Results. No differences were detected in the global and dimensional QoR-40 scores following surgery; however, following postanesthesia care unit (PACU) discharge, pain scores were higher in patients receiving ondansetron compared with patients who received dexamethasone. Conclusion. Neither ondansetron nor dexamethasone improves the quality of recovery after lower limbs orthopedic surgery under spinal anesthesia using intrathecal morphine.

scholarly journals Anatomical Consideration of the Motor Point Location of the Tibialis Anterior Muscle for effective Neuromuscular Electrical Stimulation

2011 ◽  
Vol 23 (3) ◽  
pp. 381-384 ◽  
Author(s):  
Hirokazu Narita ◽  
Shoji Chiba ◽  
Hideki Yoshida ◽  
Hideaki Mizohata ◽  
Yoshikazu Tonosaki ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Neuromuscular Electrical Stimulation ◽  
Motor Point ◽  
Point Location

A validated approach for collecting fine-wire electromyographic recordings in four canine shoulder muscles during highly dynamic tasks

2015 ◽  
Vol 11 (2) ◽  
pp. 65-74 ◽  
Author(s):  
K.L. Cullen ◽  
J.P. Dickey ◽  
S.H.M. Brown ◽  
S.G. Nykamp ◽  
L.R. Bent ◽  
...  
Keyword(s):  
Data Collection ◽  
Muscle Activation ◽  
Biceps Brachii ◽  
Electrode Placement ◽  
Electromyographic Activity ◽  
Anatomical Landmarks ◽  
Triceps Brachii ◽  
Performance Tasks ◽  
Fine Wire ◽  
Shoulder Muscles

This study investigated the feasibility of obtaining ultrasound-guided intramuscular fine-wire electromyographic (fEMG) recordings from four canine shoulder muscles during highly dynamic activities. Four cadaveric canines were utilised to confirm the appropriate anatomical landmarks and the use of real time ultrasound guidance for electrode placement for four shoulder muscles: Biceps Brachii (BB), Supraspinatus (SP), Infraspinatus (IF), and Triceps Brachii – Long Head (TBLH). Electromyographic activity of the left BB, S P, IF, and TBLH was then recorded in two research dogs while walking and trotting to refine the data collection procedures. Finally, the full experimental protocol was piloted with two client-owned, specially-trained agility dogs, confirming the feasibility of collecting fEMG recordings while performing dynamic, highly-specific agility-related tasks and verifying our EMG amplitude normalisation protocol to enable comparisons across muscles and performance tasks. We present specific guidelines regarding the placement of fEMG electrodes and data collection/normalisation procedures to enable investigations of muscle activation during dynamic activities.

scholarly journals Haemodynamic Changes in the Superior Mesenteric Artery Induced by Acupuncture Stimulation on the Lower Limbs

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Masashi Watanabe ◽  
Shin Takayama ◽  
Yoshiko Yamamoto ◽  
Satoru Nagase ◽  
Takashi Seki ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Lower Limbs ◽  
Physiological Effects ◽  
Physiological Alterations ◽  
Haemodynamic Changes ◽  
Manual Rotation ◽  
Healthy Participants ◽  
Stimulation Group ◽  
Acupoint Stimulation

Acupuncture is commonly performed on acupoints. A comparison of quantitative physiological alterations induced by stimulation on different acupoints has never been performed in the superior mesenteric artery (SMA) in humans. Therefore, we investigated changes in blood flow volume (BFV) in the SMA as an indicator of physiological effects induced by stimulation on 3 points. Thirty healthy participants aged29±10years (mean±SD) were enrolled. All participants underwent stimulations on 3 points located in the lower legs: ST36, LR3, and a non-acupoint. Control pertains to a condition with no-stimulation. Stimulation was performed bilaterally with manual rotation of the needles. BFV was measured by ultrasonography before insertion and 10, 20, 30, and 60 minutes after stimulation. Following acupuncture on ST36, BFV increased significantly 20 and 30 minutes after stimulation, compared to BFV before insertion (P<0.05). Following stimulation on LR3 and the non-acupoint, no significant differences in BFV could be found. Relative to the no-stimulation group, stimulation on LR3, and the non-acupoint, stimulation on ST36 elicited a significant increase in BFV (P<0.05). The results suggest that stimulation on the different points causes distinct physiological effects in BFV in the SMA.

scholarly journals Continuous Positive Airway Pressure Adherence for Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa L. Somers ◽  
Ed Peterson ◽  
Saurabh Sharma ◽  
Kathleen Yaremchuk
Keyword(s):  
Chart Review ◽  
High School Graduates ◽  
Patient Adherence ◽  
Retrospective Chart Review ◽  
Initial Visit ◽  
Obstructive Sleep ◽  
Improve Compliance ◽  
Male Patients ◽  
One Year ◽  
To Receive

Objective. To determine predictors of patient adherence to CPAP. Design. A retrospective chart review identified patients with AHI values greater than 15 who were recommended to receive CPAP. Compliance was measured at a 1-to 4-month interval and at 1 year. Results. There were 106 of 368 (29%) patients who received CPAP therapy that were compliant with CPAP use at 1 to 4 months. Forty-six patients (12%) were using CPAP at one year. For the male group at one year, the model demonstrated the AHI value (P  value=.026) as a predictor of compliance if greater than 27.3 and a significant two-way interaction between age and AHI (P=.023). Increased length of time from the initial visit and receiving the CPAP machine was associated with poorer compliance (P=.002). Those living in areas with higher incomes and with a higher percentage of non-high-school graduates were more likely to be compliant (P=.01 and P=.044). Conclusion. Older male patients with higher AHI values were noted to be more adherent to CPAP. Efforts should be made to try to minimize the length of time between the initial visit and the time to receive CPAP to improve compliance.

scholarly journals Muscle motor point identification is essential for optimizing neuromuscular electrical stimulation use

2014 ◽  
Vol 11 (1) ◽  
pp. 17 ◽  
Author(s):  
Massimiliano Gobbo ◽  
Nicola A Maffiuletti ◽  
Claudio Orizio ◽  
Marco A Minetto
Keyword(s):  
Electrical Stimulation ◽  
Neuromuscular Electrical Stimulation ◽  
Motor Point
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