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Lubin P, Zidi M. Mechanical properties change of immobilized skeletal muscle in short position measured by shear wave elastography and pure shearing test. J Mech Behav Biomed Mater 2024; 150:106317. [PMID: 38118374 DOI: 10.1016/j.jmbbm.2023.106317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/26/2023] [Accepted: 12/10/2023] [Indexed: 12/22/2023]
Abstract
The purpose of this study was to evaluate the effects of immobilization on mechanical properties of skeletal muscle over the time. An in vivo rat model was used to investigate the shear modulus change of the flexor carpi ulnaris (FCU) in a short position. Measurements were performed by shear wave elastography (SWE) to compare contralateral and immobilized cases. The results showed a significant increase of 18.1% (p = 3.86. 10-7) in the shear modulus of immobilized skeletal muscle after two weeks (D14) when compared with the contralateral case. For the purposes of comparison, in vitro mechanical pure shearing tests were performed on samples collected from the skeletal muscles of the same rats. Although the difference between contralateral and immobilized cases was 17.6% (p = 0.32) at D14, the shear modulus difference was 35.7% (p = 0.0126 and p = 1.57.10-5 for immobilization and contralateral respectively) between in vivo and in vitro approaches. The mechanical properties changes were then correlated with the density of collagen from histological analysis, and it was shown that the contralateral collagen surface density was 25.4% higher than the immobilized density at D14 (p = 0.001). Thus, the results showed the feasibility of the comparison between the two approaches, which can surely be improved by optimizing the experimental protocols.
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Affiliation(s)
- Pénélope Lubin
- Bioengineering, Tissues and Neuroplasticity, UR 7377, Université Paris-Est Créteil, Faculté de Santé /EPISEN, 8 rue du Général Sarrail, 94010, Créteil, France
| | - Mustapha Zidi
- Bioengineering, Tissues and Neuroplasticity, UR 7377, Université Paris-Est Créteil, Faculté de Santé /EPISEN, 8 rue du Général Sarrail, 94010, Créteil, France.
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Sayed RKA, Hibbert JE, Jorgenson KW, Hornberger TA. The Structural Adaptations That Mediate Disuse-Induced Atrophy of Skeletal Muscle. Cells 2023; 12:2811. [PMID: 38132132 PMCID: PMC10741885 DOI: 10.3390/cells12242811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
The maintenance of skeletal muscle mass plays a fundamental role in health and issues associated with quality of life. Mechanical signals are one of the most potent regulators of muscle mass, with a decrease in mechanical loading leading to a decrease in muscle mass. This concept has been supported by a plethora of human- and animal-based studies over the past 100 years and has resulted in the commonly used term of 'disuse atrophy'. These same studies have also provided a great deal of insight into the structural adaptations that mediate disuse-induced atrophy. For instance, disuse results in radial atrophy of fascicles, and this is driven, at least in part, by radial atrophy of the muscle fibers. However, the ultrastructural adaptations that mediate these changes remain far from defined. Indeed, even the most basic questions, such as whether the radial atrophy of muscle fibers is driven by the radial atrophy of myofibrils and/or myofibril hypoplasia, have yet to be answered. In this review, we thoroughly summarize what is known about the macroscopic, microscopic, and ultrastructural adaptations that mediated disuse-induced atrophy and highlight some of the major gaps in knowledge that need to be filled.
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Affiliation(s)
- Ramy K. A. Sayed
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
| | - Jamie E. Hibbert
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
| | - Kent W. Jorgenson
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
| | - Troy A. Hornberger
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
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Hinks A, Franchi MV, Power GA. Ultrasonographic measurements of fascicle length overestimate adaptations in serial sarcomere number. Exp Physiol 2023; 108:1308-1324. [PMID: 37608723 PMCID: PMC10988429 DOI: 10.1113/ep091334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
Ultrasound-derived measurements of muscle fascicle length (FL) are often used to infer increases (chronic stretch or training) or decreases (muscle disuse or aging) in serial sarcomere number (SSN). Whether FL adaptations measured via ultrasound can truly approximate SSN adaptations has not been investigated. We casted the right hindlimb of 15 male Sprague-Dawley rats in a dorsiflexed position (i.e., stretched the plantar flexors) for 2 weeks, with the left hindlimb serving as a control. Ultrasound images of the soleus, lateral gastrocnemius (LG), and medial gastrocnemius (MG) were obtained with the ankle at 90° and full dorsiflexion for both hindlimbs pre and post-cast. Following post-cast ultrasound measurements, legs were fixed in formalin with the ankle at 90°, then muscles were dissected and fascicles were teased out for measurement of sarcomere lengths via laser diffraction and calculation of SSN. Ultrasound detected an 11% increase in soleus FL, a 12% decrease in LG FL, and an 8-11% increase in MG FL for proximal fascicles and at full dorsiflexion. These adaptations were partly reflected by SSN adaptations, with a 6% greater soleus SSN in the casted leg than the un-casted leg, but no SSN differences for the gastrocnemii. Weak relationships were observed between ultrasonographic measurements of FL and measurements of FL and SSN from dissected fascicles. Our results showed that ultrasound-derived FL measurements can overestimate an increase in SSN by ∼5%. Future studies should be cautious when concluding a large magnitude of sarcomerogenesis from ultrasound-derived FL measurements, and may consider applying a correction factor. NEW FINDINGS: What is the central question of this study? Measurements of muscle fascicle length via ultrasound are often used to infer changes in serial sarcomere number, such as increases following chronic stretch or resistance training, and decreases with ageing: does ultrasound-derived fascicle length accurately depict adaptations in serial sarcomere number? What is the main finding and its importance? Ultrasound detected an ∼11% increase in soleus fascicle length, but measurements on dissected fascicles showed the actual serial sarcomere number increase was only ∼6%; therefore, measurements of ultrasound-derived fascicle length can overestimate serial sarcomere number adaptations by as much as 5%.
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Affiliation(s)
- Avery Hinks
- Department of Human Health and Nutritional Sciences, College of Biological SciencesUniversity of GuelphGuelphOntarioCanada
| | - Martino V. Franchi
- Department of Biomedical Sciences, Human Neuromuscular Physiology LaboratoryUniversity of PaduaPaduaItaly
- CIR‐MYO Myology CentreUniversity of PaduaPaduaItaly
| | - Geoffrey A. Power
- Department of Human Health and Nutritional Sciences, College of Biological SciencesUniversity of GuelphGuelphOntarioCanada
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Spasticity Management after Spinal Cord Injury: The Here and Now. J Pers Med 2022; 12:jpm12050808. [PMID: 35629229 PMCID: PMC9144471 DOI: 10.3390/jpm12050808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
Spasticity is a common comorbidity of spinal cord injury (SCI) that is characterized by velocity dependent tone and spasms manifested by uninhibited reflex activity of muscles below the level of injury. For some, spasticity can be beneficial and facilitate functional standing, transfers, and some activities of daily living. For others, it may be problematic, painful, and interfere with mobility and function. This manuscript will address the anatomy and physiology of neuromuscular reflexes as well as the pathophysiology that occurs after SCI. Spasticity assessment will be discussed in terms of clinical history and findings on physical examinations, including responses to passive and active movement, deep tendon reflexes, and other long tract signs of upper motor neuron injury, as well as gait and function. Management strategies will be discussed including stretch, modalities, pharmacotherapy, neurolysis, and surgical options.
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Wang B, He K, Zhu Y, Fu X, Yao Q, Chen H, Wang X. Quantitative Analysis of Abdominal Muscles Using Elastography in Female Patients With Incisional Hernia. Front Surg 2022; 9:831184. [PMID: 35495759 PMCID: PMC9039235 DOI: 10.3389/fsurg.2022.831184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the thickness and shear wave speed (SWS) of the anterolateral abdominal wall muscles in female patients with incisional hernias of different widths, in order to analyze the biomechanical properties of abdominal wall muscles. This study included 53 patients with incisional hernia (Group A [hernia width <4 cm]: 21 patients, Group B [hernia width ≥4 cm]: 32 patients). The muscle thickness and SWS values of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA), and the hernia width were measured using Siemens Acuson S2000 ultrasound systems. Four detection points were labeled on the anterolateral abdominal wall: points 1, 2, 3, and 4, corresponding to the upper right, upper left, lower right, and lower left, respectively. The muscle thickness of the IO at point 3 was significantly different between both groups (p = 0.024). Group B had significantly higher SWS values than Group A, especially for the EO (points 1, 2, and 3), IO (points 1 and 2), and TrA (points 2 and 4) (p < 0.05). Pearson correlation analysis shows no significant correlation between muscle thickness and the SWS values of EO, IO, and TrA (all p > 0.05). Linear correlation analysis showed a significantly positive correlation between hernia width and the mean SWS value of EO, IO, and TrA (p = 0.004, 0.005, and 0.043, respectively). Muscle thickness was not reliable measure to directly reflect the biomechanical changes of the abdominal wall muscles in patients with incisional hernia. Comparatively, SWE can accurately measure the stiffness of the abdominal wall muscles and intuitively evaluate its biomechanical properties.
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Affiliation(s)
- Bo Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Kai He
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulan Zhu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaojian Fu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiyuan Yao
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hao Chen
| | - Xiaohong Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
- Xiaohong Wang
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Sugimoto T, Imai S, Yoshikawa M, Fujisato T, Hashimoto T, Nakamura T. Mechanical unloading in 3D-engineered muscle leads to muscle atrophy by suppressing protein synthesis. J Appl Physiol (1985) 2022; 132:1091-1103. [PMID: 35297688 DOI: 10.1152/japplphysiol.00323.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Three dimensional (3D)-engineered muscle is an useful approach to a more comprehensive understanding of molecular mechanisms underlying unloading-induced muscle atrophy. We investigated the effects of mechanical unloading on molecular muscle protein synthesis (MPS)- and muscle protein breakdown (MPB)-related signaling pathways involved in muscle atrophy in 3D-engineered muscle, and to better understand in vitro model of muscle disuse. The 3D-engineered muscle consisting of C2C12 myoblasts and type-1 collagen gel was allowed to differentiate for 2 weeks and divided into three groups: 0 days of stretched-on control (CON), 2 and/or 7 days of stretched-on (ON), in which both ends of the muscle were fixed with artificial tendons, and the stretched-off group (OFF), in which one side of the artificial tendon was detached. Muscle weight (-38.1 to -48.4%), length (-67.0 to -73.5%), twitch contractile force (-70.5 to -75.0%) and myosin heavy chain expression (-32.5 to -50.5%) in the OFF group were significantly decreased on days 2 and 7 compared with the ON group (P < 0.05, respectively), despite that ON group was stable over time. Although determinative molecular signaling could not be identified, the MPS rate reflected by puromysin labeled protein was significantly decreased following mechanical unloading (P < 0.05, -38.5 to -51.1%). Meanwhile, MPB, particularly the ubiquitin-proteasome pathway, was not impacted. Hence, mechanical unloading of 3D-engineered muscle in vitro leads to muscle atrophy by suppressing MPS, cell differentiation, and cell growth rather than the promotion of MPB.
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Affiliation(s)
- Takeshi Sugimoto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Shoma Imai
- Division of Human Sciences, Faculty of Engineering, Osaka Institute of Technology, Ohmiya, Osaka, Japan
| | - Maki Yoshikawa
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Toshia Fujisato
- Biomedical Engineering Graduate School of Engineering, Osaka Institute of Technology, Ohmiya, Osaka, Japan
| | - Takeshi Hashimoto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Tomohiro Nakamura
- Division of Human Sciences, Faculty of Engineering, Osaka Institute of Technology, Ohmiya, Osaka, Japan
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Attwaters M, Hughes SM. Cellular and molecular pathways controlling muscle size in response to exercise. FEBS J 2022; 289:1428-1456. [PMID: 33755332 DOI: 10.1111/febs.15820] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/27/2021] [Accepted: 03/12/2021] [Indexed: 12/14/2022]
Abstract
From the discovery of ATP and motor proteins to synaptic neurotransmitters and growth factor control of cell differentiation, skeletal muscle has provided an extreme model system in which to understand aspects of tissue function. Muscle is one of the few tissues that can undergo both increase and decrease in size during everyday life. Muscle size depends on its contractile activity, but the precise cellular and molecular pathway(s) by which the activity stimulus influences muscle size and strength remain unclear. Four correlates of muscle contraction could, in theory, regulate muscle growth: nerve-derived signals, cytoplasmic calcium dynamics, the rate of ATP consumption and physical force. Here, we summarise the evidence for and against each stimulus and what is known or remains unclear concerning their molecular signal transduction pathways and cellular effects. Skeletal muscle can grow in three ways, by generation of new syncytial fibres, addition of nuclei from muscle stem cells to existing fibres or increase in cytoplasmic volume/nucleus. Evidence suggests the latter two processes contribute to exercise-induced growth. Fibre growth requires increase in sarcolemmal surface area and cytoplasmic volume at different rates. It has long been known that high-force exercise is a particularly effective growth stimulus, but how this stimulus is sensed and drives coordinated growth that is appropriately scaled across organelles remains a mystery.
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Affiliation(s)
- Michael Attwaters
- Randall Centre for Cell and Molecular Biophysics, School of Basic and Medical Biosciences, King's College London, UK
| | - Simon M Hughes
- Randall Centre for Cell and Molecular Biophysics, School of Basic and Medical Biosciences, King's College London, UK
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Lam K, Kwan JSK, Kwan CW, Chi I. Factors Associated with Development of New Joint Contractures in Long-Term Care Residents. J Am Med Dir Assoc 2021; 23:92-97. [PMID: 34175292 DOI: 10.1016/j.jamda.2021.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Limb contractures are associated with poor outcomes and quality of life in long-term care (LTC) residents. This study examined the rate of developing new joint contracture in the LTC residents and associated risk factors to formulate effective interventions in this critical but understudied area. DESIGN This is an observational study with data obtained from the Hong Kong Longitudinal Study on LTC Residents between 2005 and 2016. SETTING AND PARTICIPANTS Trained assessors (nurses, social workers, and therapists) used the Minimum Data Set Resident Assessment Instrument (MDS-RAI 2.0) to collect the data of the residents from 9 residential LTC facilities. MEASURES Limb contractures were defined as a functional limitation in the range of motion involving the upper or lower limbs. Primary outcomes included annual prevalence of joint contractures and factors that were associated with the development of new joint contractures. RESULTS We analyzed the data for 1914 older residents (674 males, mean age 83.4 years). During the first 5 years since admission, the annual prevalence of upper limb contractures increased from 29.8% to 36.5%, and lower limb contractures increased from 41.5% to 57.4%. Overall, the increment of the prevalence rate of joint contractures per year ranged from 0.7% to 3.2% for the upper limbs and 0.3% to 6.0% per year for the lower limbs. Impaired mobility, presence of neurologic diseases, and older age were the leading independent risk factors for the development of new joint contractures. CONCLUSIONS AND IMPLICATIONS Joint contractures are highly prevalent among residents admitted to the LTC facilities, and many residents develop new contractures during the first 5 years of their admission. Immobility appears to be the main modifiable risk factor. Further studies are needed to identify potential strategies to prevent new contractures in this vulnerable group.
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Affiliation(s)
- Kuen Lam
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong, China.
| | - Joseph S K Kwan
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Chi Wai Kwan
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China
| | - Iris Chi
- Suzanne Dwork-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Sachdeva R, Beavis C, Obaid H, Farthing JP, Kim SY. Surgical repair of the supraspinatus: architectural changes in the muscle pre- and postoperatively. Singapore Med J 2020; 63:97-104. [PMID: 32798361 DOI: 10.11622/smedj.2020123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Shortening of the tendon and muscle is recognised as a strong predictor for surgical failure of supraspinatus tendon tears. Changes in muscle architecture following repair have not been thoroughly investigated. We aimed to compare the architecture of the supraspinatus pre- and postoperatively. METHODS We recruited eight participants with full-thickness supraspinatus tears. Images of the supraspinatus were captured preoperatively (pre-op) and postoperatively at one (post-op1), three (post-op2) and six (post-op3) months in relaxed and contracted states (0° and 60° glenohumeral abduction). Fibre bundle length (FBL), pennation angle (PA) and muscle thickness (MT) were quantified. Self-reported function, and maximal isometric abduction and external rotation strengths were assessed. RESULTS Mean FBL increased from pre-op to post-op1 (p = 0.001) in the relaxed state and from pre-op to post-op2 (p = 0.002) in the contracted state. Decrease in FBL was observed from post-op2 to post-op3 in the relaxed state. Mean PA decreased from pre-op to post-op1 (p < 0.001) in the relaxed state, but increased from post-op2 to post-op3 in both relaxed (p = 0.006) and contracted (p = 0.004) states. At post-op3, external rotation (p = 0.009) and abduction (p = 0.005) strengths were greater than at post-op2. Overall function increased by 47.67% from pre-op to post-op3. CONCLUSION Lengthening of the supraspinatus occurs with surgery, altering the length-tension relationship of the muscle, which can compromise muscle function and lead to inferior surgical outcomes. These findings may guide clinicians to optimise loads, velocities and shoulder ranges for effective postoperative rehabilitation.
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Affiliation(s)
- Rohit Sachdeva
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cole Beavis
- Division of Orthopaedics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Haron Obaid
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jonathan P Farthing
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Soo Y Kim
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Nelson CM, Marchese V, Rock K, Henshaw RM, Addison O. Alterations in Muscle Architecture: A Review of the Relevance to Individuals After Limb Salvage Surgery for Bone Sarcoma. Front Pediatr 2020; 8:292. [PMID: 32612962 PMCID: PMC7308581 DOI: 10.3389/fped.2020.00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 05/07/2020] [Indexed: 11/13/2022] Open
Abstract
Osteosarcoma and Ewing's sarcoma are the most common primary bone malignancies affecting children and adolescents. Optimal treatment requires a combination of chemotherapy and/or radiation along with surgical removal when feasible. Advances in multiple aspects of surgical management have allowed limb salvage surgery (LSS) to supplant amputation as the most common procedure for these tumors. However, individuals may experience significant impairment after LSS, including deficits in range of motion and strength that limit function and impact participation in work, school, and the community, ultimately affecting quality of life. Muscle force and speed of contraction are important contributors to normal function during activities such as gait, stairs, and other functional tasks. Muscle architecture is the primary contributor to muscle function and adapts to various stimuli, including periods of immobilization-protected weightbearing after surgery. The impacts of LSS on muscle architecture and how adaptations may impact deficits within the rehabilitation period and into long-term survivorship is not well-studied. The purpose of this paper is to [1] provide relevant background on bone sarcomas and LSS, [2] highlight the importance of muscle architecture, its measurement, and alterations as seen in other relevant populations and [3] discuss the clinical relevance of muscle architectural changes and the impact on muscle dysfunction in this population. Understanding the changes that occur in muscle architecture and its impact on long-term impairments in bone sarcoma survivors is important in developing new rehabilitation treatments that optimize functional outcomes.
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Affiliation(s)
- Christa M Nelson
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Victoria Marchese
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kelly Rock
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Robert M Henshaw
- Department of Orthopedic Oncology, MedStar Georgetown Orthopedic Institute, Washington, DC, United States.,Department of Orthopedic Oncology, Children's National Medical Center, Washington, DC, United States
| | - Odessa Addison
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States.,Baltimore VA GRECC, Baltimore, MD, United States
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11
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Mechanical and microstructural changes of skeletal muscle following immobilization and/or stroke. Biomech Model Mechanobiol 2019; 19:61-80. [DOI: 10.1007/s10237-019-01196-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/26/2019] [Indexed: 11/27/2022]
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12
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Frisk RF, Lorentzen J, Barber L, Nielsen JB. Characterization of torque generating properties of ankle plantar flexor muscles in ambulant adults with cerebral palsy. Eur J Appl Physiol 2019; 119:1127-1136. [PMID: 30778762 DOI: 10.1007/s00421-019-04102-z] [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: 08/27/2018] [Accepted: 02/12/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE Weakness of plantar flexor muscles is related to reduced push-off and forward propulsion during gait in persons with cerebral palsy (CP). It has not been clarified to what an extent altered muscle contractile properties contribute to this muscle weakness. Here, we investigated the torque generating capacity and muscle fascicle length in the triceps surae muscle throughout ankle range of motion (ROM) in adults with CP using maximal single muscle twitches elicited by electrical nerve stimulation and ultrasonography. METHODS Fourteen adults with CP (age 36, SD 10.6, GMFCS I-III) and 17 neurological intact (NI) adults (age 36, SD 4.5) participated. Plantar flexor torque during supramaximal stimulation of the tibial nerve was recorded in a dynamometer at 8 ankle angles throughout ROM. Medial gastrocnemius (MG) fascicle length was tracked using ultrasonography. RESULTS Adults with CP showed reduced plantar flexor torque and fascicle shortening during supramaximal stimulation throughout ROM. The largest torque generation was observed at the ankle joint position where the largest shortening of MG fascicles was observed in both groups. This was at a more plantarflexed position in the CP group. CONCLUSION Reduced torque and fascicle shortening during supramaximal stimulation of the tibial nerve indicate impaired contractile properties of plantar flexor muscles in adults with CP. Maximal torque was observed at a more plantarflexed position in adults with CP indicating an altered torque-fascicle length/ankle angle relation. The findings suggest that gait rehabilitation in adults with CP may require special focus on improvement of muscle contractility.
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Affiliation(s)
- Rasmus Feld Frisk
- Department of Neuroscience, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen N, Denmark. .,Professionshøjskolen Absalon, Roskilde, Denmark. .,Elsass Institute, Charlottenlund, Denmark.
| | - Jakob Lorentzen
- Department of Neuroscience, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen N, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Lee Barber
- School of Health, Medical and Allied Sciences, Central Queensland University, Bundaberg, Australia.,Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jens Bo Nielsen
- Department of Neuroscience, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen N, Denmark.,Elsass Institute, Charlottenlund, Denmark
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13
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Passive material properties of stroke-impaired plantarflexor and dorsiflexor muscles. Clin Biomech (Bristol, Avon) 2017; 49:48-55. [PMID: 28866442 PMCID: PMC5681874 DOI: 10.1016/j.clinbiomech.2017.08.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 08/23/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Following a stroke, intrinsic muscle properties such as stiffness may be altered, which is accompanied by increased spasticity and contractures. Previously, quantification of muscle stiffness has been based off of indirect measurements. Using shear wave ultrasound elastography, direct measurements of muscle material properties can be made. METHODS Our aim was to evaluate material properties, specifically passive stiffness, using shear wave ultrasound elastography across a range of muscle lengths, in the medial gastrocnemius and the tibialis anterior in chronic stroke survivors. FINDINGS Our main results show significant increases of 27.7% and 26.9% in shear wave velocity of stroke-impaired medial gastrocnemius compared to the unimpaired contralateral side at 90° ankle angle (P=0.033) and 15° plantarflexion (P=0.001), respectively. However, no significant difference was found in the tibialis anterior between the two sides. Relatively weak correlations were found between SW velocity in the medial gastrocnemius and joint stiffness for both the non-paretic (ρ=0.384, P=0.001), and paretic side (ρ=0.363, P=0.002). Additionally, muscle stiffness estimates of stroke-impaired tibialis anterior from joint torque and angle measurements were significantly greater by 23.1% (P=0.033) than the unimpaired contralateral side. However, no significant difference was found in the medial gastrocnemius. INTERPRETATION These results indicate that there are non-uniform changes in passive stiffness of stroke-impaired muscle. Therefore, muscles need to be evaluated individually to assess alterations. Additionally, interpretation of joint-based calculations of muscle stiffness should be made cautiously. Having the ability to non-invasively assess muscle stiffness adaptations in vivo would aid in prognosis, evaluation, and treatment following a stroke.
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Abstract
Gastrocnemius contracture is a common condition associated with painful overload symptoms in the forefoot and midfoot. Multiple techniques have been described for the recession of gastrocnemius tendon in patients who failed nonsurgical treatment. We present an endoscopic recession technique for the release of the gastrocnemius tendon just distal to the level of the musculotendinous junction as a minimally invasive operative option. This technique aims to decrease wound complications, unsightly scar, overlengthening, and postoperative pain, while having versatility for performing with supine or prone positioning.
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Affiliation(s)
- Phinit Phisitkul
- 1 Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Alexej Barg
- 2 Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Annunziato Amendola
- 3 Department of Orthopedic Surgery, Chief, Division of Sports Medicine, Duke University, Durham, NC, USA
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Recent developments in understanding the length dependence of contractile response of skeletal muscle. Eur J Appl Physiol 2017; 117:1059-1071. [DOI: 10.1007/s00421-017-3591-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
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Cho SH, Kim JH, Song W. In Vivo Rodent Models of Skeletal Muscle Adaptation to Decreased Use. Endocrinol Metab (Seoul) 2016; 31:31-7. [PMID: 26996420 PMCID: PMC4803558 DOI: 10.3803/enm.2016.31.1.31] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 01/17/2016] [Accepted: 01/25/2016] [Indexed: 12/25/2022] Open
Abstract
Skeletal muscle possesses plasticity and adaptability to external and internal physiological changes. Due to these characteristics, skeletal muscle shows dramatic changes depending on its response to stimuli such as physical activity, nutritional changes, disease status, and environmental changes. Modulation of the rate of protein synthesis/degradation plays an important role in atrophic responses. The purpose of this review is to describe different features of skeletal muscle adaptation with various models of deceased use. In this review, four models were addressed: immobilization, spinal cord transection, hindlimb unloading, and aging. Immobilization is a form of decreased use in which skeletal muscle shows electrical activity, tension development, and motion. These results differ by muscle group. Spinal cord transection was selected to simulate spinal cord injury. Similar to the immobilization model, dramatic atrophy occurs in addition to fiber type conversion in this model. Despite the fact that electromyography shows unremarkable changes in muscle after hindlimb unloading, decreased muscle mass and contractile force are observed. Lastly, aging significantly decreases the numbers of muscle fibers and motor units. Skeletal muscle responses to decreased use include decreased strength, decreased fiber numbers, and fiber type transformation. These four models demonstrated different changes in the skeletal muscle. This review elucidates the different skeletal muscle adaptations in these four decreased use animal models and encourages further studies.
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Affiliation(s)
- Su Han Cho
- Health and Exercise Science Laboratory, Institute of Sport Science, Seoul National University, Seoul, Korea
| | - Jang Hoe Kim
- Health and Exercise Science Laboratory, Institute of Sport Science, Seoul National University, Seoul, Korea
| | - Wook Song
- Health and Exercise Science Laboratory, Institute of Sport Science, Seoul National University, Seoul, Korea
- Institute on Aging, Seoul National University, Seoul, Korea.
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Pleguezuelos E, Esquinas C, Moreno E, Guirao L, Ortiz J, Garcia-Alsina J, Merí A, Miravitlles M. Muscular Dysfunction in COPD: Systemic Effect or Deconditioning? Lung 2016; 194:249-57. [DOI: 10.1007/s00408-015-9838-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/26/2015] [Indexed: 12/21/2022]
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Hösl M, Böhm H, Arampatzis A, Döderlein L. Effects of ankle-foot braces on medial gastrocnemius morphometrics and gait in children with cerebral palsy. J Child Orthop 2015; 9:209-19. [PMID: 26108740 PMCID: PMC4486505 DOI: 10.1007/s11832-015-0664-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/09/2015] [Indexed: 02/03/2023] Open
Abstract
PURPOSE In children with cerebral palsy (CP), braces are used to counteract progressive joint and muscle contracture and improve function. We examined the effects of positional ankle-foot braces on contracture of the medial gastrocnemius (MG) and gait in children with CP while referencing to typically developing children. METHODS Seventeen independently ambulant children with CP and calf muscle contracture (age 10.4 ± 3.0y) and 17 untreated typically developing peers (age 9.5 ± 2.6y) participated. Children with CP were analysed before and 16 ± 4 weeks after ankle-foot bracing. MG muscle belly length and thickness, tendon and fascicle length, as well as their extensibility were captured by 2D ultrasound and 3D motion capturing during passive, manually applied stretches. In addition, 3D gait analysis was conducted. RESULTS Prior to bracing, the MG muscle-tendon unit in children with CP was 22 % less extensible. At matched amounts of muscle-tendon unit stretch, the muscle belly and fascicles in CP were 7 % and 14 % shorter while the tendon was 11 % longer. Spastic fascicles displayed 32 % less extensibility than controls. Brace wear increased passive dorsiflexion primarily with the knees flexed. During gait, children walked faster and foot lift in swing improved. MG muscle belly and tendon length showed little change, but fascicles further shortened (-11 %) and muscle thickness (-8 %) decreased. CONCLUSIONS Use of ankle-foot braces improves function but may lead to a loss of sarcomeres in series, which could explain the shortened fascicles. To potentially induce gastrocnemius muscle growth, braces may also need to extend the knee or complementary training may be necessary to offset the immobilizing effects of braces.
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Affiliation(s)
- Matthias Hösl
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
- />Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
| | - Harald Böhm
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
| | - Adamantios Arampatzis
- />Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
| | - Leonhard Döderlein
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
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Reilly BD, Cramp RL, Franklin CE. Activity, abundance and expression of Ca2+-activated proteases in skeletal muscle of the aestivating frog, Cyclorana alboguttata. J Comp Physiol B 2014; 185:243-55. [DOI: 10.1007/s00360-014-0880-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 11/18/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022]
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Sassoon CSH, Zhu E, Fang L, Sieck GC, Powers SK. Positive end-expiratory airway pressure does not aggravate ventilator-induced diaphragmatic dysfunction in rabbits. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2014; 18:494. [PMID: 25212227 PMCID: PMC4210557 DOI: 10.1186/s13054-014-0494-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 08/05/2014] [Indexed: 02/02/2023]
Abstract
Introduction Immobilization of hindlimb muscles in a shortened position results in an accelerated rate of inactivity-induced muscle atrophy and contractile dysfunction. Similarly, prolonged controlled mechanical ventilation (CMV) results in diaphragm inactivity and induces diaphragm muscle atrophy and contractile dysfunction. Further, the application of positive end-expiratory airway pressure (PEEP) during mechanical ventilation would result in shortened diaphragm muscle fibers throughout the respiratory cycle. Therefore, we tested the hypothesis that, compared to CMV without PEEP, the combination of PEEP and CMV would accelerate CMV-induced diaphragm muscle atrophy and contractile dysfunction. To test this hypothesis, we combined PEEP with CMV or with assist-control mechanical ventilation (AMV) and determined the effects on diaphragm muscle atrophy and contractile properties. Methods The PEEP level (8 cmH2O) that did not induce lung overdistension or compromise circulation was determined. In vivo segmental length changes of diaphragm muscle fiber were then measured using sonomicrometry. Sedated rabbits were randomized into seven groups: surgical controls and those receiving CMV, AMV or continuous positive airway pressure (CPAP) with or without PEEP for 2 days. We measured in vitro diaphragmatic force, diaphragm muscle morphometry, myosin heavy-chain (MyHC) protein isoforms, caspase 3, insulin-like growth factor 1 (IGF-1), muscle atrophy F-box (MAFbx) and muscle ring finger protein 1 (MuRF1) mRNA. Results PEEP shortened end-expiratory diaphragm muscle length by 15%, 14% and 12% with CMV, AMV and CPAP, respectively. Combined PEEP and CMV reduced tidal excursion of segmental diaphragm muscle length; consequently, tidal volume (VT) decreased. VT was maintained with combined PEEP and AMV. CMV alone decreased maximum tetanic force (Po) production by 35% versus control (P < 0.01). Combined PEEP and CMV did not decrease Po further. Po was preserved with AMV, with or without PEEP. Diaphragm muscle atrophy did not occur in any fiber types. Diaphragm MyHC shifted to the fast isoform in the combined PEEP and CMV group. In both the CMV and combined PEEP and CMV groups compared to controls, IGF-1 mRNAs were suppressed, whereas Caspase-3, MAFbx and MuRF1 mRNA expression were elevated. Conclusions Two days of diaphragm muscle fiber shortening with PEEP did not exacerbate CMV-induced diaphragm muscle dysfunction.
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Nagai M, Aoyama T, Ito A, Iijima H, Yamaguchi S, Tajino J, Zhang X, Akiyama H, Kuroki H. Contributions of biarticular myogenic components to the limitation of the range of motion after immobilization of rat knee joint. BMC Musculoskelet Disord 2014; 15:224. [PMID: 25001065 PMCID: PMC4132191 DOI: 10.1186/1471-2474-15-224] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 07/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muscle atrophy caused by immobilization in the shortened position is characterized by a decrease in the size or cross-sectional area (CSA) of myofibers and decreased muscle length. Few studies have addressed the relationship between limitation of the range of motion (ROM) and the changes in CSA specifically in biarticular muscles after atrophy because of immobilization. We aimed to determine the contribution of 2 distinct muscle groups, the biarticular muscles of the post thigh (PT) and those of the post leg (PL), to the limitation of ROM as well as changes in the myofiber CSAs after joint immobilization surgery. METHODS Male Wistar rats (n = 40) were randomly divided into experimental and control groups. In the experimental group, the left knee was surgically immobilized by external fixation for 1, 2, 4, 8, or 16 weeks (n = 5 each) and sham surgery was performed on the right knee. The rats in the control groups (n = 3 per time point) did not undergo surgery. After the indicated immobilization periods, myotomy of the PT or PL biarticular muscles was performed and the ROM was measured. The hamstrings and gastrocnemius muscles from the animals operated for 1 or 16 weeks were subjected to morphological analysis. RESULTS In immobilized knees, the relative contribution of the PT biarticular myogenic components to the total restriction reached 80% throughout the first 4 weeks and decreased thereafter. The relative contribution of the PL biarticular myogenic components remained <20% throughout the immobilization period. The ratio of the myofiber CSA of the immobilized to that of the sham-operated knees was significantly lower at 16 weeks after surgery than at 1 week after surgery only in the hamstrings. CONCLUSIONS The relative contribution of the PT and PL components to myogenic contracture did not significantly change during the experimental period. However, the ratio of hamstrings CSAs to the sham side was larger than the ratio of medial gastrocnemius CSAs to the sham side after complete atrophy because of immobilization.
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Affiliation(s)
- Momoko Nagai
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tomoki Aoyama
- Department of Development and Rehabilitation of Motor Function, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hirotaka Iijima
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Shoki Yamaguchi
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Junichi Tajino
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Xiangkai Zhang
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Van Dyke JM, Bain JL, Riley DA. Stretch-activated signaling is modulated by stretch magnitude and contraction. Muscle Nerve 2013; 49:98-107. [DOI: 10.1002/mus.23880] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Jonathan M. Van Dyke
- Department of Cell Biology; Neurobiology & Anatomy, Medical College of Wisconsin; 8701 Watertown Plank Road Milwaukee Wisconsin 53226 USA
| | - James L.W. Bain
- Department of Cell Biology; Neurobiology & Anatomy, Medical College of Wisconsin; 8701 Watertown Plank Road Milwaukee Wisconsin 53226 USA
| | - Danny A. Riley
- Department of Cell Biology; Neurobiology & Anatomy, Medical College of Wisconsin; 8701 Watertown Plank Road Milwaukee Wisconsin 53226 USA
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Bodine SC. Disuse-induced muscle wasting. Int J Biochem Cell Biol 2013; 45:2200-8. [PMID: 23800384 DOI: 10.1016/j.biocel.2013.06.011] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 12/17/2022]
Abstract
Loss of skeletal muscle mass occurs frequently in clinical settings in response to joint immobilization and bed rest, and is induced by a combination of unloading and inactivity. Disuse-induced atrophy will likely affect every person in his or her lifetime, and can be debilitating especially in the elderly. Currently there are no good therapies to treat disuse-induced muscle atrophy, in part, due to a lack of understanding of the cellular and molecular mechanisms responsible for the induction and maintenance of muscle atrophy. Our current understanding of disuse atrophy comes from the investigation of a variety of models (joint immobilization, hindlimb unloading, bed rest, spinal cord injury) in both animals and humans. Under conditions of unloading, it is widely accepted that there is a decrease in protein synthesis, however, the role of protein degradation, especially in humans, is debated. This review will examine the current understanding of the molecular and cellular mechanisms regulating muscle loss under disuse conditions, discussing the similarities and areas of dispute between the animal and human literature. This article is part of a Directed Issue entitled: Molecular basis of muscle wasting.
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Affiliation(s)
- Sue C Bodine
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, One Shields Avenue, Davis, CA 95616, United States.
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24
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Skalsky AJ, McDonald CM. Prevention and management of limb contractures in neuromuscular diseases. Phys Med Rehabil Clin N Am 2013; 23:675-87. [PMID: 22938881 DOI: 10.1016/j.pmr.2012.06.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Limb contractures are a common impairment in neuromuscular diseases. They contribute to increased disability from decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living, and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures compared with neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve range of motion in neuromuscular diseases in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from contractures.
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Affiliation(s)
- Andrew J Skalsky
- Rady Children's Hospital, Division of Pediatric Rehabilitation, MC 5096, 3020 Children's Way, University of California San Diego School of Medicine, San Diego, CA 92123, USA
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Zöllner AM, Abilez OJ, Böl M, Kuhl E. Stretching skeletal muscle: chronic muscle lengthening through sarcomerogenesis. PLoS One 2012; 7:e45661. [PMID: 23049683 PMCID: PMC3462200 DOI: 10.1371/journal.pone.0045661] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 08/20/2012] [Indexed: 12/25/2022] Open
Abstract
Skeletal muscle responds to passive overstretch through sarcomerogenesis, the creation and serial deposition of new sarcomere units. Sarcomerogenesis is critical to muscle function: It gradually re-positions the muscle back into its optimal operating regime. Animal models of immobilization, limb lengthening, and tendon transfer have provided significant insight into muscle adaptation in vivo. Yet, to date, there is no mathematical model that allows us to predict how skeletal muscle adapts to mechanical stretch in silico. Here we propose a novel mechanistic model for chronic longitudinal muscle growth in response to passive mechanical stretch. We characterize growth through a single scalar-valued internal variable, the serial sarcomere number. Sarcomerogenesis, the evolution of this variable, is driven by the elastic mechanical stretch. To analyze realistic three-dimensional muscle geometries, we embed our model into a nonlinear finite element framework. In a chronic limb lengthening study with a muscle stretch of 1.14, the model predicts an acute sarcomere lengthening from 3.09m to 3.51m, and a chronic gradual return to the initial sarcomere length within two weeks. Compared to the experiment, the acute model error was 0.00% by design of the model; the chronic model error was 2.13%, which lies within the rage of the experimental standard deviation. Our model explains, from a mechanistic point of view, why gradual multi-step muscle lengthening is less invasive than single-step lengthening. It also explains regional variations in sarcomere length, shorter close to and longer away from the muscle-tendon interface. Once calibrated with a richer data set, our model may help surgeons to prevent muscle overstretch and make informed decisions about optimal stretch increments, stretch timing, and stretch amplitudes. We anticipate our study to open new avenues in orthopedic and reconstructive surgery and enhance treatment for patients with ill proportioned limbs, tendon lengthening, tendon transfer, tendon tear, and chronically retracted muscles.
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Affiliation(s)
- Alexander M. Zöllner
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Oscar J. Abilez
- Department of Surgery, Stanford University, Stanford, California, United States of America
| | - Markus Böl
- Department of Mechanical Engineering, TU Braunschweig, Braunschweig, Germany
| | - Ellen Kuhl
- Departments of Mechanical Engineering, Bioengineering, and Cardiothoracic Surgery, Stanford University, Stanford, California, United States of America
- * E-mail:
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Abstract
PRACTICAL RELEVANCE There is an increasing demand for effective postoperative and post-injury rehabilitation for any cat with compromised physical function due to injury, surgery or disease. CLINICAL CHALLENGES The design of a suitable rehabilitation programme that will assist the recovery process, as well as ensure the return of neuromusculoskeletal control to the highest levels of function possible, requires a good understanding of feline behaviour, accurate assessment of the cat's condition and the correct implementation of a range of physiotherapeutic modalities. AUDIENCE This two-part review article is directed at the primary care veterinary team. The clinical application of a variety of physiotherapeutic modalities in the rehabilitation of cats is examined in this second part. EVIDENCE BASE Although evidence supporting the benefits of physiotherapy and rehabilitation with cats is sparse, many techniques, treatments and rehabilitation regimens successfully used on human patients are being readily adapted for animal use. Treatment recommendations described in this review are primarily based on the author's experience, and that of colleagues, except where specific reference is made to published evidence.
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Affiliation(s)
- Brian Sharp
- The Queen Mother Hospital for Animals, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
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Zumstein MA, Frey E, von Rechenberg B, Frigg R, Gerber C, Meyer DC. Device for lengthening of a musculotendinous unit by direct continuous traction in the sheep. BMC Vet Res 2012; 8:50. [PMID: 22551079 PMCID: PMC3462135 DOI: 10.1186/1746-6148-8-50] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 04/18/2012] [Indexed: 11/10/2022] Open
Abstract
Background Retraction, atrophy and fatty infiltration are signs subsequent to chronic rotator cuff tendon tears. They are associated with an increased pennation angle and a shortening of the muscle fibers in series. These deleterious changes of the muscular architecture are not reversible with current repair techniques and are the main factors for failed rotator cuff tendon repair. Whereas fast stretching of the retracted musculotendinous unit results in proliferation of non-contractile fibrous tissue, slow stretching may lead to muscle regeneration in terms of sarcomerogenesis. To slowly stretch the retracted musculotendinous unit in a sheep model, two here described tensioning devices have been developed and mounted on the scapular spine of the sheep using an expandable threaded rod, which has been interposed between the retracted tendon end and the original insertion site at the humeral head. Traction is transmitted in line with the musculotendinous unit by sutures knotted on the expandable threaded rod. The threaded rod of the tensioner is driven within the body through a rotating axis, which enters the body on the opposite side. The tendon end, which was previously released (16 weeks prior) from its insertion site with a bone chip, was elongated with a velocity of 1 mm/day. Results After several steps of technical improvements, the tensioner proved to be capable of actively stretching the retracted and degenerated muscle back to the original length and to withstand the external forces acting on it. Conclusion This technical report describes the experimental technique for continuous elongation of the musculotendinous unit and reversion of the length of chronically shortened muscle.
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Affiliation(s)
- Matthias A Zumstein
- Dept. of Orthopedics, University of Zurich, Balgrist, Zürich, 8008, Switzerland
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Abstract
Active stretch is necessary for regulating muscle fiber length (ie, the number of series sarcomeres). Elevated cytoplasmic calcium is the proposed component of contractile activity required to activate signaling pathways for sarcomere number regulation. Passive stretch reduces muscle tissue stiffness, most likely by signaling connective tissue remodeling via fibroblasts. Passive stretch may induce sarcomere addition if the muscle fibers are lengthened sufficiently to raise cytoplasmic calcium through stretch-activated calcium channels. The magnitude of stretch in vivo is limited by the physiologic range of movement and stretch pain tolerance. The greatest effect of stretching muscle fibers is expected when the lengthening exceeds the optimum fiber length (Lo).
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Wu YN, Ren Y, Zhang LQ. In vivo sarcomere imaging and fiber tension measurements. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2010; 2010:1986-9. [PMID: 21096789 DOI: 10.1109/iembs.2010.5627513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Current work demonstrates a new method and a new device for simultaneous in vivo measurements of sarcomere imaging and fiber tension. Sarcomere, a building block of muscles, plays a critical role in muscle contraction. In the pathological conditions, the biomechanical properties of sarcomere and muscle fibers may be altered significantly. We developed a novel methodology by combining the optical image capture system with force measurement which allowed us to investigate the muscle cell properties in vivo under monitored/controlled tension. The methodology was validated in an in vivo rat model as well as using an in vitro corroboration setup. The in vivo evaluation provides us a powerful tool to investigate pathological changes of fibers/sarcomeres and help determine proper treatment.
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Affiliation(s)
- Yi-Ning Wu
- Rehabilitation Institute of Chicago, IL 60611, USA.
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Muraki T, Domire ZJ, McCullough MB, Chen Q, An KN. Measurement of stiffness changes in immobilized muscle using magnetic resonance elastography. Clin Biomech (Bristol, Avon) 2010; 25:499-503. [PMID: 20236744 PMCID: PMC3042859 DOI: 10.1016/j.clinbiomech.2010.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 02/10/2010] [Accepted: 02/11/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND The isolated evaluation of changes in muscle following immobilization and disuse is a challenge in living subjects. The purpose of this study was to determine whether magnetic resonance elastography is capable of detecting these changes. METHODS An animal model was created to produce a mild joint contracture following 42 days of one forelimb immobilization in a maximally flexed position with twice-daily passive exercise. Eight pairs of dog forelimbs were harvested. Magnetic resonance elastography scans were performed on the experimental limb in an extended elbow position with a torque of 0.6 N m. Scans of the contralateral limb were performed in two conditions, position matching and torque matching. Furthermore, wet weight, cross sectional area, resting muscle length, and range of elbow joint motion were measured. FINDINGS The muscle from the experimental limb showed significant reduction in muscle mass, cross sectional area, slack length, and range of elbow motion. When comparing limbs in position matching condition, the muscle lengths were similar, and the experimental muscle had a significantly higher shear modulus (79.1 (SD 12.0)kPa) than the contralateral muscle (31.9 (SD 24.4)kPa). When comparing limbs in torque matching conditions, the muscle strains were similar, and the experimental muscle had a significantly lower shear modulus than the contralateral muscle (113.0 (SD 24.8)kPa). INTERPRETATION These findings suggest that following immobilization, magnetic resonance elastography has the potential to be used as a clinical tool to guide rehabilitation and as a research tool to study the loss of passive elastic components of muscle.
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Ben M, Harvey LA. Regular stretch does not increase muscle extensibility: a randomized controlled trial. Scand J Med Sci Sports 2010; 20:136-44. [DOI: 10.1111/j.1600-0838.2009.00926.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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The Influence of Passive Stretch on Muscle Oxygen Saturation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2010; 662:317-22. [DOI: 10.1007/978-1-4419-1241-1_45] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Rannou F, Droguet M, Giroux-Metges MA, Pennec Y, Gioux M, Pennec JP. Differences in sodium voltage-gated channel properties according to myosin heavy chain isoform expression in single muscle fibres. J Physiol 2009; 587:5249-58. [PMID: 19752118 DOI: 10.1113/jphysiol.2009.176446] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The myosin heavy chain (MHC) isoform determines the characteristics and shortening velocity of muscle fibres. The functional properties of the muscle fibre are also conditioned by its membrane excitability through the electrophysiological properties of sodium voltage-gated channels. Macropatch-clamp is used to study sodium channels in fibres from peroneus longus (PL) and soleus (Sol) muscles (Wistar rats, n = 8). After patch-clamp recordings, single fibres are identified by SDS-PAGE electrophoresis according to their myosin heavy chain isoform (slow type I and the three fast types IIa, IIx, IIb). Characteristics of sodium currents are compared (Student's t test) between fibres exhibiting only one MHC isoform. Four MHC isoforms are identified in PL and only type I in Sol single fibres. In PL, maximal sodium current (I(max)), maximal sodium conductance (g(Na,max)) and time constants of activation and inactivation ((m) and (h)) increase according to the scheme I-->IIa-->IIx-->IIb (P < 0.05). (m) values related to sodium channel type and/or function, are similar in Sol I and PL IIb fibres (P = 0.97) despite different contractile properties. The voltage dependence of activation (V(a,1/2)) shows a shift towards positive potentials from Sol type I to IIa, IIx and finally IIb fibres from PL (P < 0.05). These data are consistent with the earlier recruitment of slow fibres in a fast-mixed muscle like PL, while slow fibres of postural muscle such as soleus could be recruited in the same ways as IIb fibres in a fast muscle.
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Affiliation(s)
- F Rannou
- Université de Brest, Faculté de Médecine et des Sciences de la Santé, EA 4326, Laboratoire de Physiologie, Brest, F-29200 France
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Nascimento CCF, Padula N, Milani JGPO, Shimano AC, Martinez EZ, Mattiello-Sverzut AC. Histomorphometric analysis of the response of rat skeletal muscle to swimming, immobilization and rehabilitation. Braz J Med Biol Res 2009; 41:818-24. [PMID: 18820773 DOI: 10.1590/s0100-879x2008000900013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 07/31/2008] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to determine to what extent, if any, swimming training applied before immobilization in a cast interferes with the rehabilitation process in rat muscles. Female Wistar rats, mean weight 260.52 +/- 16.26 g, were divided into 4 groups of 6 rats each: control, 6 weeks under baseline conditions; trained, swimming training for 6 weeks; trained-immobilized, swimming training for 6 weeks and then immobilized for 1 week; trained-immobilized-rehabilitated, swimming training for 6 weeks, immobilized for 1 week and then remobilized with swimming for 2 weeks. The animals were then sacrificed and the soleus and tibialis anterior muscles were dissected, frozen in liquid nitrogen and processed histochemically (H&E and mATPase). Data were analyzed statistically by the mixed effects linear model (P < 0.05). Cytoarchitectural changes such as degenerative characteristics in the immobilized group and regenerative characteristics such as centralized nucleus, fiber size variation and cell fragmentation in the groups submitted to swimming were more significant in the soleus muscle. The diameters of the lesser soleus type 1 and type 2A fibers were significantly reduced in the trained-immobilized group compared to the trained group (P < 0.001). In the tibialis anterior, there was an increase in the number of type 2B fibers and a reduction in type 2A fibers when trained-immobilized rats were compared to trained rats (P < 0.001). In trained-immobilized-rehabilitated rats, there was a reduction in type 2B fibers and an increase in type 2A fibers compared to trained-immobilized rats (P < 0.009). We concluded that swimming training did not minimize the deleterious effects of immobilization on the muscles studied and that remobilization did not favor tissue re-adaptation.
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Affiliation(s)
- C C F Nascimento
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Okita M, Nakano J, Kataoka H, Sakamoto J, Origuchi T, Yoshimura T. Effects of therapeutic ultrasound on joint mobility and collagen fibril arrangement in the endomysium of immobilized rat soleus muscle. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:237-244. [PMID: 19010586 DOI: 10.1016/j.ultrasmedbio.2008.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 06/21/2008] [Accepted: 09/01/2008] [Indexed: 05/27/2023]
Abstract
This study examined effects of therapeutic ultrasound on joint mobility and collagen fibril arrangement in the endomysium of immobilized rat soleus muscle. Twenty-two male Wistar rats were divided randomly into control (n = 5) and experimental groups (n = 17). In the experimental group, bilateral ankle joints of each rat were fixed in full plantar flexion with a plaster cast over a 4-wk period. Five animals in the experimental group were immobilized throughout the 4-wk (immobilization group) period, whereas the remaining rats in the experimental group were randomly divided into the ultrasound (US, n = 6) and sham (n = 6) treatment groups. Under anesthesia, continuous ultrasonic energy (frequency, 1 MHz; intensity, 1.0 W/cm(2)) was delivered to the triceps surae muscle of the US group for 15 min per d, 6 d per wk over the 4-wk immobilization period. Ultrasonic energy was not delivered to the triceps surae muscle in sham animals; only the transducer head was moved. Ankle joint mobility on dorsiflexion in the immobilization, sham and US groups was significantly smaller than that of the control group, whereas in the US group, this parameter was significantly greater than in the immobilization and sham groups. Collagen fibril arrangement in the endomysium of the control and US groups was longitudinal to the axis of the muscle fibers; in contrast, it was circumferential in the immobilization and sham groups. Our findings revealed that joint immobilization induces decreased joint mobility and collagen fibril movement in the endomysium; furthermore, ultrasound treatment can prevent these changes. We hypothesized that therapeutic ultrasound during the immobilization process may inhibit deterioration of muscle contracture.
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Affiliation(s)
- Minoru Okita
- Unit of Physical and Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto Nagasaki, Japan.
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Lieber RL. Biology and mechanics of skeletal muscle: what hand surgeons need to know when tensioning a tendon transfer. J Hand Surg Am 2008; 33:1655-6. [PMID: 18984353 DOI: 10.1016/j.jhsa.2008.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 08/07/2008] [Indexed: 02/02/2023]
Affiliation(s)
- Richard L Lieber
- Department of Orthopaedics and Bioengineering, Biomedical Sciences Graduate Group, University of California, San Diego, CA, USA.
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Mirbagheri MM, Alibiglou L, Thajchayapong M, Rymer WZ. Muscle and reflex changes with varying joint angle in hemiparetic stroke. J Neuroeng Rehabil 2008; 5:6. [PMID: 18304313 PMCID: PMC2292203 DOI: 10.1186/1743-0003-5-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 02/27/2008] [Indexed: 11/25/2022] Open
Abstract
Background Despite intensive investigation, the origins of the neuromuscular abnormalities associated with spasticity are not well understood. In particular, the mechanical properties induced by stretch reflex activity have been especially difficult to study because of a lack of accurate tools separating reflex torque from torque generated by musculo-tendinous structures. The present study addresses this deficit by characterizing the contribution of neural and muscular components to the abnormally high stiffness of the spastic joint. Methods Using system identification techniques, we characterized the neuromuscular abnormalities associated with spasticity of ankle muscles in chronic hemiparetic stroke survivors. In particular, we systematically tracked changes in muscle mechanical properties and in stretch reflex activity during changes in ankle joint angle. Modulation of mechanical properties was assessed by applying perturbations at different initial angles, over the entire range of motion (ROM). Experiments were performed on both paretic and non-paretic sides of stroke survivors, and in healthy controls. Results Both reflex and intrinsic muscle stiffnesses were significantly greater in the spastic/paretic ankle than on the non-paretic side, and these changes were strongly position dependent. The major reflex contributions were observed over the central portion of the angular range, while the intrinsic contributions were most pronounced with the ankle in the dorsiflexed position. Conclusion In spastic ankle muscles, the abnormalities in intrinsic and reflex components of joint torque varied systematically with changing position over the full angular range of motion, indicating that clinical perceptions of increased tone may have quite different origins depending upon the angle where the tests are initiated. Furthermore, reflex stiffness was considerably larger in the non-paretic limb of stroke patients than in healthy control subjects, suggesting that the non-paretic limb may not be a suitable control for studying neuromuscular properties of the ankle joint. Our findings will help elucidate the origins of the neuromuscular abnormalities associated with stroke-induced spasticity.
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Affiliation(s)
- Mehdi M Mirbagheri
- Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, USA.
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Mohagheghi AA, Khan T, Meadows TH, Giannikas K, Baltzopoulos V, Maganaris CN. In vivo gastrocnemius muscle fascicle length in children with and without diplegic cerebral palsy. Dev Med Child Neurol 2008; 50:44-50. [PMID: 18173630 DOI: 10.1111/j.1469-8749.2007.02008.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The effect of spastic cerebral palsy on in vivo gastrocnemius muscle fascicle length is not clear. Similarity of fascicle lengths in children with diplegia and typically developing children, but shortening of fascicle lengths in the paretic legs of children with hemiplegia compared with the non-paretic legs, are both reported. In the former case, comparisons were made between fascicle lengths normalized to leg length, whereas in the latter case, absolute fascicle lengths were compared. The inherent assumptions when normalizing fascicle length (measured via ultrasonography) were not validated, raising the possibility that inappropriate normalization contributed to the controversy. We used statistical methods to control the potential confounding effect of leg length on fascicle length, and tested the feasibility of the normalization method for a group of 18 children with diplegia (nine males, nine females; mean age 8y 7mo [SD 3y 11mo], range 2-15y; Gross Motor Function Classification System levels II and III) and 50 typically developing children (20 males, 30 females; mean age 9y 1mo [SD 2y 4mo], range 4-14y). Children with diplegia, as a group, had shorter absolute and normalized fascicle lengths (p<0.05) but we could not refute the appropriateness of the normalization method. Other methodological issues (such as sample characteristics) might have contributed to the apparent controversy between the studies.
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Affiliation(s)
- A A Mohagheghi
- Aspire Centre for Disability Sciences, Institute of Orthopaedics, University College London, Royal National Orthopaedic Hospital, Stanmore, UK.
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Differences in gastrocnemius muscle architecture between the paretic and non-paretic legs in children with hemiplegic cerebral palsy. Clin Biomech (Bristol, Avon) 2007; 22:718-24. [PMID: 17475377 DOI: 10.1016/j.clinbiomech.2007.03.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 03/09/2007] [Accepted: 03/14/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to investigate the architectural alterations of skeletal muscle following hemiplegic cerebral palsy. If associated with functional and clinical measures of disability, information on muscle architecture could then be used as an objective tool in the assessment of motor disability in these patients. METHODS Ultrasonography was used to assess in vivo the gastrocnemius muscle architecture in the paretic and non-paretic legs of eight children with cerebral palsy. FINDINGS Fascicle length and muscle thickness at the resting ankle position were reduced in the paretic compared to the non-paretic legs by up to 18% and 20%, respectively (P<0.05), indicating a loss of both in-series and in-parallel sarcomeres in the affected muscles. However, pennation angle was similar (P>0.05) in the two legs. INTERPRETATION The present results indicate that paresis in hemiplegic cerebral palsy may affect the geometry of skeletal muscle. Further studies are required to examine the relation between muscle architecture, severity of motor disability, and treatment.
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Boakes JL, Foran J, Ward SR, Lieber RL. Muscle adaptation by serial sarcomere addition 1 year after femoral lengthening. Clin Orthop Relat Res 2007; 456:250-3. [PMID: 17065842 DOI: 10.1097/01.blo.0000246563.58091.af] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A common complication of reconstructive surgery is muscle contracture and consequent loss of joint motion. This particularly occurs in surgical lengthening procedures where the muscle adaptive capacity seems to limit the extent of possible lengthening. We used intraoperative laser diffraction to determine the skeletal muscle adaptation that occurred in a 16-year-old girl who had 4-cm femoral lengthening for a leg-length discrepancy secondary to posttraumatic growth arrest. Fascicle length changed dramatically during distraction from a starting value of approximately 9 cm to a new length of 19 cm. In vivo vastus lateralis sarcomere length measured intraoperatively at the initial surgery was 3.64 microm, whereas sarcomere length measured 8 months later was 3.11 microm. The fact that fascicle length increased dramatically and in vivo sarcomere length decreased slightly reveals an increase in serial sarcomeres from 25,000 to 58,650. This direct measurement of fascicle length and sarcomere length confirms sarcomerogenesis in human skeletal muscle secondary to chronic length change, and shows the capacity of human muscle to adapt to length changes.
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Affiliation(s)
- Jennette L Boakes
- Department of Orthopaedic Surgery, Shriners Hospital for Children, Sacramento, CA, USA
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DuBay DA, Choi W, Urbanchek MG, Wang X, Adamson B, Dennis RG, Kuzon WM, Franz MG. Incisional herniation induces decreased abdominal wall compliance via oblique muscle atrophy and fibrosis. Ann Surg 2007; 245:140-6. [PMID: 17197977 PMCID: PMC1867936 DOI: 10.1097/01.sla.0000251267.11012.85] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study is to measure abdominal wall myopathic histologic and mechanical changes during incisional herniation and its effect on incisional hernia repairs. SUMMARY BACKGROUND DATA Unloaded skeletal muscles undergo characteristic atrophic changes, including change in fiber type composition, decreased cross-sectional area, and pathologic fibrosis. We hypothesize that these atrophic changes decrease muscle elastic properties and may contribute to the high laparotomy wound failure rate observed following incisional hernia repair. METHODS A rat model of chronic incisional hernia formation was used. Failing midline laparotomy incisions developed into incisional hernias. Controls were uninjured and sham laparotomy (healed) groups. Internal oblique muscles were harvested for fiber typing, measurement of cross-sectional area, collagen deposition, and mechanical analysis. Mesh hernia repairs were performed on a second group of rats with chronic incisional hernias or acute anterior abdominal wall myofascial defects. RESULTS The hernia group developed lateral abdominal wall shortening and oblique muscle atrophy. This was associated with a change in the distribution of oblique muscle fiber types, decreased cross-sectional area, and pathologic fibrosis consistent with myopathic disuse atrophy. These muscles exhibited significant decreased extensibility and increased stiffness. The healed (sham) laparotomy group expressed an intermediate phenotype between the uninjured and hernia groups. Recurrent hernia formation was most frequent in the chronic hernia model, and hernia repairs mechanically disrupted at a lower force compared with nonherniated abdominal walls. CONCLUSIONS The internal oblique muscles of the abdominal wall express a pattern of changes consistent with those seen in chronically unloaded skeletal muscles. The internal oblique muscles become fibrotic during herniation, reducing abdominal wall compliance and increasing the transfer of load forces to the midline wound at the time of hernia repair.
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Affiliation(s)
- Derek A DuBay
- Department of Surgery, Section of General Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
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Soares AG, Aoki MS, Miyabara EH, Deluca CV, Ono HY, Gomes MD, Moriscot AS. Ubiquitin-ligase and deubiquitinating gene expression in stretched rat skeletal muscle. Muscle Nerve 2007; 36:685-93. [PMID: 17657803 DOI: 10.1002/mus.20866] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In order to gain insight into intracellular mechanisms involved in longitudinal growth of skeletal muscle, we determined gene expression of ubiquitin-ligases (MAFbx/atrogin-1, E3 alpha, and MuRF-1) and deubiquitinating enzymes (UBP45, UBP69, and USP28) at different time-points (24, 48, and 96 h) of continuous stretch of the soleus and tibialis anterior (TA) muscles. In the soleus, real-time polymerase chain reaction (PCR) showed that MAFbx/atrogin-1, E3 alpha, and MuRF-1 gene expression was downregulated, peaking at 24-48 h. Gene expression of all deubiquitinating enzymes increased with continuous stretch of soleus. In the TA, gene expression of the ubiquitin-ligases MAFbx/atrogin-1 and MuRF-1 was elevated, whereas expression of UBP45 and UBP69 was downregulated. Western blot analysis showed that the overall ubiquitination level decreased in the soleus and increased in the TA during stretch. These results suggest that ubiquitin-ligases and deubiquitinating enzymes are involved in longitudinal growth induced by continuous muscle stretch.
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Affiliation(s)
- Antonio Garcia Soares
- Department of Cell and Developmental Biology, Biomedical Sciences Institute, University of Sao Paulo, Avenida Lineu Prestes 1524, 05508-900 Sao Paulo, SP, Brazil
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Jaspers RT, Feenstra HM, van Beek-Harmsen BJ, Huijing PA, van der Laarse WJ. Differential effects of muscle fibre length and insulin on muscle-specific mRNA content in isolated mature muscle fibres during long-term culture. Cell Tissue Res 2006; 326:795-808. [PMID: 16847642 DOI: 10.1007/s00441-006-0227-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Accepted: 04/22/2006] [Indexed: 02/07/2023]
Abstract
The aims of this study were (1) to determine the relationship between muscle fibre cross-sectional area and cytoplasmic density of myonuclei in high- and low-oxidative Xenopus muscle fibres and (2) to test whether insulin and long-term high fibre length caused an increase in the number of myonuclei and in the expression of alpha-skeletal actin and of myogenic regulatory factors (myogenin and MyoD) in these muscle fibres. In high- and low-oxidative muscle fibres from freshly frozen iliofibularis muscles, the number of myonuclei per millimetre fibre length was proportional to muscle fibre cross-sectional area. The in vivo myonuclear density thus seemed to be strictly regulated, suggesting that the induction of hypertrophy required the activation of satellite cells. The effects of muscle fibre length and insulin on myonuclear density and myonuclear mRNA content were investigated on high-oxidative single muscle fibres cultured for 4-5 days. Muscle fibres were kept at a low length (~15% below passive slack length) in culture medium with a high insulin concentration (~6 nmol/l: "high insulin medium") or without insulin, and at a high length (~5% above passive slack length) in high insulin medium. High fibre length and high insulin medium did not change the myonuclear density of isolated muscle fibres during culture. High insulin increased the myonuclear alpha-skeletal actin mRNA content, whereas fibre length had no effect on alpha-skeletal actin mRNA content. After culture at high fibre length in high insulin medium, the myonuclear myogenin mRNA content was 2.5-fold higher than that of fibres cultured at low length in high insulin medium or in medium without insulin. Myonuclear MyoD mRNA content was not affected by fibre length or insulin. These in vitro experiments indicate that high muscle fibre length and insulin enhance muscle gene expression but that other critical factors are required to induce adaptation of muscle fibre size and performance.
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Affiliation(s)
- R T Jaspers
- Institute for Fundamental and Clinical Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
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Huijing PA, Jaspers RT. Adaptation of muscle size and myofascial force transmission: a review and some new experimental results. Scand J Med Sci Sports 2005; 15:349-80. [PMID: 16293149 DOI: 10.1111/j.1600-0838.2005.00457.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper considers the literature and some new experimental results important for adaptation of muscle fiber cross-sectional area and serial sarcomere number. Two major points emerge: (1) general rules for the regulation of adaptation (for in vivo immobilization, low gravity conditions, synergist ablation, tenotomy and retinaculum trans-section experiments) cannot be derived. As a consequence, paradoxes are reported in the literature. Some paradoxes are resolved by considering the interaction between different levels of organization (e.g. muscle geometrical effects), but others cannot. (2) An inventory of signal transduction pathways affecting rates of muscle protein synthesis and/or degradation reveals controversy concerning the pathways and their relative contributions. A major explanation for the above is not only the inherently limited control of the experimental conditions in vivo, but also of in situ experiments. Culturing of mature single Xenopus muscle fibers at high and low lengths (allowing longitudinal study of adaptation for periods up to 3 months) did not yield major changes in the fiber cross-sectional area or the serial sarcomere number. This is very different from substantial effects (within days) of immobilization in vivo. It is concluded that overall strain does not uniquely regulate muscle fiber size. Force transmission, via pathways other than the myotendinous junctions, may contribute to the discrepancies reported: because of substantial serial heterogeneity of sarcomere lengths within muscle fibers creating local variations in the mechanical stimuli for adaptation. For the single muscle fiber, mechanical signalling is quite different from the in vivo or in vitro condition. Removal of tensile and shear effects of neighboring tissues (even of antagonistic muscle) modifies or removes mechanical stimuli for adaptation. It is concluded that the study of adaptation of muscle size requires an integrative approach taking into account fundamental mechanisms of adaptation, as well as effects of higher levels of organization. More attention should be paid to adaptation of connective tissues within and surrounding the muscle and their effects on muscular properties.
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Affiliation(s)
- P A Huijing
- Instituut voor Fundamentele en Klinische Bewegingswetenschappen, Faculteit Bewegingswetenschappen, Vrije Universiteit, Amsterdam, The Netherlands.
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Jaspers RT, Feenstra HM, Verheyen AK, van der Laarse WJ, Huijing PA. Effects of strain on contractile force and number of sarcomeres in series of Xenopus laevis single muscle fibres during long-term culture. J Muscle Res Cell Motil 2004; 25:285-96. [PMID: 15548856 DOI: 10.1007/s10974-004-8716-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the present study is to test whether mechanical strain uniquely regulates muscle fibre atrophy/hypertrophy and adaptation of the number of sarcomeres in series within mature muscle fibres in vitro . Mature single muscle fibres from Xenopus laevis illiofibularis muscle were cultured (4-97 days) while kept at negative strain ( approximately 20% below passive slack length, 'short fibres') or at positive strain ( approximately 5% over passive slack length, 'long fibres'). Before and after culture the number of sarcomeres in series was determined using laser diffraction. During culture, twitch and tetanic force characteristics were measured every day. Survival time of long fibres was substantially less than that of short fibres. Of the long fibres 40% died or became inexcitable within 1 week, whereas this did not occur for short fibres. During culture, twitch and tetanic force of all short fibres increased substantially. Regression analysis showed that the post-culture number of sarcomeres in series was not significantly changed compared to the number before culture. It is concluded that culture at negative strain does not result in atrophy or a reduction of the number of sarcomeres in series, even after 97 days. For the long fibres we did not detect any hypertrophy as tetanic force remained stable or decreased slowly, while twitch force varied. Regression analysis of the change of the number of sarcomeres in series as a function of the culture time showed a positive slope ( P=0.054). Two out of four long fibres that were cultured for at least 2 weeks showed an increase in the number of sarcomeres of 4-5%. Compared with in vivo adaptation to mechanical stimuli this is much less than would be expected. The data suggest that strain may not be the only factor that regulates hypertrophy and the number of sarcomeres in series.
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Affiliation(s)
- R T Jaspers
- Instituut voor Fundamentele en Klinische Bewegingswetenschappen, Faculteit Bewegingswetenschappen, Vrije Universiteit, Van der Boechorststraat 9, Amsterdam, The Netherlands
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Lieber RL, Steinman S, Barash IA, Chambers H. Structural and functional changes in spastic skeletal muscle. Muscle Nerve 2004; 29:615-27. [PMID: 15116365 DOI: 10.1002/mus.20059] [Citation(s) in RCA: 251] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This review summarizes current information regarding the changes in structure or function that occur in skeletal muscle secondary to spasticity. Most published studies have reported an increase in fiber size variability in spastic muscle. There is no general agreement regarding any shift in fiber type distribution secondary to spasticity. Mechanical studies in whole limbs as well as in isolated single cells support the notion of an intrinsic change in the passive mechanical properties of muscle after spasticity in addition to the more widely reported neural changes that occur. Evidence is presented for changes within both the muscle cell and extracellular matrix that contribute to the overall changes in the tissue. Taken together, the literature supports the notion that, although spasticity is multifactorial and neural in origin, significant structural alterations in muscle also occur. An understanding of the specific changes that occur in the muscle and extracellular matrix may facilitate the development of new conservative or surgical therapies for this problem.
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Affiliation(s)
- Richard L Lieber
- Departments of Orthopaedic Surgery and Bioengineering, University of California and Veterans Administration Medical Centers, 3350 La Jolla Village Drive, San Diego, California 92161, USA.
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Dupont Salter AC, Richmond FJR, Loeb GE. Effects of muscle immobilization at different lengths on tetrodotoxin-induced disuse atrophy. IEEE Trans Neural Syst Rehabil Eng 2003; 11:209-17. [PMID: 14518783 DOI: 10.1109/tnsre.2003.817675] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Previous studies have shown that immobilization causes muscle atrophy and that the rate of atrophy depends on the length at which the muscle is immobilized. However, most studies have been carried out in neurologically intact animals that were capable of generating at least some voluntary muscle activation. In this study, tetrodotoxin was applied chronically to the rat sciatic nerve to produce complete paralysis of distal muscles for seven days, and the ankle was immobilized to hold the muscles at long or short lengths. Paralysis without immobilization resulted in relative weight losses of 36% for soleus, 19% for tibialis anterior (TA), and 17% for lateral gastrocnemius (LG) muscles. Casting the ankle in plantarflexion stretched TA and reduced its weight loss to 10%. Soleus and LG were shortened by this intervention and had increased losses of 43% and 28%, respectively. Fixing the limb in dorsiflexion resulted in a posture similar to that adopted by the unrestrained rats and had no significant effect on the amount of muscle atrophy compared to that in unrestrained paralyzed animals.
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MESH Headings
- Adaptation, Physiological
- Anatomy, Cross-Sectional
- Animals
- Ankle Joint/pathology
- Ankle Joint/physiopathology
- Female
- Immobilization
- Muscle Fibers, Skeletal/classification
- Muscle Fibers, Skeletal/pathology
- Muscle, Skeletal/pathology
- Muscle, Skeletal/physiopathology
- Muscular Disorders, Atrophic/chemically induced
- Muscular Disorders, Atrophic/pathology
- Muscular Disorders, Atrophic/physiopathology
- Organ Size
- Posture
- Rats
- Rats, Sprague-Dawley
- Reference Values
- Tetrodotoxin
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Jaspers RT, Feenstra HM, Lee- de Groot MB, Huijing PA, van der Laarse WJ. Twitch and tetanic tension during culture of mature Xenopus laevis single muscle fibres. Arch Physiol Biochem 2001; 109:410-7. [PMID: 11935381 DOI: 10.1076/apab.109.5.410.11825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Investigation of the mechanisms of muscle adaptation requires independent control of the regulating factors. The aim of the present study was to develop a serum-free medium to culture mature single muscle fibres of Xenopus laevis. As an example, we used the culture system to study adaptation of twitch and tetanic force characteristics, number of sarcomeres in series and fibre cross-section. Fibres dissected from m. iliofibularis (n = 10) were kept in culture at a fibre mean sarcomere length of 2.3 microm in a culture medium without serum. Twitch and tetanic tension were determined daily. Before and after culture the number of sarcomeres was determined by laser diffraction and fibre cross-sectional area (CSA) was determined by microscopy. For five fibres twitch tension increased during culture and tetanic tension was stable for periods varying from 8 to 14 days ('stable fibres'), after which fibres were removed from culture for analysis. Fibre CSA and the number of sarcomeres in series remained constant during culture. Five other fibres showed a substantial reduction in twitch and tetanic tension within the first five days of culture ('unstable fibres'). After 7-9 days of culture, three of these fibres died. For two of the unstable fibres, after the substantial force reduction, twitch and tetanic tension increased again. Finally at day 14 and 18 of culture, respectively, the tensions attained values higher than their original values. For stable fibres, twitch contraction time, twitch half-relaxation time and tetanus 10%-relaxation time increased during culture. For unstable fibres these parameters fluctuated. For all fibres the stimulus threshold fluctuated during the first two days, and then remained constant, even for the fibres that were cultured for at least two weeks. It is concluded that the present culture system for mature muscle fibres allows long-term studies within a well-defined medium. Unfortunately, initial tetanic and twitch force are poor predictors of the long-term behaviour of the fibres.
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Affiliation(s)
- R T Jaspers
- Instituut voor Fundamentele en Klinische Bewegingswetenschappen, Faculteit Bewegingswetenschappen, Vrije Universiteit, Amsterdam, The Netherlands
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Shah SB, Peters D, Jordan KA, Milner DJ, Fridén J, Capetanaki Y, Lieber RL. Sarcomere number regulation maintained after immobilization in desmin-null mouse skeletal muscle. J Exp Biol 2001; 204:1703-10. [PMID: 11316490 DOI: 10.1242/jeb.204.10.1703] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The serial sarcomere number of skeletal muscle changes in response to chronic length perturbation. The role of the intermediate filament desmin in regulating these changes was investigated by comparing the architectural adaptations of the tibialis anterior, extensor digitorum longus (EDL) and soleus from wild-type mice with those of homozygous desmin knockout mice after hindlimb immobilization. After 28 days, serial sarcomere number increased significantly in the lengthened wild-type tibialis anterior (by approximately 9 %) and EDL (by approximately 17 %). Surprisingly, muscles from desmin knockout mice also experienced significant serial remodeling, with the serial sarcomere number of the tibialis anterior increasing by approximately 10 % and that of the EDL by approximately 27 %. A consistent result was observed in the shortened soleus: a significant decrease in sarcomere number was observed in the muscles from both wild-type (approximately 26 %) and knockout (approximately 12 %) mice. Thus, although desmin is not essential for sarcomerogenesis or sarcomere subtraction in mouse hindlimb muscles, the results do suggest subtle differences in the nature of sarcomere number adaptation. We speculate that desmin may play a role in regulating the optimal arrangement of sarcomeres within the muscle or in sensing the magnitude of the immobilization effect itself.
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Affiliation(s)
- S B Shah
- Department of Orthopaedics, Biomedical Sciences Graduate Group, Veterans Affairs and University of California Medical Centers, San Diego, CA 92161, USA
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