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Schimmoeller T, Colbrunn R, Nagle T, Lobosky M, Neumann EE, Owings TM, Landis B, Jelovsek JE, Erdemir A. Instrumentation of off-the-shelf ultrasound system for measurement of probe forces during freehand imaging. J Biomech 2019; 83:117-124. [PMID: 30514629 DOI: 10.1016/j.jbiomech.2018.11.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 11/18/2022]
Abstract
Ultrasound is a popular and affordable imaging modality, but the nature of freehand ultrasound operation leads to unknown applied loads at non-quantifiable angles. The purpose of this paper was to demonstrate an instrumentation strategy for an ultrasound system to measure probe forces and orientation during freehand imaging to characterize the interaction between the probe and soft-tissue as well as enhance repeatability. The instrumentation included a 6-axis load cell, an inertial measurement unit, and an optional sensor for camera-based motion capture. A known method for compensation of the ultrasound probe weight was implemented, and a novel method for temporal synchronization was developed. While load and optical sensing was previously achieved, this paper presents a strategy for potential instrumentation on a variety of ultrasound machines. A key feature was the temporal synchronization, utilizing the electrocardiogram (EKG) feature built-in to the ultrasound. The system was used to perform anatomical imaging of tissue layers of musculoskeletal extremities and imaging during indentation on an in vivo subject and an in vitro specimen. The outcomes of the instrumentation strategy were demonstrated during minimal force and indentation imaging. In short, the system presented robust instrumentation of an existing ultrasound system to fully characterize the probe force, orientation, and optionally its movement during imaging while efficiently synchronizing all data. Researchers may use the instrumentation strategy on any EKG capable ultrasound systems if mechanical characterization of soft tissue or minimization of forces and deformations of tissue during anatomical imaging are desired.
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Affiliation(s)
- Tyler Schimmoeller
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Robb Colbrunn
- BioRobotics and Mechanical Testing Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tara Nagle
- BioRobotics and Mechanical Testing Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mark Lobosky
- Engineering Design Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erica E Neumann
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tammy M Owings
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Benjamin Landis
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J Eric Jelovsek
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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Noorkoiv M, Theis N, Lavelle G. A comparison of 3D ultrasound to MRI for the measurement and estimation of gastrocnemius muscle volume in adults and young people with and without cerebral palsy. Clin Anat 2019; 32:319-327. [DOI: 10.1002/ca.23314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 07/31/2018] [Accepted: 11/14/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Marika Noorkoiv
- Institute of Environment, Health and Societies, Ageing Studies Research Theme, Brunel University London; Uxbridge United Kingdom
- Centre for Human Performance; Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London; Uxbridge United Kingdom
- Division of Physiotherapy, Department of Clinical Sciences; Brunel University London; Uxbridge United Kingdom
| | - Nicola Theis
- Faculty of Applied Sciences; Oxstalls Campus, University of Gloucestershire; Gloucester United Kingdom
| | - Grace Lavelle
- Institute of Environment, Health and Societies, Ageing Studies Research Theme, Brunel University London; Uxbridge United Kingdom
- Centre for Human Performance; Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London; Uxbridge United Kingdom
- Division of Physiotherapy, Department of Clinical Sciences; Brunel University London; Uxbridge United Kingdom
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Shim VB, Hansen W, Newsham-West R, Nuri L, Obst S, Pizzolato C, Lloyd DG, Barrett RS. Influence of altered geometry and material properties on tissue stress distribution under load in tendinopathic Achilles tendons – A subject-specific finite element analysis. J Biomech 2019; 82:142-148. [DOI: 10.1016/j.jbiomech.2018.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/17/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022]
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Barber L, Alexander C, Shipman P, Boyd R, Reid S, Elliott C. Validity and reliability of a freehand 3D ultrasound system for the determination of triceps surae muscle volume in children with cerebral palsy. J Anat 2018; 234:384-391. [PMID: 30525186 DOI: 10.1111/joa.12927] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2018] [Indexed: 11/30/2022] Open
Abstract
This study assessed the validity, intra-rater and inter-rater reliability of segmentation of in vivo medial gastrocnemius (MG), lateral gastrocnemius (LG) and soleus (SOL) muscle volume measurement using a single sweep freehand 3D ultrasound (3DUS) in children with cerebral palsy (CP). The MG, LG and SOL of both limbs of 18 children with CP (age 8 years 4 months ± 1 year 10 months, 11 males, unilateral CP = 9, bilateral CP = 9, Gross Motor Functional Classification System I = 11, II = 7) were scanned using freehand 3DUS and magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented and volumes rendered by two raters. Validity was assessed using limits of agreement method. Intra-rater and inter-rater reliability was assessed using intra-class correlation (ICC), coefficient of variance (CV) and minimal detectable change (MDC). Freehand 3DUS overestimated muscle volume of the MG and LG by < 0.3 mL (1%) and underestimated SOL by < 1.3 mL (1.5%) compared with MRI. ICCs for intra-rater reliability of the segmentation process for the freehand 3DUS system and MRI for muscle volume were > 0.98 and 0.99, respectively, for all muscles. ICCs for inter-rater reliability of the segmentation process for freehand 3DUS and MRI volumes were > 0.96 and 0.98, respectively, for all muscles. MDCs for single rater freehand 3DUS and MRI were < 4.0 mL (14%) and 3.2 mL (11%), respectively, in all muscles. Freehand 3DUS is a valid and reliable method for the measurement of lower leg muscle volume that can be measured with a single sweep in children with CP in vivo. It can be used as an alternative to MRI for the detection of clinically relevant changes in calf muscle volume as the result of growth and interventions.
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Affiliation(s)
- L Barber
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia.,Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - C Alexander
- School of Sport Science, Exercise and Health, University of Western Australia, Perth, WA, Australia
| | - P Shipman
- Diagnostic Imaging, Princess Margaret Hospital, Subiaco, WA, Australia
| | - R Boyd
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - S Reid
- School of Sport Science, Exercise and Health, University of Western Australia, Perth, WA, Australia
| | - C Elliott
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Cenni F, Bar-On L, Schless SH, Kalkman B, Aertbelien E, Bruyninckx H, Desloovere K. Medial Gastrocnemius Muscle-Tendon Junction and Fascicle Lengthening across the Range of Motion Analyzed in 2-D and 3-D Ultrasound Images. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2505-2518. [PMID: 30172570 DOI: 10.1016/j.ultrasmedbio.2018.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/23/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
Ultrasound imaging modalities offer a clinically viable method to visualize musculoskeletal structures. However, proper data comparison between investigations is compromised because of a lack of measurement error documentation and method standardization. This investigation analyzes the reliability and validity of extracting medial gastrocnemius belly and fascicle lengths and pennation angles in different ankle joint positions, across the full range of motion, in a cohort of 11 children with spastic cerebral palsy and 11 typically developed children. Each of these parameters was extracted from two consecutive acquisitions, using both 2-D and 3-D ultrasound images. The findings suggest that the muscle tendon junction extraction in 2-D images can be a suitable parameter for analyzing medial gastrocnemius muscle length in typically developed children and children with spastic cerebral palsy, although averaging over multiple measurements is recommended to reduce variability. More caution should be taken when performing analyses based on fascicle length.
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Affiliation(s)
- Francesco Cenni
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium.
| | - Lynn Bar-On
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Simon-Henri Schless
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Barbara Kalkman
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Erwin Aertbelien
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | | | - Kaat Desloovere
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Franchi MV, Raiteri BJ, Longo S, Sinha S, Narici MV, Csapo R. Muscle Architecture Assessment: Strengths, Shortcomings and New Frontiers of in Vivo Imaging Techniques. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2492-2504. [PMID: 30185385 DOI: 10.1016/j.ultrasmedbio.2018.07.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
Skeletal muscle structural assembly (and its remodeling in response to loading-unloading states) can be investigated macroscopically by assessing muscle architecture, described as fascicle geometric disposition within the muscle. Over recent decades, various medical imaging techniques have been developed to facilitate the in vivo assessment of muscle architecture. However, the main advantages and limitations of these methodologies have been fragmentally discussed. In the present article, the main techniques used for the evaluation of muscle architecture are presented: conventional B-mode ultrasonography, extended-field-of-view ultrasound, 3-D ultrasound and magnetic resonance imaging-based diffusion tensor imaging. By critically discussing potentials and shortcomings of each methodology, we aim to provide readers with an overview of both established and new techniques for the in vivo assessment of muscle architecture. This review may serve as decision guidance facilitating selection of the appropriate technique to be applied in biomedical research or clinical routine.
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Affiliation(s)
- Martino V Franchi
- Laboratory for Muscle Plasticity, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Sports Medicine Research, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
| | | | - Stefano Longo
- Department of Biomedical Sciences for Health, Università degli studi di Milano, Milan, Italy
| | - Shantanu Sinha
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Marco V Narici
- Institute of Physiology, Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Robert Csapo
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine & Health Tourism (ISAG), University for Health Sciences, Medical Informatics and Technology, Hall, Austria
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Dries B, Vanwanseele B, Jonkers I, Dingemanse W, Vander Sloten J, Villamonte‐Chevalier A, Van der Vekens E, Polis I, Vanderperren K, Van Bree H, Gielen I. Musculotendon excursion potential, tendon slack and muscle fibre length: the interaction of the canine gastrocnemius muscle and tendon. J Anat 2018; 233:460-467. [PMID: 29984496 PMCID: PMC6131973 DOI: 10.1111/joa.12845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 11/30/2022] Open
Abstract
Although the form-function relation of muscles and tendons has been studied extensively, little in vivo data exist on the musculotendon properties of the gastrocnemius complex in dogs. Using a combination of ultrasound and 3D motion tracking, musculotendon parameters were obtained in vivo from the lateral gastrocnemius muscle and the gastrocnemius tendon in nine healthy Labrador Retrievers. These parameters include musculotendon length and excursion potential, tendon slack length, muscle belly length, muscle fibre length, pennation angle and architectural index. This study also examined the variation of muscle and tendon length contributions to musculotendon length, as well as the relation between musculotendon excursion potential and muscle fibre length or tendon length. To facilitate comparison between dog breeds, the femur length as a potential scaling parameter was examined. In the Labrador gastrocnemius musculotendon complex, the tendon contributes 41% (± 9%) of musculotendon length. In longer musculotendon complexes, the contribution of the muscle belly increases while the tendon contribution decreases. Longer muscle belly and musculotendon complexes were, however, associated with shorter muscle fibres. No significant relations were found between musculotendon excursion potential and muscle fibre length or tendon slack length, and femur length did not prove to be a reliable scale factor for the length-related musculotendon parameters examined in this study. Longer musculotendon complexes exhibit relatively longer muscle bellies, which are in turn associated with shorter muscle fibre lengths. This trade-off between gastrocnemius muscle belly length and muscle fibre length might have the advantage that muscle volume stays constant regardless of the length of the limbs.
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Affiliation(s)
- B. Dries
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - B. Vanwanseele
- Human Movement Biomechanics Research GroupFaculty of Movement and Rehabilitation SciencesKU LeuvenLeuvenBelgium
| | - I. Jonkers
- Human Movement Biomechanics Research GroupFaculty of Movement and Rehabilitation SciencesKU LeuvenLeuvenBelgium
| | - W. Dingemanse
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - J. Vander Sloten
- Biomechanics SectionFaculty of Engineering ScienceKU LeuvenLeuvenBelgium
| | - A. Villamonte‐Chevalier
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - E. Van der Vekens
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - I. Polis
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - K. Vanderperren
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - H. Van Bree
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - I. Gielen
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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An innovative solution to reduce muscle deformation during ultrasonography data collection. J Biomech 2018; 77:194-200. [PMID: 29935732 DOI: 10.1016/j.jbiomech.2018.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/05/2018] [Accepted: 06/09/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND 3D freehand ultrasound enables the creation of volumetric data. The acquisition of morphological features, such as muscle volume, is influenced by the variations in force applied to the skin with the ultrasound probe. To minimise the deformations, a concave-shaped plastic mount combined with a custom-shaped gel pad was developed for the ultrasound head, named Portico. This study analyses to what extent the Portico reduces muscle deformation and corresponding errors in estimating muscle volume. METHOD Twenty medial gastrocnemius (MG) muscles were assessed (10 from typically developing children; 10 from children with spastic cerebral palsy). Two repetitions were acquired in each of the following approaches: (1) with the lower leg submerged in a water tank as a non-deformed reference; (2) probe-on-skin (PoS) as the conventional approach and (3) the newly introduced Portico. PoS and Portico data were registered with respect to the ones corresponding in a water tank. An in-house software package (Py3DFreeHandUS) was used to process the data and MG volume was estimated using MeVisLab. The minimal detectable change (MDC) was calculated. RESULTS With respect to the PoS approach, the Portico reduced muscle deformation by 46%. For both the typically developing and spastic cerebral palsy cohorts, lower MDCs were found when using the Portico. DISCUSSION Despite the improvements, the Portico did not yield statistically more reliable MG volume estimations than the traditional PoS approach. Further improvement can be attained by optimising the fit between the gel pad and the curvature of the limb, using a larger choice of Portico geometries.
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GILLETT JARREDG, LICHTWARK GLENA, BOYD ROSLYNN, BARBER LEEA. Functional Anaerobic and Strength Training in Young Adults with Cerebral Palsy. Med Sci Sports Exerc 2018; 50:1549-1557. [DOI: 10.1249/mss.0000000000001614] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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60
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Willerslev-Olsen M, Choe Lund M, Lorentzen J, Barber L, Kofoed-Hansen M, Nielsen JB. Impaired muscle growth precedes development of increased stiffness of the triceps surae musculotendinous unit in children with cerebral palsy. Dev Med Child Neurol 2018; 60:672-679. [PMID: 29573407 DOI: 10.1111/dmcn.13729] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 10/17/2022]
Abstract
AIM If increased muscle stiffness and contractures in children with cerebral palsy (CP) are related to impaired muscle growth, reduced muscle growth should precede or coincide with increased muscle stiffness during development. Here, we compared the volume of the medial gastrocnemius muscle and the passive (non-neural) stiffness of the triceps surae musculotendinous unit in typically developing children and children with CP from birth until 4 years of age. METHOD Forty-one children with CP and 45 typically developing children were included. Freehand three-dimensional ultrasound was used to evaluate the volume of the medial gastrocnemius muscle. Biomechanical and electrophysiological measures were used to determine passive and reflex mediated stiffness of the triceps surae musculotendinous unit. RESULTS Medial gastrocnemius muscle volume increased with the same rate in typically developing and children with CP until 12 months of age, when a significant smaller rate of growth was observed in children with CP. Passive stiffness of the triceps surae musculotendinous unit showed a linear increase with age in typically developing children. Children with CP older than 27 months showed a significant increase in passive stiffness. Reflex mediated stiffness was only pathologically increased in four children with CP. INTERPRETATION The deviation of medial gastrocnemius muscle volume, earlier than musculotendinous unit stiffness, is consistent with the hypothesis. The data also point out that muscle atrophy and muscle stiffness already develops within the first 1 to 2 years. This emphasizes the necessity of early interventions to promote lower limb muscle growth in this population. WHAT THIS PAPER ADDS Medial gastrocnemius muscle growth is reduced in children with cerebral palsy (CP) around 12 months after birth. Triceps surae musculotendinous unit stiffness is increased in children with CP around 27 months after birth. Reflex excitability is rarely increased in children with CP. Reduced muscle growth may be involved in the pathophysiology of contractures.
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Affiliation(s)
- Maria Willerslev-Olsen
- Institute for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Mai Choe Lund
- Institute for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Jakob Lorentzen
- Institute for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | | | - Jens Bo Nielsen
- Institute for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Elsass Institute, Charlottenlund, Denmark
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Vigotsky AD, Schoenfeld BJ, Than C, Brown JM. Methods matter: the relationship between strength and hypertrophy depends on methods of measurement and analysis. PeerJ 2018; 6:e5071. [PMID: 29967737 PMCID: PMC6026459 DOI: 10.7717/peerj.5071] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/04/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose The relationship between changes in muscle size and strength may be affected by both measurement and statistical approaches, but their effects have not been fully considered or quantified. Therefore, the purpose of this investigation was to explore how different methods of measurement and analysis can affect inferences surrounding the relationship between hypertrophy and strength gain. Methods Data from a previous study-in which participants performed eight weeks of elbow flexor training, followed by an eight-week period of detraining-were reanalyzed using different statistical models, including standard between-subject correlations, analysis of covariance, and hierarchical linear modeling. Results The associative relationship between strength and hypertrophy is highly dependent upon both method/site of measurement and analysis; large differences in variance accounted for (VAF) by the statistical models were observed (VAF = 0-24.1%). Different sites and measurements of muscle size showed a range of correlations coefficients with one another (r = 0.326-0.945). Finally, exploratory analyses revealed moderate-to-strong relationships between within-individual strength-hypertrophy relationships and strength gained over the training period (ρ = 0.36-0.55). Conclusions Methods of measurement and analysis greatly influence the conclusions that may be drawn from a given dataset. Analyses that do not account for inter-individual differences may underestimate the relationship between hypertrophy and strength gain, and different methods of assessing muscle size will produce different results. It is suggested that robust experimental designs and analysis techniques, which control for different mechanistic sources of strength gain and inter-individual differences (e.g., muscle moment arms, muscle architecture, activation, and normalized muscle force), be employed in future investigations.
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Affiliation(s)
- Andrew D Vigotsky
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States of America
| | - Brad J Schoenfeld
- Department of Health Sciences, City University of New York, Herbert H. Lehman College, Bronx, NY, United States of America
| | - Christian Than
- School of Biomedical Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - J Mark Brown
- School of Biomedical Sciences, University of Queensland, St. Lucia, Queensland, Australia
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Actuator-Assisted Calibration of Freehand 3D Ultrasound System. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:9314626. [PMID: 29854371 PMCID: PMC5954878 DOI: 10.1155/2018/9314626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/21/2018] [Accepted: 04/11/2018] [Indexed: 11/23/2022]
Abstract
Freehand three-dimensional (3D) ultrasound has been used independently of other technologies to analyze complex geometries or registered with other imaging modalities to aid surgical and radiotherapy planning. A fundamental requirement for all freehand 3D ultrasound systems is probe calibration. The purpose of this study was to develop an actuator-assisted approach to facilitate freehand 3D ultrasound calibration using point-based phantoms. We modified the mathematical formulation of the calibration problem to eliminate the need of imaging the point targets at different viewing angles and developed an actuator-assisted approach/setup to facilitate quick and consistent collection of point targets spanning the entire image field of view. The actuator-assisted approach was applied to a commonly used cross wire phantom as well as two custom-made point-based phantoms (original and modified), each containing 7 collinear point targets, and compared the results with the traditional freehand cross wire phantom calibration in terms of calibration reproducibility, point reconstruction precision, point reconstruction accuracy, distance reconstruction accuracy, and data acquisition time. Results demonstrated that the actuator-assisted single cross wire phantom calibration significantly improved the calibration reproducibility and offered similar point reconstruction precision, point reconstruction accuracy, distance reconstruction accuracy, and data acquisition time with respect to the freehand cross wire phantom calibration. On the other hand, the actuator-assisted modified “collinear point target” phantom calibration offered similar precision and accuracy when compared to the freehand cross wire phantom calibration, but it reduced the data acquisition time by 57%. It appears that both actuator-assisted cross wire phantom and modified collinear point target phantom calibration approaches are viable options for freehand 3D ultrasound calibration.
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63
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Kruse A, Schranz C, Tilp M, Svehlik M. Muscle and tendon morphology alterations in children and adolescents with mild forms of spastic cerebral palsy. BMC Pediatr 2018; 18:156. [PMID: 29743109 PMCID: PMC5941654 DOI: 10.1186/s12887-018-1129-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background Early detection of changes at the muscular level before a contracture develops is important to gain knowledge about the development of deformities in individuals with spasticity. However, little information is available about muscle morphology in children with spastic diplegic cerebral palsy (CP) without contracture or equinus gait. Therefore, the aim of this study was to compare the gastrocnemius medialis (GM) and Achilles tendon architecture of children and adolescents with spastic CP without contracture or equinus gait to that of typically developing (TD) children. Methods Two-dimensional ultrasonography was used to assess the morphological properties of the GM muscle and Achilles tendon in 10 children with spastic diplegic CP (Gross Motor Function Classification System level I–II) and 12 TD children (mean age 12.0 (2.8) and 11.3 (2.5) years, respectively). The children with CP were not restricted in the performance of daily tasks, and therefore had a high functional capacity. Mean muscle and tendon parameters were statistically compared (independent t-tests or Mann-Whitney U-tests). Results When normalized to lower leg length, muscle-tendon unit length and GM muscle belly length were found to be significantly shorter (p < 0.05, effect size (ES) = 1.00 and 0.98, respectively) in the children with spastic CP. Furthermore, there was a tendency for increased Achilles tendon length when expressed as a percentage of muscle-tendon unit length (p = 0.08, ES = − 0.80) in the individuals with CP. This group also showed shorter muscle fascicles (3.4 cm vs. 4.4 cm, p < 0.01, ES = 1.12) and increased fascicle pennation angle (21.9° vs. 18.1°, p < 0.01, ES = − 1.36, respectively). However, muscle thickness and Achilles tendon cross-sectional area did not differ between groups. Resting ankle joint angle was significantly more plantar flexed (− 26.2° vs. − 20.8°, p < 0.05, ES = 1.06) in the children with CP. Conclusions Morphological alterations of the plantar flexor muscle-tendon unit are also present in children and adolescents with mild forms of spastic CP. These alterations may contribute to functional deficits such as muscle weakness, and therefore have to be considered in the clinical decision-making process, as well as in the selection of therapeutic interventions.
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Affiliation(s)
- Annika Kruse
- Institute of Sports Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Christian Schranz
- Department of Paediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Markus Tilp
- Institute of Sports Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.
| | - Martin Svehlik
- Department of Paediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
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Muscle-tendon length and force affect human tibialis anterior central aponeurosis stiffness in vivo. Proc Natl Acad Sci U S A 2018; 115:E3097-E3105. [PMID: 29555756 DOI: 10.1073/pnas.1712697115] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The factors that drive variable aponeurosis behaviors in active versus passive muscle may alter the longitudinal stiffness of the aponeurosis during contraction, which may change the fascicle strains for a given muscle force. However, it remains unknown whether these factors can drive variable aponeurosis behaviors across different muscle-tendon unit (MTU) lengths and influence the subsequent fascicle strains during contraction. Here, we used ultrasound and elastography techniques to examine in vivo muscle fascicle behavior and central aponeurosis deformations of human tibialis anterior (TA) during force-matched voluntary isometric dorsiflexion contractions at three MTU lengths. We found that increases in TA MTU length increased both the length and apparent longitudinal stiffness of the central aponeurosis at low and moderate muscle forces (P < 0.01). We also found that increased aponeurosis stiffness was directly related to reduced magnitudes of TA muscle fascicle shortening for the same change in force (P < 0.01). The increase in slope and shift to longer overall lengths of the active aponeurosis force-length relationship as MTU length increased was likely due to a combination of parallel lengthening of aponeurosis and greater transverse aponeurosis strains. This study provides in vivo evidence that human aponeurosis stiffness is increased from low to moderate forces and that the fascicle strains for a given muscle force are MTU length dependent. Further testing is warranted to determine whether MTU length-dependent stiffness is a fundamental property of the aponeurosis in pennate muscles and evaluate whether this property can enhance muscle performance.
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Cenni F, Schless SH, Bar-On L, Aertbeliën E, Bruyninckx H, Hanssen B, Desloovere K. Reliability of a clinical 3D freehand ultrasound technique: Analyses on healthy and pathological muscles. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 156:97-103. [PMID: 29428080 DOI: 10.1016/j.cmpb.2017.12.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 11/24/2017] [Accepted: 12/21/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE 3D freehand Ultrasonography is a medical imaging technique that can be used to measure muscle and tendon morphological and structural properties, including volume, lengths and echo-intensity. These properties are clinically relevant in neurological disorders such as spastic cerebral palsy to monitor disease progression and evaluate the effect of treatment. This study presents a methodology for extracting these parameters along with a clinical reliability analysis for the data acquisition and processing. METHODS The medial gastrocnemius muscles and Achilles tendon of 10 typically developing children and 10 children with spastic cerebral palsy were assessed. An open-source in-house software library developed in Python (Py3DFreeHandUS) was used to reconstruct, into one 3D data set, the data simultaneously acquired from an US machine and a motion tracking system. US images were manually segmented and linearly interpolated by means of a new simplified approach which involved sequentially decreasing the total number of images used for muscle border segmentation from 100% to 5%. Acquisition and processing reliability was defined based on repeated measures from different data processers and from different data acquirers, respectively. RESULTS When only 10% of the US images were outlined, there was an average underestimation of muscle volume of 1.1% and 1.6% with respect the computation of all the available images, for the typically developing and spastic cerebral palsy groups, respectively. For both groups, the reliability was higher for data processing than for data acquisition. High inter-class correlation coefficient values were found for processing and acquisition reliability, with worst case values of 0.89 and 0.61, respectively. The standard error of measurement, expressed as a percentage of the average volumes, was smaller than 2.6 ml (4.8%) in all cases. CONCLUSIONS The present analysis demonstrates the effectiveness of applying 3D freehand ultrasonography in a clinical setting for analysing healthy and pathological paediatric muscle.
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Affiliation(s)
- Francesco Cenni
- KU Leuven, Department of Mechanical Engineering, Celestijnenlaan 300b, 3001 Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium.
| | - Simon-Henri Schless
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
| | - Lynn Bar-On
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
| | - Erwin Aertbeliën
- KU Leuven, Department of Mechanical Engineering, Celestijnenlaan 300b, 3001 Leuven, Belgium
| | - Herman Bruyninckx
- KU Leuven, Department of Mechanical Engineering, Celestijnenlaan 300b, 3001 Leuven, Belgium
| | - Britta Hanssen
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
| | - Kaat Desloovere
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
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Cenni F, Schless SH, Bar-On L, Molenaers G, Van Campenhout A, Aertbeliën E, Bruyninckx H, Hanssen B, Desloovere K. Can in Vivo Medial Gastrocnemius Muscle-Tendon Unit Lengths be Reliably Estimated by Two Ultrasonography Methods? A Within-Session Analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:110-118. [PMID: 29122315 DOI: 10.1016/j.ultrasmedbio.2017.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
A clinically feasible method to reliably estimate muscle-tendon unit (MTU) lengths could provide essential diagnostic and treatment planning information. A 3-D freehand ultrasound (3-DfUS) method was previously validated for extracting in vivo medial gastrocnemius (MG) lengths, although the processing time can be considered substantial for the clinical environment. This investigation analyzed a quicker and simpler method using the US transducer as a spatial pointer (US-PaP), where the within-session reliability of extracting the muscle-tendon unit (MTU) and tendon lengths are estimated. MG MTU lengths were extracted in a group of 14 healthy adults using both 3-DfUS and US-PaP. Two consecutive acquisitions were performed per participant, and the data processed by two researchers independently. The intra-class correlation coefficients were above 0.97, and the standard error of measurements below 3.6 mm (1.5%). This investigation proposes that the simplified US-PaP method is a viable alternative for estimating MG MTU lengths.
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Affiliation(s)
- Francesco Cenni
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium.
| | - Simon-Henri Schless
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Lynn Bar-On
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Guy Molenaers
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Development and Regeneration, University Hospital, Leuven, Belgium; Department of Orthopaedic Surgery, University Hospital, Leuven, Belgium
| | - Anja Van Campenhout
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Development and Regeneration, University Hospital, Leuven, Belgium; Department of Orthopaedic Surgery, University Hospital, Leuven, Belgium
| | - Erwin Aertbeliën
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | | | - Britta Hanssen
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Schless SH, Hanssen B, Cenni F, Bar-On L, Aertbeliën E, Molenaers G, Desloovere K. Estimating medial gastrocnemius muscle volume in children with spastic cerebral palsy: a cross-sectional investigation. Dev Med Child Neurol 2018; 60:81-87. [PMID: 29067675 DOI: 10.1111/dmcn.13597] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 11/29/2022]
Abstract
AIM This cross-sectional investigation evaluates the reliability of estimating medial gastrocnemius anatomical cross-sectional area (aCSA) in typically developing and spastic cerebral palsy (SCP) cohorts. It verifies whether muscle volume estimations based on aCSA improve when aCSA is multiplied by muscle-tendon unit (MTU) or muscle length, and whether the resulting errors in volume estimations are smaller than changes after intervention. METHOD Fifteen typically developing children (mean age 8y 2mo [SD 1y 5mo], six males, nine females) and 30 children with SCP (mean age 9y 2mo [SD 2y 5mo], 22 males, eight females, Gross Motor Function Classification System [GMFCS] level I=15, II=15) participated in the investigation. The SCP cohort was divided according to GMFCS level. A three-dimensional freehand ultrasound technique was used to estimate medial gastrocnemius aCSA, muscle volume, MTU, and muscle length. Estimated muscle volume (aCSA×MTU or muscle length) was compared with the measured muscle volume. RESULTS Anatomical cross-sectional area, muscle volume, and muscle length significantly differed between the typically developing and two SCP cohorts (p≤0.050). aCSA multiplied by either MTU or muscle length improved estimations of medial gastrocnemius volume. Leave-one-out cross-validation revealed an absolute difference with measured muscle volume of 3.77 ml (SD 2.90). INTERPRETATION This investigation revealed that medial gastrocnemius muscle volume can be reliably estimated in a clinically feasible manner in typically developing children and those with SCP. WHAT THIS PAPER ADDS Medial gastrocnemius anatomical cross-sectional area (aCSA) can be reliably estimated in children with spastic cerebral palsy. The location of the anatomical cross-section should be taken with respect to muscle and not bone length. Medial gastrocnemius volume can be reliably estimated by multiplying aCSA and muscle length. The errors in volume estimations are smaller than reported differences after interventions.
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Affiliation(s)
- Simon-Henri Schless
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Britta Hanssen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Francesco Cenni
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium.,Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | - Lynn Bar-On
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Erwin Aertbeliën
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | - Guy Molenaers
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium.,Department of Orthopaedic Medicine, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
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Obst SJ, Boyd R, Read F, Barber L. Quantitative 3-D Ultrasound of the Medial Gastrocnemius Muscle in Children with Unilateral Spastic Cerebral Palsy. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2814-2823. [PMID: 28967503 DOI: 10.1016/j.ultrasmedbio.2017.08.929] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 08/07/2017] [Accepted: 08/13/2017] [Indexed: 06/07/2023]
Abstract
Three-dimensional ultrasound (3-DUS) was used to examine the size and appearance of the medial gastrocnemius (MG) muscle in children with unilateral cerebral palsy (CP). Twenty-six children with CP and 10 typically developing (TD) children participated. Three-dimensional US images of both limbs in children with CP and the right limb in TD children were analysed using quantitative methods to determine muscle volume, global echo intensity, global echo pattern and regional echo intensity. Significant differences in MG volume and all echo parameters were found between TD and CP children. The more involved limb was smaller and had higher echo intensity and a more heterogenous echo pattern compared with the TD group. Compared with that of the more involved limb, the MG of the less involved limb was larger but had a similar echo appearance. The MG of both limbs in children with unilateral spastic CP is smaller and, based on quantitative ultrasound, structurally different from that of TD children.
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Affiliation(s)
- Steven J Obst
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia.
| | - Roslyn Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Felicity Read
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Weide G, van der Zwaard S, Huijing PA, Jaspers RT, Harlaar J. 3D Ultrasound Imaging: Fast and Cost-effective Morphometry of Musculoskeletal Tissue. J Vis Exp 2017. [PMID: 29286445 PMCID: PMC5755508 DOI: 10.3791/55943] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The developmental goal of 3D ultrasound imaging (3DUS) is to engineer a modality to perform 3D morphological ultrasound analysis of human muscles. 3DUS images are constructed from calibrated freehand 2D B-mode ultrasound images, which are positioned into a voxel array. Ultrasound (US) imaging allows quantification of muscle size, fascicle length, and angle of pennation. These morphological variables are important determinants of muscle force and length range of force exertion. The presented protocol describes an approach to determine volume and fascicle length of m. vastus lateralis and m. gastrocnemius medialis. 3DUS facilitates standardization using 3D anatomical references. This approach provides a fast and cost-effective approach for quantifying 3D morphology in skeletal muscles. In healthcare and sports, information on the morphometry of muscles is very valuable in diagnostics and/or follow-up evaluations after treatment or training.
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Affiliation(s)
- Guido Weide
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences; Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam Movement Sciences
| | - Stephan van der Zwaard
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences
| | - Peter A Huijing
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences
| | - Richard T Jaspers
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences;
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam Movement Sciences
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Pizzolato C, Lloyd DG, Barrett RS, Cook JL, Zheng MH, Besier TF, Saxby DJ. Bioinspired Technologies to Connect Musculoskeletal Mechanobiology to the Person for Training and Rehabilitation. Front Comput Neurosci 2017; 11:96. [PMID: 29093676 PMCID: PMC5651250 DOI: 10.3389/fncom.2017.00096] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022] Open
Abstract
Musculoskeletal tissues respond to optimal mechanical signals (e.g., strains) through anabolic adaptations, while mechanical signals above and below optimal levels cause tissue catabolism. If an individual's physical behavior could be altered to generate optimal mechanical signaling to musculoskeletal tissues, then targeted strengthening and/or repair would be possible. We propose new bioinspired technologies to provide real-time biofeedback of relevant mechanical signals to guide training and rehabilitation. In this review we provide a description of how wearable devices may be used in conjunction with computational rigid-body and continuum models of musculoskeletal tissues to produce real-time estimates of localized tissue stresses and strains. It is proposed that these bioinspired technologies will facilitate a new approach to physical training that promotes tissue strengthening and/or repair through optimal tissue loading.
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Affiliation(s)
- Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - David G. Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Rod S. Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Jill L. Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Ming H. Zheng
- Centre for Orthopaedic Translational Research, School of Surgery, University of Western Australia, Nedlands, WA, Australia
| | - Thor F. Besier
- Auckland Bioengineering Institute and Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - David J. Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Mozaffari MH, Lee WS. Freehand 3-D Ultrasound Imaging: A Systematic Review. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2099-2124. [PMID: 28716431 DOI: 10.1016/j.ultrasmedbio.2017.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/01/2017] [Accepted: 06/05/2017] [Indexed: 05/20/2023]
Abstract
Two-dimensional ultrasound (US) imaging has been successfully used in clinical applications as a low-cost, portable and non-invasive image modality for more than three decades. Recent advances in computer science and technology illustrate the promise of the 3-D US modality as a medical imaging technique that is comparable to other prevalent modalities and that overcomes certain drawbacks of 2-D US. This systematic review covers freehand 3-D US imaging between 1970 and 2017, highlighting the current trends in research fields, the research methods, the main limitations, the leading researchers, standard assessment criteria and clinical applications. Freehand 3-D US systems are more prevalent in the academic environment, whereas in clinical applications and industrial research, most studies have focused on 3-D US transducers and improvement of hardware performance. This topic is still an interesting active area for researchers, and there remain many unsolved problems to be addressed.
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Affiliation(s)
- Mohammad Hamed Mozaffari
- School of Electrical Engineering and Computer Science (EECS), University of Ottawa, Ottawa, Ontario, Canada.
| | - Won-Sook Lee
- School of Electrical Engineering and Computer Science (EECS), University of Ottawa, Ottawa, Ontario, Canada
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Reliability of Achilles Tendon Moment Arm Measured In Vivo Using Freehand Three-Dimensional Ultrasound. J Appl Biomech 2017; 33:300-304. [PMID: 28084870 DOI: 10.1123/jab.2016-0261] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated reliability of freehand three-dimensional ultrasound (3DUS) measurement of in vivo human Achilles tendon (AT) moment arm. Sixteen healthy adults were scanned on 2 separate occasions by a single investigator. 3DUS scans were performed over the free AT, medial malleolus, and lateral malleolus with the ankle passively positioned in maximal dorsiflexion, mid dorsiflexion, neutral, mid plantar flexion and maximal plantar flexion. 3D reconstructions of the AT, medial malleolus, and lateral malleolus were created from manual segmentation of the ultrasound images and used to geometrically determine the AT moment arm using both a straight (straight ATMA) and curved (curved ATMA) tendon line-of-action. Both methods were reliable within- and between-session (intra-class correlation coefficients > 0.92; coefficient of variation < 2.5 %) and revealed that AT moment arm increased by ∼ 7 mm from maximal dorsiflexion (∼ 41mm) to maximal plantar flexion (∼ 48 mm). Failing to account for tendon curvature led to a small overestimation (< 2 mm) of AT moment arm that was most pronounced in ankle plantar flexion, but was less than the minimal detectable change of the method and could be disregarded.
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Boyd RN, Davies PSW, Ziviani J, Trost S, Barber L, Ware R, Rose S, Whittingham K, Sakzewski L, Bell K, Carty C, Obst S, Benfer K, Reedman S, Edwards P, Kentish M, Copeland L, Weir K, Davenport C, Brooks D, Coulthard A, Pelekanos R, Guzzetta A, Fiori S, Wynter M, Finn C, Burgess A, Morris K, Walsh J, Lloyd O, Whitty JA, Scuffham PA. PREDICT-CP: study protocol of implementation of comprehensive surveillance to predict outcomes for school-aged children with cerebral palsy. BMJ Open 2017; 7:e014950. [PMID: 28706091 PMCID: PMC5734266 DOI: 10.1136/bmjopen-2016-014950] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8-12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity). METHODS AND ANALYSES This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006-2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models. ETHICS AND DISSEMINATION The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5-5 then 8-12 years of direct clinical assessment to enable prediction of outcomes and healthcare needs essential for tailoring interventions (eg, rehabilitation, orthopaedic surgery and nutritional supplements) and the projected healthcare utilisation. TRIAL REGISTRATION NUMBER ACTRN: 12616001488493.
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Affiliation(s)
- Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Peter SW Davies
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Ziviani
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Stewart Trost
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Robert Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Stephen Rose
- CSIRO Australian e-Health Research Centre, Canberra, Australia
- Medical Imaging, Diagnostic and Interventional Neuroradiology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Kristie Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Christopher Carty
- Queensland Children's Motion Analysis Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Steven Obst
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Katherine Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Priya Edwards
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Megan Kentish
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Lisa Copeland
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Kelly Weir
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Clinical Governance, Education and Research, Gold Coast Health, Brisbane, Queensland, Australia
| | - Camilla Davenport
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Denise Brooks
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Alan Coulthard
- Medical Imaging, Diagnostic and Interventional Neuroradiology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Rebecca Pelekanos
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, Instituto Di Ricovero E Cura A Carattere Scientifico (IRCCS), Pisa, Italy
| | - Simona Fiori
- Department of Developmental Neuroscience, Instituto Di Ricovero E Cura A Carattere Scientifico (IRCCS), Pisa, Italy
| | - Meredith Wynter
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Christine Finn
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea Burgess
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Kym Morris
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia
| | - John Walsh
- Medical Imaging, Diagnostic and Interventional Neuroradiology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Queensland Children's Motion Analysis Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- Department of Paediatric Orthopaedics, The Mater Health Services, Brisbane, Queensland, Australia
| | - Owen Lloyd
- Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Jennifer A Whitty
- Norwich Medical School, University of East Anglia, Norwich, UK
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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74
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Handsfield GG, Bolsterlee B, Inouye JM, Herbert RD, Besier TF, Fernandez JW. Determining skeletal muscle architecture with Laplacian simulations: a comparison with diffusion tensor imaging. Biomech Model Mechanobiol 2017; 16:1845-1855. [DOI: 10.1007/s10237-017-0923-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/22/2017] [Indexed: 10/19/2022]
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75
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Hansen W, Shim VB, Obst S, Lloyd DG, Newsham-West R, Barrett RS. Achilles tendon stress is more sensitive to subject-specific geometry than subject-specific material properties: A finite element analysis. J Biomech 2017; 56:26-31. [DOI: 10.1016/j.jbiomech.2017.02.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/23/2017] [Accepted: 02/26/2017] [Indexed: 10/20/2022]
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76
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Böl M, Leichsenring K, Siebert T. Effects of Growth on Muscle, Tendon, and Aponeurosis Tissues in Rabbit Shank Musculature. Anat Rec (Hoboken) 2017; 300:1123-1136. [DOI: 10.1002/ar.23538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/01/2016] [Accepted: 10/25/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Markus Böl
- Department of Mechanical Engineering, Institute of Solid Mechanics Technische Universität Braunschweig; Braunschweig 38106 Germany
| | - Kay Leichsenring
- Department of Mechanical Engineering, Institute of Solid Mechanics Technische Universität Braunschweig; Braunschweig 38106 Germany
| | - Tobias Siebert
- Department of Sport and Motion Science; University of Stuttgart; Stuttgart 70569 Germany
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77
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Barber LA, Read F, Lovatt Stern J, Lichtwark G, Boyd RN. Medial gastrocnemius muscle volume in ambulant children with unilateral and bilateral cerebral palsy aged 2 to 9 years. Dev Med Child Neurol 2016; 58:1146-1152. [PMID: 27098082 DOI: 10.1111/dmcn.13132] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 12/23/2022]
Abstract
AIM Calf muscle growth in children with unilateral cerebral palsy (UCP) and bilateral cerebral palsy (BCP) is unknown. This cross-sectional study examines the medial gastrocnemius growth rates of ambulatory children with UCP and BCP compared with children with typical development (CTD), aged 2 to 9 years. METHOD Fifty children with UCP (mean age 66mo [SD 18], 29 males, Gross Motor Function Classification System [GMFCS] I=32, II=18), 50 children with BCP (age 64mo [SD 19], 31 males, GMFCS I=21, II=29), and 78 CTD (age 64mo [SD 16], 40 males) participated in the study. The medial gastrocnemius muscle volume was measured at rest using a validated freehand three-dimensional (3D) ultrasound method. RESULTS Normalized medial gastrocnemius muscle growth rate was significantly less in the children with UCP (0.001 mL/kg/mo) compared with the BCP (0.015 mL/kg/mo, p=0.001) and CTD (0.014 mL/kg/mo, p<0.001) groups. Normalized medial gastrocnemius muscle growth rate was the same in the BCP and CTD groups (p=0.77). INTERPRETATION The normalized growth rate of the medial gastrocnemius muscle in children aged 2 to 9 years with UCP is significantly lower compared with children with BCP and CTD. The growth rate differences in the children with UCP compared with BCP raises questions about the underlying mechanisms that lead to reduced growth in each cerebral palsy (CP) group and potential differences in muscle recovery response in UCP and BCP following treatment.
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Affiliation(s)
- Lee A Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia.
| | - Felicity Read
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia
| | - Jacquie Lovatt Stern
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia
| | - Glen Lichtwark
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia
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78
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Cenni F, Monari D, Desloovere K, Aertbeliën E, Schless SH, Bruyninckx H. The reliability and validity of a clinical 3D freehand ultrasound system. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 136:179-187. [PMID: 27686714 DOI: 10.1016/j.cmpb.2016.09.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/28/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Acquiring large anatomical volumes in a feasible manner is useful for clinical decision-making. A relatively new technique called 3D freehand ultrasonography is capable of this by combining a conventional 2D ultrasonography system. Currently, a thorough analysis of this technique is lacking, as the analyses are dependent on the software implementation details and the choice of measurement systems. Therefore this study starts by making this implementation available under the form of an open-source software library to perform 3D freehand ultrasonography. Following that, reliability and validity analyses of extracting volumes and lengths will be carried out using two independent motion-tracking systems. METHODS A PC-based ultrasonography device and two optical motion-tracking systems were used for data acquisition. An in-house software library called Py3DFreeHandUS was developed to reconstruct (off-line) the corresponding data into one 3D data set. Reliability and validity analyses of the entire experimental set-up were performed by estimating the volumes and lengths of ground truth objects. Ten water-filled balloons and six cross-wires were used. Repeat measurements were also performed by two experienced operators. RESULTS The software library Py3DFreeHandUS is available online, along with the relevant documentation. The reliability analyses showed high intra- and inter-operator intra-class correlation coefficient results for both volumes and lengths. The accuracy analysis revealed a discrepancy in all cases of around 3%, which corresponded to 3 ml and 1 mm for volume and length measurements, respectively. Similar results were found for both of the motion-tracking systems. CONCLUSIONS The undertaken analyses for estimating volume and lengths acquired with 3D freehand ultrasonography demonstrated reliable design measurements and suitable performance for applications that do not require sub-mm and -ml accuracy.
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Affiliation(s)
- Francesco Cenni
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300b, 3001 Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium.
| | - Davide Monari
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300b, 3001 Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium
| | - Kaat Desloovere
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Erwin Aertbeliën
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300b, 3001 Leuven, Belgium
| | - Simon-Henri Schless
- Clinical Motion Analysis Laboratory, University Hospital, Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Herman Bruyninckx
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300b, 3001 Leuven, Belgium
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79
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Ryan JM, Theis N, Kilbride C, Baltzopoulos V, Waugh C, Shortland A, Lavelle G, Noorkoiv M, Levin W, Korff T. Strength Training for Adolescents with cerebral palsy (STAR): study protocol of a randomised controlled trial to determine the feasibility, acceptability and efficacy of resistance training for adolescents with cerebral palsy. BMJ Open 2016; 6:e012839. [PMID: 27707836 PMCID: PMC5073599 DOI: 10.1136/bmjopen-2016-012839] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Gait is inefficient in children with cerebral palsy, particularly as they transition to adolescence. Gait inefficiency may be associated with declines in gross motor function and participation among adolescents with cerebral palsy. Resistance training may improve gait efficiency through a number of biomechanical and neural mechanisms. The aim of the Strength Training for Adolescents with cerebral palsy (STAR) trial is to evaluate the effect of resistance training on gait efficiency, activity and participation in adolescents with cerebral palsy. We also aim to determine the biomechanical and neural adaptations that occur following resistance training and evaluate the feasibility and acceptability of such an intervention for adolescents with cerebral palsy. METHODS AND ANALYSIS 60 adolescents (Gross Motor Function Classification System level I-III) will be randomised to a 10-week resistance training group or a usual care control group according to a computer-generated random schedule. The primary outcome is gait efficiency. Secondary outcomes are habitual physical activity, participation, muscle-tendon mechanics and gross motor function. General linear models will be used to evaluate differences in continuous data between the resistance training and usual care groups at 10 and 22 weeks, respectively. A process evaluation will be conducted alongside the intervention. Fidelity of the resistance training programme to trial protocol will be quantified by observations of exercise sessions. Semistructured interviews will be conducted with participants and physiotherapists following the resistance training programme to determine feasibility and acceptability of the programme. ETHICS AND DISSEMINATION This trial has ethical approval from Brunel University London's Department of Clinical Sciences' Research Ethics Committee and the National Research Ethics Service (NRES) Committee London-Surrey Borders. The results of the trial will be submitted for publication in academic journals, presented at conferences and distributed to adolescents, families and healthcare professionals through the media with the assistance of the STAR advisory group. TRIAL REGISTRATION NUMBER ISRCTN90378161; Pre-results.
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Affiliation(s)
- Jennifer M Ryan
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Nicola Theis
- School of Sport, Health and Applied Science, St. Mary's University, Twickenham, UK
| | - Cherry Kilbride
- College of Health and Life Sciences, Brunel University London, London, UK
| | | | - Charlie Waugh
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Shortland
- One Small Step Gait Laboratory, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Grace Lavelle
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Marika Noorkoiv
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Wendy Levin
- Department of Physiotherapy, Royal Free London NHS Foundation Trust, Swiss Cottage School Development and Research Centre, London, UK
| | - Thomas Korff
- College of Health and Life Sciences, Brunel University London, London, UK
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80
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Hug F, Goupille C, Baum D, Raiteri BJ, Hodges PW, Tucker K. Nature of the coupling between neural drive and force-generating capacity in the human quadriceps muscle. Proc Biol Sci 2016; 282:rspb.2015.1908. [PMID: 26609085 DOI: 10.1098/rspb.2015.1908] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The force produced by a muscle depends on both the neural drive it receives and several biomechanical factors. When multiple muscles act on a single joint, the nature of the relationship between the neural drive and force-generating capacity of the synergistic muscles is largely unknown. This study aimed to determine the relationship between the ratio of neural drive and the ratio of muscle force-generating capacity between two synergist muscles (vastus lateralis (VL) and vastus medialis (VM)) in humans. Twenty-one participants performed isometric knee extensions at 20 and 50% of maximal voluntary contractions (MVC). Myoelectric activity (surface electromyography (EMG)) provided an index of neural drive. Physiological cross-sectional area (PCSA) was estimated from measurements of muscle volume (magnetic resonance imaging) and muscle fascicle length (three-dimensional ultrasound imaging) to represent the muscles' force-generating capacities. Neither PCSA nor neural drive was balanced between VL and VM. There was a large (r = 0.68) and moderate (r = 0.43) correlation between the ratio of VL/VM EMG amplitude and the ratio of VL/VM PCSA at 20 and 50% of MVC, respectively. This study provides evidence that neural drive is biased by muscle force-generating capacity, the greater the force-generating capacity of VL compared with VM, the stronger bias of drive to the VL.
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Affiliation(s)
- François Hug
- School of Health and Rehabilitation Sciences, The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Brisbane, Australia Laboratory EA 4334 'Movement, Interactions, Performance', University of Nantes, Nantes, France
| | - Clément Goupille
- Laboratory EA 4334 'Movement, Interactions, Performance', University of Nantes, Nantes, France
| | - Daniel Baum
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia, and
| | - Brent J Raiteri
- School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Performance, The University of Queensland, Brisbane, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Brisbane, Australia
| | - Kylie Tucker
- School of Health and Rehabilitation Sciences, The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Brisbane, Australia School of Biomedical Sciences, The University of Queensland, Brisbane, Australia, and
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81
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Nuri L, Obst SJ, Newsham-West R, Barrett RS. Regional three-dimensional deformation of human Achilles tendon during conditioning. Scand J Med Sci Sports 2016; 27:1263-1272. [DOI: 10.1111/sms.12742] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 12/15/2022]
Affiliation(s)
- L. Nuri
- School of Allied Health Sciences; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - S. J. Obst
- School of Allied Health Sciences; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - R. Newsham-West
- School of Allied Health Sciences; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - R. S. Barrett
- School of Allied Health Sciences; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
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82
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Raiteri BJ, Cresswell AG, Lichtwark GA. Three-dimensional geometrical changes of the human tibialis anterior muscle and its central aponeurosis measured with three-dimensional ultrasound during isometric contractions. PeerJ 2016; 4:e2260. [PMID: 27547566 PMCID: PMC4974924 DOI: 10.7717/peerj.2260] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/25/2016] [Indexed: 12/03/2022] Open
Abstract
Background. Muscles not only shorten during contraction to perform mechanical work, but they also bulge radially because of the isovolumetric constraint on muscle fibres. Muscle bulging may have important implications for muscle performance, however quantifying three-dimensional (3D) muscle shape changes in human muscle is problematic because of difficulties with sustaining contractions for the duration of an in vivo scan. Although two-dimensional ultrasound imaging is useful for measuring local muscle deformations, assumptions must be made about global muscle shape changes, which could lead to errors in fully understanding the mechanical behaviour of muscle and its surrounding connective tissues, such as aponeurosis. Therefore, the aims of this investigation were (a) to determine the intra-session reliability of a novel 3D ultrasound (3DUS) imaging method for measuring in vivo human muscle and aponeurosis deformations and (b) to examine how contraction intensity influences in vivo human muscle and aponeurosis strains during isometric contractions. Methods. Participants (n = 12) were seated in a reclined position with their left knee extended and ankle at 90° and performed isometric dorsiflexion contractions up to 50% of maximal voluntary contraction. 3DUS scans of the tibialis anterior (TA) muscle belly were performed during the contractions and at rest to assess muscle volume, muscle length, muscle cross-sectional area, muscle thickness and width, fascicle length and pennation angle, and central aponeurosis width and length. The 3DUS scan involved synchronous B-mode ultrasound imaging and 3D motion capture of the position and orientation of the ultrasound transducer, while successive cross-sectional slices were captured by sweeping the transducer along the muscle. Results. 3DUS was shown to be highly reliable across measures of muscle volume, muscle length, fascicle length and central aponeurosis length (ICC ≥ 0.98, CV < 1%). The TA remained isovolumetric across contraction conditions and progressively shortened along its line of action as contraction intensity increased. This caused the muscle to bulge centrally, predominantly in thickness, while muscle fascicles shortened and pennation angle increased as a function of contraction intensity. This resulted in central aponeurosis strains in both the transverse and longitudinal directions increasing with contraction intensity. Discussion. 3DUS is a reliable and viable method for quantifying multidirectional muscle and aponeurosis strains during isometric contractions within the same session. Contracting muscle fibres do work in directions along and orthogonal to the muscle’s line of action and central aponeurosis length and width appear to be a function of muscle fascicle shortening and transverse expansion of the muscle fibres, which is dependent on contraction intensity. How factors other than muscle force change the elastic mechanical behaviour of the aponeurosis requires further investigation.
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Affiliation(s)
- Brent J Raiteri
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland , Brisbane , Queensland , Australia
| | - Andrew G Cresswell
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland , Brisbane , Queensland , Australia
| | - Glen A Lichtwark
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland , Brisbane , Queensland , Australia
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83
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Haberfehlner H, Maas H, Harlaar J, Becher JG, Buizer AI, Jaspers RT. Freehand three-dimensional ultrasound to assess semitendinosus muscle morphology. J Anat 2016; 229:591-9. [PMID: 27271461 PMCID: PMC5013067 DOI: 10.1111/joa.12501] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 11/26/2022] Open
Abstract
In several neurological disorders and muscle injuries, morphological changes of the m. semitendinosus (ST) are presumed to contribute to movement limitations around the knee. Freehand three-dimensional (3D) ultrasound (US), using position tracking of two-dimensional US images to reconstruct a 3D voxel array, can be used to assess muscle morphology in vivo. The aims of this study were: (i) to introduce a newly developed 3D US protocol for ST; and (ii) provide a first comparison of morphological characteristics determined by 3D US with those measured on dissected cadaveric muscles. Morphological characteristics of ST (e.g. muscle belly length, tendon length, fascicle length and whole muscle volume, and volumes of both compartments) were assessed in six cadavers using a 3D US protocol. Subsequently, ST muscles were removed from the body to measure the same morphological characteristics. Mean differences between morphological characteristics measured by 3D US and after dissection were smaller than 10%. Intra-class correlation coefficients (ICCs) were higher than 0.75 for all variables except for the lengths of proximal fascicles (ICC = 0.58). Measurement of the volume of proximal compartment by 3D US was not feasible, due to low US image quality proximally. We conclude that the presented 3D US protocol allows for reasonably accurate measurements of key morphological characteristics of ST muscle.
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Affiliation(s)
- Helga Haberfehlner
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, VU University Medical Center, MOVE Research Institute Amsterdam, The Netherlands
| | - Huub Maas
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center, MOVE Research Institute Amsterdam, The Netherlands
| | - Jules G Becher
- Department of Rehabilitation Medicine, VU University Medical Center, MOVE Research Institute Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, VU University Medical Center, MOVE Research Institute Amsterdam, The Netherlands
| | - Richard T Jaspers
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
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84
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Abe T, Tayashiki K, Nakatani M, Watanabe H. Relationships of ultrasound measures of intrinsic foot muscle cross-sectional area and muscle volume with maximum toe flexor muscle strength and physical performance in young adults. J Phys Ther Sci 2016; 28:14-9. [PMID: 26957721 PMCID: PMC4755967 DOI: 10.1589/jpts.28.14] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/05/2015] [Indexed: 12/28/2022] Open
Abstract
[Purpose] To investigate the relationships between toe flexor muscle strength with
(TFS-5-toes) and without (TFS-4-toes) the contribution of the great toe, anatomical and
physiological muscle cross-sectional areas (CSA) of intrinsic toe flexor muscle and
physical performance were measured. [Subjects] Seventeen men (82% sports-active) and 17
women (47% sports-active), aged 20 to 35 years, volunteered. [Methods] Anatomical CSA was
measured in two intrinsic toe flexor muscles (flexor digitorum brevis [FDB] and abductor
hallucis) by ultrasound. Muscle volume and muscle length of the FDB were also estimated,
and physiological CSA was calculated. [Results] Both TFS-5-toes and TFS-4-toes correlated
positively with walking speed in men (r=0.584 and r=0.553, respectively) and women
(r=0.748 and r=0.533, respectively). Physiological CSA of the FDB was significantly
correlated with TFS-5-toes (r=0.748) and TFS-4-toes (r=0.573) in women. In men,
physiological CSA of the FDB correlated positively with TFS-4-toes (r=0.536), but not with
TFS-5-toes (r=0.333). [Conclusion] Our results indicate that physiological CSA of the FDB
is moderately associated with TFS-4-toes while toe flexor strength correlates with walking
performance.
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Affiliation(s)
- Takashi Abe
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Japan
| | - Kota Tayashiki
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Japan
| | - Miyuki Nakatani
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Japan
| | - Hironori Watanabe
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Japan
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85
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Watson EL, Greening NJ, Viana JL, Aulakh J, Bodicoat DH, Barratt J, Feehally J, Smith AC. Progressive Resistance Exercise Training in CKD: A Feasibility Study. Am J Kidney Dis 2015; 66:249-57. [DOI: 10.1053/j.ajkd.2014.10.019] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/14/2014] [Indexed: 11/11/2022]
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86
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Vieira TM, Botter A, Minetto MA, Hodson-Tole EF. Spatial variation of compound muscle action potentials across human gastrocnemius medialis. J Neurophysiol 2015; 114:1617-27. [PMID: 26156382 DOI: 10.1152/jn.00221.2015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/26/2015] [Indexed: 12/14/2022] Open
Abstract
The massed action potential (M wave) elicited through nerve stimulation underpins a wide range of physiological and mechanical understanding of skeletal muscle structure and function. Although systematic approaches have evaluated the effect of different factors on M waves, the effect of the location and distribution of activated fibers within the muscle remains unknown. By detecting M waves from the medial gastrocnemius (MG) of 12 participants with a grid of 128 electrodes, we investigated whether different populations of muscle units have different spatial organization within MG. If populations of muscle units occupy discrete MG regions, current pulses of progressively greater intensities applied to the MG nerve branch would be expected to lead to local changes in M-wave amplitudes. Electrical pulses were therefore delivered at 2 pps, with the current pulse amplitude increased every 10 stimuli to elicit different degrees of muscle activation. The localization of MG response to increases in current intensity was determined from the spatial distribution of M-wave amplitude. Key results revealed that increases in M-wave amplitude were detected somewhat locally, by 10-50% of the 128 electrodes. Most importantly, the electrodes detecting greatest increases in M-wave amplitude were localized at different regions in the grid, with a tendency for greater stimulation intensities to elicit M waves in the more distal MG region. The presented results indicate that M waves recorded locally may not provide a representative MG response, with major implications for the estimation of, e.g., the maximal stimulation levels, the number of motor units, and the onset and normalization in H-reflex studies.
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Affiliation(s)
- Taian M Vieira
- Laboratorio di Ingegneria del Sistema Neuromuscolare, Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy; Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto Botter
- Laboratorio di Ingegneria del Sistema Neuromuscolare, Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy;
| | - Marco A Minetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy; and
| | - Emma F Hodson-Tole
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, United Kingdom
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87
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Gillett JG, Lichtwark GA, Boyd RN, Barber LA. FAST CP: protocol of a randomised controlled trial of the efficacy of a 12-week combined Functional Anaerobic and Strength Training programme on muscle properties and mechanical gait deficiencies in adolescents and young adults with spastic-type cerebral palsy. BMJ Open 2015; 5:e008059. [PMID: 26116614 PMCID: PMC4486965 DOI: 10.1136/bmjopen-2015-008059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Individuals with cerebral palsy (CP) have muscles that are smaller, weaker and more resistant to stretch compared to typically developing people. Progressive resistance training leads to increases in muscle size and strength. In CP, the benefits of resistance training alone may not transfer to improve other activities such as walking; however, the transfer of strength improvements to improved mobility may be enhanced by performing training that involves specific functional tasks or motor skills. This study aims to determine the efficacy of combined functional anaerobic and strength training in (1) influencing muscle strength, structure and function and (2) to determine if any changes in muscle strength and structure following training impact on walking ability and gross motor functional capacity and performance in the short (following 3 months of training) and medium terms (a further 3 months post-training). METHODS AND ANALYSIS 40 adolescents and young adults with CP will be recruited to undertake a 12-week training programme. The training programme will consist of 3 × 75 min sessions per week, made up of 5 lower limb resistance exercises and 2-3 functional anaerobic exercises per session. The calf muscles will be specifically targeted, as they are the most commonly impacted muscles in CP and are a key muscle group involved in walking. If, as we believe, muscle properties change following combined strength and functional training, there may be long-term benefits of this type of training in slowing the deterioration of muscle function in people with spastic-type CP. ETHICS AND DISSEMINATION Ethical approval has been obtained from the ethics committees at The University of Queensland (2014000066) and Children's Health Queensland (HREC/15/QRCH/30). The findings will be disseminated by publications in peer-reviewed journals, conferences and local research organisations' media. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry (ACTRN12614001217695).
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Affiliation(s)
- Jarred G Gillett
- Faculty of Medicine and Biomedical Sciences, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Herston, Queensland, Australia Queensland Children's Motion Analysis Service, Royal Children's Hospital, Herston, Queensland, Australia
| | - Glen A Lichtwark
- Queensland Children's Motion Analysis Service, Royal Children's Hospital, Herston, Queensland, Australia
| | - Roslyn N Boyd
- Faculty of Medicine and Biomedical Sciences, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Lee A Barber
- Faculty of Medicine and Biomedical Sciences, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Herston, Queensland, Australia
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88
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Martins NSDF, Carneiro LT, Dantas HDM, Esperança C, Marroquim RG, Oliveira LFD, Machado JC. Generation of 3D ultrasound biomicroscopic images: technique validation and in vivo volumetric imaging of rat lateral gastrocnemius. ACTA ACUST UNITED AC 2015. [DOI: 10.1590/1517-3151.0209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
| | | | | | | | | | | | - João Carlos Machado
- Universidade Federal do Rio de Janeiro, Brasil; Universidade Federal do Rio de Janeiro, Brasil
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89
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Abe T, Loenneke JP, Thiebaud RS. Morphological and functional relationships with ultrasound measured muscle thickness of the lower extremity: a brief review. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2015; 23:166-73. [PMID: 27433253 DOI: 10.1177/1742271x15587599] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ultrasound is a potential method for assessing muscle size of the extremity and trunk. In a large muscle, however, a single image from portable ultrasound measures only muscle thickness (MT), not anatomical muscle cross-sectional area (CSA) or muscle volume (MV). Thus, it is important to know whether MT is related to anatomical CSA and MV in an individual muscle of the extremity and trunk. In this review, we summarize previously published articles in the lower extremity demonstrating the relationships between ultrasound MT and muscle CSA or MV as measured by magnetic resonance imaging and computed tomography scans. The relationship between MT and isometric and isokinetic joint performance is also reviewed. A linear relationship is observed between MT and muscle CSA or MV in the quadriceps, adductor, tibialis anterior, and triceps surae muscles. Intrarater correlation coefficients range from 0.90 to 0.99, except for one study. It would appear that anterior upper-thigh MT, mid-thigh MT and posterior thigh MT are the best predictors for evaluating adductor, quadriceps, and hamstrings muscle size, respectively. Despite a limited number of studies, anterior as well as posterior lower leg MT appear to reflect muscle CSA and MV of the lower leg muscles. Based on previous studies, ultrasound measured anterior thigh MT may be a valuable predictor of knee extension strength. Nevertheless, more studies are needed to clarify the relationship between lower extremity function and MT.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Robert S Thiebaud
- Department of Kinesiology, School of Education, Texas Wesleyan University, Fort Worth, TX 76105, USA
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90
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Obst SJ, Newsham-West R, Barrett RS. Changes in Achilles tendon mechanical properties following eccentric heel drop exercise are specific to the free tendon. Scand J Med Sci Sports 2015; 26:421-31. [DOI: 10.1111/sms.12466] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 01/23/2023]
Affiliation(s)
- S. J. Obst
- School of Allied Health Sciences; Centre for Musculoskeletal Research; Griffith Health Institute; Griffith University; Gold Coast Queensland Australia
| | - R. Newsham-West
- School of Allied Health Sciences; Centre for Musculoskeletal Research; Griffith Health Institute; Griffith University; Gold Coast Queensland Australia
| | - R. S. Barrett
- School of Allied Health Sciences; Centre for Musculoskeletal Research; Griffith Health Institute; Griffith University; Gold Coast Queensland Australia
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91
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PANIZZOLO FAUSTOA, MAIORANA ANDREWJ, NAYLOR LOUISEH, LICHTWARK GLENA, DEMBO LAWRENCE, LLOYD DAVIDG, GREEN DANIELJ, RUBENSON JONAS. Is the Soleus a Sentinel Muscle for Impaired Aerobic Capacity in Heart Failure? Med Sci Sports Exerc 2015; 47:498-508. [DOI: 10.1249/mss.0000000000000431] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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92
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Howren AM, Jamieson DH, Alvarez CM. Early ultrasonographic evaluation of idiopathic clubfeet treated with manipulations, casts, and Botox(®): a double-blind randomized control trial. J Child Orthop 2015; 9:85-91. [PMID: 25609054 PMCID: PMC4340848 DOI: 10.1007/s11832-015-0633-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 01/08/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The manipulations, casts, and Botox(®) method for treating idiopathic clubfoot is an alternative non-surgical treatment method. Botox(®)-induced reversible muscle paralysis of the gastrocsoleus enables a physician to manipulate and cast the clubfoot in greater dorsiflexion. Ultrasound is incorporated during the early treatment stages to monitor the underlying physiology of the muscle-tendon unit following Botox(®). METHODS Ultrasonographic evaluation was performed parallel to a double-blind randomized control trial administering Botox(®) or placebo to correct clubfoot. Patients underwent two-dimensional ultrasound to monitor the length changes to the gastrocsoleus and Achilles tendon unit at two time points: pre-injection (baseline) and 6 weeks post-blinded injection. Gastrocsoleus and Achilles tendon length measurements were analyzed among placebo, Botox(®) and contralateral controls using repeated measures ANOVA. RESULTS The baseline gastrocsoleus length of the clubfoot (322.4 pixels) before blinded injection appears shorter than controls (337.5 pixels), but fails to reach significance (p = 0.05). The complex length within each of the three treatment groups displayed no significant change between baseline and 6 weeks. The complex-tendon ratio and muscle-tendon ratio of the Botox(®) treatment group was significantly decreased compared to controls (p = 0.049 and 0.042, respectively). Briefly, when expressed as a proportion, an increase in Achilles tendon length and decrease in gastrocsoleus is observed when clubfeet are treated with Botox(®). CONCLUSIONS Only in the Botox(®) treatment cohort did the muscle shrink to uncover tendon (seen as a decreased complex-tendon ratio and muscle-tendon ratio) over the 6-week interval to effectively increase tendon length with respect to the unit as a whole.
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Affiliation(s)
- Alyssa M Howren
- Department of Orthopaedics, British Columbia's Children's Hospital, 1D18-4480 Oak Street, Vancouver, BC V6H 3V4, Canada,
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93
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Spasticity and its contribution to hypertonia in cerebral palsy. BIOMED RESEARCH INTERNATIONAL 2015; 2015:317047. [PMID: 25649546 PMCID: PMC4306250 DOI: 10.1155/2015/317047] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 12/15/2014] [Indexed: 11/23/2022]
Abstract
Spasticity is considered an important neural contributor to muscle hypertonia in children with cerebral palsy (CP). It is most often treated with antispasticity medication, such as Botulinum Toxin-A. However, treatment response is highly variable. Part of this variability may be due to the inability of clinical tests to differentiate between the neural (e.g., spasticity) and nonneural (e.g., soft tissue properties) contributions to hypertonia, leading to the terms “spasticity” and “hypertonia” often being used interchangeably. Recent advancements in instrumented spasticity assessments offer objective measurement methods for distinction and quantification of hypertonia components. These methods can be applied in clinical settings and their results used to fine-tune and improve treatment. We reviewed current advancements and new insights with respect to quantifying spasticity and its contribution to muscle hypertonia in children with CP. First, we revisit what is known about spasticity in children with CP, including the various definitions and its pathophysiology. Second, we summarize the state of the art on instrumented spasticity assessment in CP and review the parameters developed to quantify the neural and nonneural components of hypertonia. Lastly, the impact these quantitative parameters have on clinical decision-making is considered and recommendations for future clinical and research investigations are discussed.
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94
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Obst SJ, Newsham-West R, Barrett RS. Three-dimensional morphology and strain of the Achilles free tendon immediately following eccentric heel drop exercise. J Exp Biol 2015; 218:3894-900. [DOI: 10.1242/jeb.127175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/10/2015] [Indexed: 12/12/2022]
Abstract
Our understanding of the immediate effects of exercise on Achilles free tendon transverse morphology is limited to single site measurements acquired at rest using 2D ultrasound. The purpose of this study was to provide a detailed 3D description of changes in Achilles free tendon morphology immediately following a single clinical dose of exercise. Freehand 3D ultrasound was used to measure Achilles free tendon length, and regional cross-sectional area (CSA), medio-lateral (ML) diameter and antero-posterior (AP) diameter in healthy young adults (n=14) at rest and during isometric muscle contraction, immediately before and after 3×15 eccentric heel drops. Post-exercise reductions in transverse strain were limited to CSA and AP diameter in the mid-proximal region of the Achilles free tendon during muscle contraction. The change in CSA strain during muscle contraction was significantly correlated to the change in longitudinal strain (r=−0.72); and the change in AP diameter strain (r=0.64). Overall findings suggest the Achilles free tendon experiences a complex change in 3D morphology following eccentric heel drop exercise that manifests under contractile, but not rest conditions, is most pronounced in the mid-proximal tendon, and primarily driven by changes in AP diameter strain and not ML diameter strain.
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Affiliation(s)
- Steven J. Obst
- School of Allied Health Sciences and Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Australia
| | - Richard Newsham-West
- School of Allied Health Sciences and Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Australia
| | - Rod S. Barrett
- School of Allied Health Sciences and Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Australia
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95
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Panizzolo FA, Maiorana AJ, Naylor LH, Dembo L, Lloyd DG, Green DJ, Rubenson J. Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity. J Biomech 2014; 47:3719-25. [PMID: 25307437 DOI: 10.1016/j.jbiomech.2014.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 08/25/2014] [Accepted: 09/14/2014] [Indexed: 01/23/2023]
Abstract
Reduced walking capacity, a hallmark of chronic heart failure (CHF), is strongly correlated with hospitalization and morbidity. The aim of this work was to perform a detailed biomechanical gait analysis to better identify mechanisms underlying reduced walking capacity in CHF. Inverse dynamic analyses were conducted in CHF patients and age- and exercise level-matched control subjects on an instrumented treadmill at self-selected treadmill walking speeds and at speeds representing +20% and -20% of the subjects' preferred speed. Surprisingly, no difference in preferred speed was observed between groups, possibly explained by an optimization of the mechanical cost of transport in both groups (the mechanical cost to travel a given distance; J/kg/m). The majority of limb kinematics and kinetics were also similar between groups, with the exception of greater ankle dorsiflexion angles during stance in CHF. Nevertheless, over two times greater ankle plantarflexion work during stance and per distance traveled is required for a given triceps surae muscle volume in CHF patients. This, together with a greater reliance on the ankle compared to the hip to power walking in CHF patients, especially at faster speeds, may contribute to the earlier onset of fatigue in CHF patients. This observation also helps explain the high correlation between triceps surae muscle volume and exercise capacity that has previously been reported in CHF. Considering the key role played by the plantarflexors in powering walking and their association with exercise capacity, our findings strongly suggest that exercise-based rehabilitation in CHF should not omit the ankle muscle group.
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Affiliation(s)
- Fausto A Panizzolo
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Andrew J Maiorana
- Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, WA 6000, Australia; School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia
| | - Louise H Naylor
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Lawrence Dembo
- Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, WA 6000, Australia; Envision Medical Imaging, Perth, Western Australia, Australia
| | - David G Lloyd
- Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Daniel J Green
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, 6009, Australia; Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jonas Rubenson
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, 6009, Australia.
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96
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Park ES, Sim E, Rha DW, Jung S. Estimation of gastrocnemius muscle volume using ultrasonography in children with spastic cerebral palsy. Yonsei Med J 2014; 55:1115-22. [PMID: 24954345 PMCID: PMC4075375 DOI: 10.3349/ymj.2014.55.4.1115] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to investigate useful parameters for estimating gastrocnemius (GCM) muscle volume (MV) using ultrasonography (US) and anthropometry in children with spastic cerebral palsy (CP). MATERIALS AND METHODS Eighteen legs from nine children with spastic CP aged 2 to 6 years were investigated in this study. Tibial length (TL) of each leg was measured and muscle thickness (MT) and anatomical cross-sectional area (aCSA) of GCM muscles were assessed using US. The volume of the GCM was measured by magnetic resonance imaging (MRI) scans. The relationship of TL, MT, and aCSA with MV measured by MRI was investigated. Simple and multiple regression analyses were performed to establish muscle volume prediction equations. RESULTS Resting MT, aCSA, and TL were highly related to MV of both medial and lateral head of GCM determined by MRI. The MV prediction equation based on simple regression analysis resulted in r² values ranging from 0.591 to 0.832 (p<0.05). The r² values were higher using aCSA as independent variable than using MT. The MV prediction equation based on multiple regression analysis resulted in r² values ranging from 0.779 to 0.903 (p<0.05). However, the relatively high standard error of the estimate values ranged from 18.0-33.6% on simple regression and 15.5-25.6% on multiple regression. The contribution of aCSA was higher than that of MT for predicting MV of GCM. CONCLUSION Our study demonstrated the suitability of US assessment of aCSA and MT combined with TL for estimating MV of GCM in children with spastic CP and showed that aCSA is more useful parameter than MT.
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Affiliation(s)
- Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eungeol Sim
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Wook Rha
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soojin Jung
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
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97
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Imaging Mechanical Muscle–Bone Relationships: How to See the Invisible. Clin Rev Bone Miner Metab 2014. [DOI: 10.1007/s12018-014-9166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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98
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Obst SJ, Renault JB, Newsham-West R, Barrett RS. Three-dimensional deformation and transverse rotation of the human free Achilles tendon in vivo during isometric plantarflexion contraction. J Appl Physiol (1985) 2014; 116:376-84. [DOI: 10.1152/japplphysiol.01249.2013] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Freehand three-dimensional ultrasound (3DUS) was used to investigate longitudinal and biaxial transverse deformation and rotation of the free Achilles tendon in vivo during a voluntary submaximal isometric muscle contraction. Participants ( n = 8) were scanned at rest and during a 70% maximal voluntary isometric contraction (MVIC) of the plantarflexors. Ultrasound images were manually digitized to render a 3D reconstruction of the free Achilles tendon for the computation of tendon length, volume, cross-sectional area (CSA), mediolateral diameter (MLD), anteroposterior diameter (APD), and transverse rotation. Tendon longitudinal and transverse (CSA, APD, and MLD) deformation and strain at 70% MVIC were calculated relative to the resting condition. There was a significant main effect of contraction on tendon length and mean CSA, MLD, and APD ( P < 0.05), but no effect on tendon volume ( P = 0.70). Group mean transverse strains for CSA, MLD, and APD averaged over the length of the tendon were −5.5%, −8.7% and 8.7%, respectively. Peak CSA, MLD, and APD transverse strains all occurred between 40% and 60% of tendon length. Transverse rotation of the free tendon was negligible at rest but increased under load, becoming externally rotated relative to the calcaneal insertion. The relationship between longitudinal and transverse strains of the free Achilles tendon during muscle-induced elongation may be indicative of interfascicle reorganization. The finding that transverse rotation and strain peaked in midportion of the free Achilles tendon may have important implications for tendon injury mechanisms and estimation of tendon stress in vivo.
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Affiliation(s)
- Steven J. Obst
- School of Rehabilitation Sciences and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Queensland, Australia
| | | | - Richard Newsham-West
- School of Rehabilitation Sciences and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Queensland, Australia
| | - Rod S. Barrett
- School of Rehabilitation Sciences and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Queensland, Australia
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99
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Obst SJ, Newsham-West R, Barrett RS. In vivo measurement of human achilles tendon morphology using freehand 3-D ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:62-70. [PMID: 24139914 DOI: 10.1016/j.ultrasmedbio.2013.08.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/17/2013] [Accepted: 08/12/2013] [Indexed: 06/02/2023]
Abstract
This study investigated the accuracy of phantom volume and length measurements and the reliability of in vivo Achilles tendon (AT) volume, length and cross-sectional area measurements obtained using freehand 3-D ultrasound. Participants (n = 13) were scanned on consecutive days under active and passive loading conditions. In vivo AT length was evaluated using a two-point method and an approach that accounted for AT curvature (centroid method). Three-dimensional ultrasound provided accurate measures of phantom volume and length (mean difference = 0.05 mL and 0.2 mm, respectively) and reliable in vivo measures of AT volume, length and average cross-sectional area, with all intra-class correlations coefficients greater than 0.98. The mean minimally detectable changes for in vivo AT volume, two-point length and centroid length were 0.2 mL, 1.5 mm and 2.0 mm, respectively. Two-point AT length underestimated centroid AT length by 0.7 mm, suggesting that the effect of curvature on in vivo AT length is negligible.
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Affiliation(s)
- Steven J Obst
- School of Rehabilitation Sciences and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Southport, Queensland, Australia.
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100
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Barber L, Hastings-Ison T, Baker R, Kerr Graham H, Barrett R, Lichtwark G. The effects of botulinum toxin injection frequency on calf muscle growth in young children with spastic cerebral palsy: a 12-month prospective study. J Child Orthop 2013; 7:425-33. [PMID: 24432106 PMCID: PMC3838523 DOI: 10.1007/s11832-013-0503-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 05/27/2013] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study was a 12-month prospective investigation of changes in the medial gastrocnemius (MG) muscle morphology in children aged 2-5 years with spastic cerebral palsy (CP) who had received no previous intramuscular injections of botulinum neurotoxin type-A (BoNT-A) and were randomised to receive either single or multiple (three) BoNT-A injections to the gastrocsoleus. MG morphological changes were compared to age-matched typically developing (TD) peers. METHODS Thirteen children with spastic CP with a mean age of 45 (15) months and 18 TD children with a mean age of 48 (14) months participated in the study. The principal outcome measures were MG muscle volume, fascicle length, pennation angle and physiological cross-sectional area (PCSA), which were obtained using 2D and 3D ultrasound. RESULTS The single and multiple injection frequency groups significantly increased MG muscle volume at 12 months relative to the baseline by 13 and 15 %, respectively. There were no significant differences in the MG muscle volume 28.5 (12.3) versus 30.3 (3.8) ml, fascicle length 48.0 (10.4) versus 44.8 (1.2) mm or PCSA 7.0 (1.2) versus 6.6 (1.7) cm(2) between the single and multiple injection groups, respectively, at 12 months follow-up. The change in MG muscle volume in the single and multiple injection groups was significantly lower than the TD peers by 66 and 60 %, respectively. INTERPRETATION In young children with spastic CP, naive to BoNT-A treatment, MG muscle growth over 12 months does not appear to be influenced by intramuscular BoNT-A injection frequency. However, MG muscle growth in the spastic CP groups was significantly lower than the age-matched TD peers. It is unclear whether this is an effect of intramuscular BoNT-A injections or reduced growth rates in children with spastic CP in general. Controlled investigations and longitudinal studies with multiple measurement time points are required in order to determine the influence of BoNT-A treatment on muscle physiological and mechanical growth factors in young children with spastic CP.
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Affiliation(s)
- Lee Barber
- />Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Tandy Hastings-Ison
- />Hugh Williamson Gait Laboratory, The Royal Children’s Hospital, Melbourne, VIC 3052 Australia , />Murdoch Childrens Research Institute, The Royal Children’s Hospital, Melbourne, VIC 3052 Australia
| | - Richard Baker
- />Centre for Health, Sport and Rehabilitation Sciences Research, School of Health Sciences, University of Salford, Manchester, M5 4WT UK
| | - H. Kerr Graham
- />Hugh Williamson Gait Laboratory, The Royal Children’s Hospital, Melbourne, VIC 3052 Australia , />Murdoch Childrens Research Institute, The Royal Children’s Hospital, Melbourne, VIC 3052 Australia , />The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Rod Barrett
- />Centre for Musculoskeletal Research, Griffith Health Institute and School of Rehabilitation Sciences, Griffith University, Southport, QLD 4222 Australia
| | - Glen Lichtwark
- />The School of Human Movement Studies, The University of Queensland, St Lucia, QLD 4072 Australia
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