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Pan A, Cao W, Wu B, Yin L, Ding H, Guo R, Liu Y, Hai Y, Zhou L. Elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis after posterior selective fusion surgery. Clin Biomech (Bristol, Avon) 2022; 99:105763. [PMID: 36122528 DOI: 10.1016/j.clinbiomech.2022.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We sought to assess the elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 curves after posterior selective fusion surgery. METHODS The shear wave elasticity imaging system was used to assess the elasticity of the thoracic paravertebral muscles and fascia both on the concave and convex sides. Three regions of interest, including the apex, upper end, and lower end of the main curve, were tested. FINDINGS Ten female patients, with an average age of 16.6 ± 2.7 years old, were included. The average post-operation follow-up period was 9.0 ± 2.4 months. The Cobb angle was significantly corrected from 63.6 ± 12.0° to 10.7 ± 5.4° (p < 0.05). The length of the trunk increased from 40.4 ± 2.5 cm to 46.0 ± 2.8 cm (p < 0.05). The elasticity of deep fascia didn't show a significant change post-operation (p > 0.05). The elasticity of the paravertebral muscle on the concave side had a significant increase at the final follow-up (p < 0.05). The elasticity of the paravertebral muscle on the convex side also increased at the upper end (p < 0.05). The elasticity asymmetry of the deep fascia decreased, but the elasticity asymmetry of the paravertebral muscle increased at the upper end of the curve (p < 0.05). INTERPRETATION The paravertebral muscle on the concave side is stiffer after surgery. Elastic asymmetry of paravertebral muscle increased and elastic asymmetry of the deep fascia decreased at the upper end of the curvature. Further study is needed to elucidate the mechanism by which the paravertebral soft tissue responds after surgery.
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Affiliation(s)
- Aixing Pan
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Wen Cao
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Bingchao Wu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Li Yin
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Hongtao Ding
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Ruijun Guo
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Yuzeng Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
| | - Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
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Peng H, Jin F, Meng D, Li J, Yu S, Zhang S, Zeng G. Exploring the Pathological Role of Collagen in Paravertebral Muscle in the Progression of Idiopathic Scoliosis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1527403. [PMID: 32802834 PMCID: PMC7421238 DOI: 10.1155/2020/1527403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Paravertebral muscle (PVM) is considered as a contributing factor of idiopathic scoliosis (IS); collagen is crucial for maintaining the mechanical properties of PVM, but only a few researches have described this field. In this study, we observed the muscle stiffness of PVM and the curvature of the spine by adjusting the content of collagen in PVM of rats and explored the role of collagen in the progression of IS. METHODS 32 female Sprague Dawley rats were randomly divided into four groups: neutralizing antibody (NA) group (group 1), normal control group (group 2), IS group (group 3), and IS with NA group (group 4). TGF-β1 NA was injected into PVM in group 1 and group 4, while Normal saline in group 2 and group 3. The Cobb angle and muscle stiffness were measured before and after injection; the rats were sacrificed at one week after injection, and performed histological, Western Blot, and qRT-PCR examinations. RESULTS X-rays showed that scoliosis occurred in group 1 and relieved in group 4. The stiffness of PVM was decreased significantly on the convex side in group 1, while on the concave side in group 4. The expression of TGF-β1 and COL1 on the concave side in IS rats (group 3) was significantly increased than that in normal rats (group 2), the concentration of COL1 and COL3 in group 3 was significantly higher than that in group 2, and the addition of TGF-β1 NA significantly downregulated COL1 and COL3 in group 1 and group 4. The concentration of COL1 in convex PVM was negatively related to Cobb angle in group 1 and group 2, and in concave PVM was positively related to Cobb angle in group 3 and group 4. However, no significant correlation was found between COL3 and Cobb angle in group 3 and group 4. CONCLUSIONS Asymmetric biomechanical characteristics of PVM was an important etiological factor of IS, which was directly correlated with collagen, it could be adjusted by local intramuscular injecting of TGF-β1 NA, and finally had an effect on the shape of the spine.
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Affiliation(s)
- Haidong Peng
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Feng Jin
- 2Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Depeng Meng
- 3Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jun Li
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Shuhan Yu
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Shen Zhang
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Guigang Zeng
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Lo WLA, Yu Q, Mao Y, Li W, Hu C, Li L. Lumbar muscles biomechanical characteristics in young people with chronic spinal pain. BMC Musculoskelet Disord 2019; 20:559. [PMID: 31759390 PMCID: PMC6875033 DOI: 10.1186/s12891-019-2935-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/07/2019] [Indexed: 11/15/2022] Open
Abstract
Background The prevalence of low back pain is rising among the young adult population. Altered lumbar muscle tone was suggested to be associated with underlying pathologies and symptoms. To date, there is minimum information available on the repeatability of lumbar spine muscle mechanical properties in the young adults who experienced low back pain. This study aimed to assess the reproducibility of mechanical properties of lumbar spinal muscle in young adults with spinal pain by myotonometer and explored the difference in reproducibility when different number of indentations was used. Methods Participants who aged between 18 to 25 and reported chronic LBP were recruited. Lumbar muscle tone (Hz) and stiffness (N/m) were assessed by myotonometer on one occasion by two assessors. Parameters were recorded by triple scans and 5-scans mode. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Bland and Altman analysis were used to assess agreement between two measurements. The relationship between muscle mechanical properties and pain score and disability level were assessed by Spearman’s rank correlation coefficient. Results The results of ICCs indicated excellent repeatability in triple scans and 5-scans mode for each lumbar level bilaterally (ICC > 0.75). SEM and SRD were smaller in triple scans than 5-scans mode for most levels. Bland and Altman analysis revealed no systematic bias. Spearman’s rank correlation analysis indicated significant high correlations between muscle tone and disability level (r = 0.80, p < 0.05), and between muscle stiffness and disability level (r = 0.81, p < 0.05). Conclusions This study found that lumbar spinal muscle tone and stiffness were repeatable parameters when measured by myotonometer. The reproducibility of muscle mechanical parameters did not appear to differ between the two scanning modes with different number of indentations. Muscle tone and stiffness measured by myotonometer may therefore be reliable as outcome measures to assess intervention induced changes. The lack of significant association between intensity of pain and mechanical properties of paraspinal muscles may suggest that muscle properties measured at rest might not be related to pain level at rest but more related to pain elicited during movement.
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Affiliation(s)
- Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yurong Mao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wenfeng Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chengpeng Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Le Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China. .,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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Liu Y, Pan A, Hai Y, Li W, Yin L, Guo R. Asymmetric biomechanical characteristics of the paravertebral muscle in adolescent idiopathic scoliosis. Clin Biomech (Bristol, Avon) 2019; 65:81-86. [PMID: 31004964 DOI: 10.1016/j.clinbiomech.2019.03.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 02/17/2019] [Accepted: 03/18/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND We sought to assess the biomechanical properties of the paravertebral muscles in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 (Lenke 1-3) curves. METHODS The MyotonPro® and shear wave elasticity imaging system were used to assess the biomechanical features of the thoracic paravertebral muscles on concave and convex side in adolescent idiopathic scoliosis patients with Lenke 1-3 curves. The Cobb angle of the main curve was measured using the anteroposterior whole spine radiograph in the standing position. FINDINGS A total of 40 adolescent idiopathic scoliosis patients with a mean Cobb angle of 66.49° (SD 32.8°) were included in this study. Muscle tone, stiffness and Deborah number on the concave side was significantly greater than that on the convex side. Relaxation time was significantly longer on the convex side than on the concave side. No statistically significant difference in muscle elasticity was observed between the concave side and the convex side (P > 0.05). Pearson correlation analysis demonstrated that stiffness on the concave side was moderately positively correlated with the Cobb angle (P < 0.05, r = 0.582); the Deborah number on both sides and the relaxation time on the concave side showed a moderate negative correlation with the Cobb angle (P < 0.05, r = -0.632; r = -0.432; r = -0.611). INTERPRETATION Concave paravertebral muscle tone and stiffness were greater than those on convex side in adolescent idiopathic scoliosis patients. The asymmetric biomechanical characteristics of paravertebral muscles are closely related to the severity of scoliosis.
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Affiliation(s)
- Yuzeng Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Aixing Pan
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
| | - Wenjing Li
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNan Road 8#, Chaoyang District, Beijing 100020, China
| | - Li Yin
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNan Road 8#, Chaoyang District, Beijing 100020, China
| | - Ruijun Guo
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNan Road 8#, Chaoyang District, Beijing 100020, China
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Imai K, Kotani T, Ushida T, Moriyama Y, Nakano T, Kikkawa F. Feasibility of using a handheld tissue hardness meter to quantify uterine contractions and its clinical application for obstetric bleeding management. J OBSTET GYNAECOL 2019; 39:757-762. [PMID: 31020886 DOI: 10.1080/01443615.2019.1581748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Postpartum haemorrhage (PPH) is a potentially life-threatening condition. Women undergoing caesarean section (CS) are at particular risk, and improvements in the management of PPH during CS are required. We investigated the use of a tissue hardness metre to quantify uterine contractions during CS with a view to its application for obstetric bleeding management. Fifty pregnant women at term who underwent elective CS were recruited. Using a tissue hardness metre, we measured uterine hardness twice during CS: after placental removal and before peritoneum closure. Each measurement was conducted at two standardised points: fundus and corpus uteri. Concurrently, obstetricians subjectively graded uterine contractions as weak, medium, or strong. The hardness metre accurately quantified the degree of uterine contraction assessed by the obstetricians, and could be an effective clinical tool for early recognition of intra-operative massive bleeding. IMPACT STATEMENT What is already known on this subject? Maintaining adequate uterine contraction leads to prevention of excessive blood loss, which decreases the incidence and severity of PPH. However, the assessment of uterine contraction is currently judged by obstetricians, who manually and subjectively evaluate uterine contraction according to uterine hardness. Therefore, uterine atony remains a clinical diagnosis without a universal definition. What do the results of this study add? The present study investigated the use of a tissue hardness metre to quantify uterine contractions during CS with a view to its application for obstetric bleeding management. The hardness metre was able to quantify the degree of uterine contraction perceived by obstetricians. Quantifying uterine hardness during CS correlates with the amount of intra-operative bleeding and is useful for early recognition of massive haemorrhage. What are the implications of these findings for clinical practice and/or further research? To improve the management of atonic PPH and avoid serious complications, the tissue hardness metre should be considered as a potential clinical tool during CS.
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Affiliation(s)
- Kenji Imai
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Tomomi Kotani
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Takafumi Ushida
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Yoshinori Moriyama
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Tomoko Nakano
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Fumitaka Kikkawa
- a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan
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Abstract
Spasticity is a serious problem that adversely affects the daily life of patients, and creates difficulties for caregivers. The symptom that causes the most disability in multiple sclerosis patients is spasticity. The methods used in the measurement and evaluation of spasticity have some incomplete aspects and errors. In this article, we examined and compared the old and new methods used in the quantitative evaluation of spasticity, and tried to define the ideal method.
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Affiliation(s)
- Belgin Petek Balci
- Department of Neurology, Faculty of Medicine, University of Health Sciences; Haseki Research and Education Hospital Neurology Clinic, İstanbul, Turkey
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Li X, Shin H, Li S, Zhou P. Assessing muscle spasticity with Myotonometric and passive stretch measurements: validity of the Myotonometer. Sci Rep 2017; 7:44022. [PMID: 28281581 PMCID: PMC5345015 DOI: 10.1038/srep44022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/03/2017] [Indexed: 11/09/2022] Open
Abstract
Spasticity of the biceps brachii muscle was assessed using the modified Ashworth Scale (MAS), Myotonometry and repeated passive stretch techniques, respectively. Fourteen subjects with chronic hemiplegia participated in the study. Spasticity was quantified by muscle displacements and compliance from the Myotonometer measurements and resistive torques from the repeated passive stretch at velocities of 5 °/s and 100 °/s, respectively. Paired t-tests indicated a significant decrease of muscle displacement and compliance in the spastic muscles as compared to the contralateral side (muscle displacement: spastic: 4.84 ± 0.33 mm, contralateral: 6.02 ± 0.49 mm, p = 0.038; compliance: spastic: 1.79 ± 0.12 mm/N, contralateral: 2.21 ± 0.18 mm/kg, p = 0.048). In addition, passive stretch tests indicated a significant increase of total torque at the velocity of 100 °/s compared with that of 5 °/s (Tt5 = 2.82 ± 0.41 Nm, Tt100 = 6.28 ± 1.01 Nm, p < 0.001). Correlation analysis revealed significant negative relationships between the stretch test and the Myotonometer measurements (r < −0.5, p < 0.05). Findings of this study provided validation of the Myotonometry technique and its high sensitivity in examination of spasticity in stroke.
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Affiliation(s)
- Xiaoyan Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, and TIRR Memorial Hermann Research Center, Houston, TX, USA
| | - Henry Shin
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, and TIRR Memorial Hermann Research Center, Houston, TX, USA
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, and TIRR Memorial Hermann Research Center, Houston, TX, USA
| | - Ping Zhou
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, and TIRR Memorial Hermann Research Center, Houston, TX, USA
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Chino K, Takahashi H. Handheld Tissue Hardness Meters for Assessing the Mechanical Properties of Skeletal Muscle: A Feasibility Study. J Manipulative Physiol Ther 2016; 39:518-522. [DOI: 10.1016/j.jmpt.2016.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 04/23/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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