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Lettner J, Królikowska A, Ramadanov N, Oleksy Ł, Hakam HT, Becker R, Prill R. Evaluating the Reliability of MyotonPro in Assessing Muscle Properties: A Systematic Review of Diagnostic Test Accuracy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:851. [PMID: 38929468 PMCID: PMC11205912 DOI: 10.3390/medicina60060851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro device offers a non-invasive method to comprehensively assess muscle biomechanical properties. This systematic review evaluates the reliability of MyotonPro across various muscles for diagnostic purposes. Materials and Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in Medline (PubMed), Ovid (Med), Epistemonikos, Embase, Cochrane Library, Clinical trials.gov, and the WHO International Clinical Trials platform. Studies assessing the reliability of MyotonPro across different muscles were included. A methodological quality assessment was performed using established tools, and reviewers independently conducted data extraction. Statistical analysis involved summarizing intra-rater and inter-rater reliability measures across muscles. Results: A total of 48 studies assessing 31 muscles were included in the systematic review. The intra-rater and inter-rater reliability were consistently high for parameters such as frequency and stiffness in muscles of the lower and upper extremities, as well as other muscle groups. Despite methodological heterogeneity and limited data on specific parameters, MyotonPro demonstrated promising reliability for diagnostic purposes across diverse patient populations. Conclusions: The findings suggest the potential of MyotonPro in clinical assessments for accurate diagnosis, treatment planning, and monitoring of muscle properties. Further research is needed to address limitations and enhance the applicability of MyotonPro in clinical practice. Reliable muscle assessments are crucial for optimizing treatment outcomes and improving patient care in various healthcare settings.
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Affiliation(s)
- Jonathan Lettner
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Tytusa Chalubinskiego 3, 50-368 Wroclaw, Poland;
| | - Nikolai Ramadanov
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Łukasz Oleksy
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland
- Department of Orthopaedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
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Garzón-Alfaro MT, Cruz-Medel I, Alcaraz-Clariana S, García-Luque L, Carmona-Pérez MC, Garrido-Castro JL, Alburquerque-Sendín F, Rodrigues-de-Souza DP. Influence of vaginal birth on lumbopelvic muscle mechanical properties on urinary incontinence. Clin Rehabil 2024; 38:558-568. [PMID: 38295335 DOI: 10.1177/02692155231224058] [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] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To identify differences in the muscle mechanical properties of the pelvic floor (PF) and lumbar paravertebral (LP) muscles between young nulliparous and uni/multiparous women. Secondarily, specific behaviors, depending on the presence or absence or urinary incontinence (UI), were also researched. DESIGN Case-control study. SETTING Higher education institution. PARTICIPANTS One hundred young women participated, divided into two groups depending on whether they had vaginal birth (nulliparous or uni/multiparous). Each group included women with and without UI. MAIN MEASURES A muscle mechanical properties (tone, stiffness, decrement-inverse of elasticity-, and viscoelastic properties: relaxation and creep) assessment of the PF and LP muscles were performed with a hand-held tonometer. RESULTS Tone and stiffness of both sides of the PF presented group by UI interaction (p < 0.05), with uni/multiparous women with UI showing higher tone and stiffness compared to multiparous women without UI. In LP muscles, uni/multiparous women showed greater tone and stiffness on the right and left sides [-2.57 Hz (95% confidence interval -4.42,-0.72) and -79.74 N/m (-143.52,-15.97); -2.20 Hz (-3.82,-0.58) and -81.30 N/m (-140.66-,21.95), respectively], as well as a decrease in viscoelastic properties compared to nulliparous women [relaxation: 2.88 ms (0.31,5.44); creep: 0.15 (0.01,0.30); relaxation: 2.69 ms (0.13,5.25); creep: 0.14 (0,0.28), respectively]. CONCLUSIONS Vaginal birth and UI have a differential influence on the muscle mechanical properties of the PF and LP muscles. The determination of muscle mechanical properties by externally applied hand-held tonometry improves the knowledge of the lumbopelvic status, with applicability in clinical and research fields.
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Affiliation(s)
- María Teresa Garzón-Alfaro
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Inés Cruz-Medel
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - María Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, Córdoba, Spain
- GC05 Systemic and chronic inflammatory autoimmune diseases of the locomotor system and connective tissue, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
- GC05 Systemic and chronic inflammatory autoimmune diseases of the locomotor system and connective tissue, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
- GC05 Systemic and chronic inflammatory autoimmune diseases of the locomotor system and connective tissue, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
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Rodrigues-de-Souza DP, Casas-Castro A, Carmona-Pérez MC, García-Luque L, Alcaraz-Clariana S, Garrido-Castro JL, Alburquerque-Sendín F. Between-sexes differences in lumbopelvic muscle mechanical properties of non-climacteric adults: a cross-sectional design. Sci Rep 2023; 13:21612. [PMID: 38062151 PMCID: PMC10703780 DOI: 10.1038/s41598-023-48984-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
The lumbopelvic muscle mechanical properties (MMPs) are clinically relevant, but their dependence on sex remains unknown. Therefore, this study aimed to identify if lumbopelvic MMPs depend on the sex in a young adult population. Thirty-five healthy nulliparous women and 35 healthy men were analyzed (age range: 18-50). Lumbopelvic MMPs, that is, tone, stiffness, elasticity, relaxation and creep, assessed with MyotonPRO®, and pelvic floor (PF) health questionnaires were compared between-sexes. Intra-group correlations between sociodemographic and clinical data, and MMPs were also determined. The MMPs of PF were different between healthy non-climacteric adults of both sexes, with women showing higher values of tone and stiffness and lower values of elasticity and viscoelastic properties than men (in all cases, p < 0.03). At lumbar level, tone and stiffness were higher for men at both sides (in all cases, p < 0.04), and relaxation was lower at left side (p = 0.02). The MMPs showed few correlations with sociodemographic data within women. However, within males, there were positive correlations for PF stiffness and viscoelastic parameters with age, BMI and function (0.334 < r < 0.591) and, at lumbar level, negative correlations for tone and stiffness ( - 0.385 < r < -0.590) and positive correlations for viscoelastic properties (0.564 < r < 0.719), with BMI. This indicated that between-sexes differences of lumbopelvic MMPs depend on the specific location of assessment in healthy non-obese young individuals. Women show higher tone and stiffness and lower elasticity and viscoelasticity than men, at PF level.
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Affiliation(s)
- Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain
| | - Azahara Casas-Castro
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - María Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Juan Luis Garrido-Castro
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071, Córdoba, Spain
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain.
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain.
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Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe. Diagnostics (Basel) 2023; 13:diagnostics13061158. [PMID: 36980466 PMCID: PMC10047914 DOI: 10.3390/diagnostics13061158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
The pelvic floor dysfunction (PFD) has become a serious public health problem. Accurate diagnosis of regional pelvic floor muscle (PFM) malfunctions is vitally important for the prevention and treatment of PFD. However, there is a lack of reliable diagnostic devices to evaluate and diagnose regional PFM abnormality. In this work, we developed a multifunctional evaluation technology (MET) based on a novel airbag-type stretchable electrode array probe (ASEA) for the diagnosis of malfunctions of regional PFM. The inflatable ASEA has specifically distributed 32 electrodes along the muscles, and is able to adapt to different human bodies for tight contact with the muscles. These allow synchronous collection of high-quality multi-channel surface electromyography (MC-sEMG) signals, and then are used to diagnose regional PFM malfunctions and evaluate inter-regional correlation. Clinical trial was conducted on 15 postpartum stress urinary incontinence (PSUI) patients and 15 matched asymptomatic women. Results showed that SUI patients responded slowly to the command and have symptoms of muscle strength degeneration. The results were consistent with the relevant clinical manifestations, and proved the reliability of MET for multifunctional PFM evaluation. Furthermore, the MET can diagnose malfunctions of regional PFM, which is inaccessible with existing technology. The results also showed that the dysfunction of PSUI patients is mainly located in iliococcygeus, pubococcygeus, and urethral sphincter regions, and there is a weak correlation between these specific regions and nearby regions. In conclusion, MET provides a point-of-care diagnostic method for abnormal function of regional PFM, which has a potential for the targeted point-to-point electrical stimulation treatment and PFD pathology research.
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Asymmetries of the Muscle Mechanical Properties of the Pelvic Floor in Nulliparous and Multiparous Women, and Men: A Cross-Sectional Study. Symmetry (Basel) 2022. [DOI: 10.3390/sym14102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to identify if the muscle mechanical properties (MMPs) of both sides of pelvic floor muscles (PFMs) are symmetrical in different populations of both sexes. Between-sides comparisons of MMPs of PFMs, assessed with manual myotonometry, were performed in three groups, with 31 subjects each, composed of healthy nulliparous women (without any type of delivery or pregnancy), multiparous women (with at least two vaginal deliveries), and healthy adult men. Intra-group correlations between MMPs and age, body mass index (BMI), or clinical state of pelvic floor were also obtained. The nulliparous women and the men showed no between-sides differences in any MMP of PFMs. However, the multiparous women showed that the right side displayed less frequency (−0.65 Hz, 95% CI = −1.01, −0.20) and decrement (0.5, 95% CI = 0.11, 0.01), and more relaxation (1.00 ms, 95% CI = 0.47, 1.54) and creep (0.07 De, 95% CI = 0.03, 0.11), than the left side. Further, MMPs were related to age, sex, and BMI, also depending on the population, with the multiparous women being the only group with some between-sides asymmetries, which in this case were positive and of fair intensity for the left side of the PFMs, between BMI, and frequency and stiffness (rho Spearman coefficient: 0.365 and 0.366, respectively). The symmetry of MMPs of the PFMs could depend on the subject’s condition. Multiparous women show a higher tendency to asymmetries than nulliparous women and men, which should be considered in research and clinical settings.
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Carmona-Pérez C, Rodrigues-de-Souza DP, Fernández-de-las-Peñas C, Alburquerque-Sendín F. Influence of Spinal Movements Associated with Physical Evaluation on Muscle Mechanical Properties of the Lumbar Paraspinal in Subjects with Acute Low Back Pain. Diagnostics (Basel) 2022; 12:diagnostics12020302. [PMID: 35204392 PMCID: PMC8870934 DOI: 10.3390/diagnostics12020302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
This research aimed to identify changes in muscle mechanical properties (MMPs) when a standardized sequence of movements is performed and to determine the influence of acute low back pain (LBP) and age on the MMPs. Socio-demographic, clinical variables and MMPs were collected in 33 patients with LBP and 33 healthy controls. A 2 × 2 × 2 (group × age × time) analysis of variance (ANOVA) mixed model was used to determine the effect of the study factors on the different MMPs. There were no significant triple interactions. After the movements, tone and stiffness increased 0.37 Hz and 22.75 N/m, respectively, in subjects <35 years, independent of their clinical status. Relaxation showed differences by age in healthy subjects and creep in LBP subjects. Furthermore, elasticity was higher in <35 years (p < 0.001) without the influence of any other factor. In conclusion, sequenced movements can modify tone and stiffness as a function of age, while age-associated changes in viscoelastic characteristics depends on pain but not on movements. The MMPs should be assessed, not only at the beginning of the physical examination at rest, but also along the patient’s follow-up, depending on their pain and age, in a clinical setting.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-914-888-884; Fax: +34-914-888-957
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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