Punctual mechanical oscillation in modulation of muscular tonus in children with spasticity

Spasticity is a motor condition present in 75 to 88% of children with Cerebral Palsy (CP). One form of treatment is called punctual mechanical oscillation (PO). The current study aimed to study different protocols for the application of PO and the magnitude of their effects. In total, 7children with medical diagnosis of CP and ICD (International Classification of Diseases) were included. The first intervention protocol (Int1) consisted of the application of PO to the spastic muscle tendon and the second intervention protocol (Int2) to the muscle belly ofthe spastic antagonist muscle. For evaluation, the Modified Ashworth Scale (MAS) was used, while simultaneously capturing the mechanomyography (MMG) signals. Data were collected pre-intervention and 1 (Post1), 15 (Post15), 30 (Post30), 45 (Post45), and60 (Post60) minutes after the interventions. The MAS values (median ± interquartile range) post intervention were statistically lower when compared to the pre values in the 2 protocols studied; in Int1between Pre (2 ± 0) andPost15 (0 ± 1.75), Post30 (0 ± 1), Post45 (1 ± 1),and Post60 (1 ± 1), and in Int2only between Pre (2 ± 1) and Post1 (0 ± 1).The values found in the MMG in both its temporal and spectral domains did not follow a pattern (p>0.05). The comparison between the protocols did not demonstrate statistical differences in any characteristics (MAS, MMGMF, and MMGRMS). However, PO was shown to be a therapeutic resource that modulated spasticity for up to 60 minutes after its application, and PO could contribute as a tool to aid the treatment of spasticity.

Morphometric analysis of palmaris longus muscle belly and its tendon: a cadaveric study in north india

Background: The Palmaris Longus Muscle is the first option in tendon graft procedures, for it fulfills the necessarycriteria of length, breadth and easy surgical accessibility. Therefore, the present study was performed with thepurpose to determine the morphometry of PL in North Indian population.Materials and methods: Material for the present study consisted of 40 limbs of different age group andsex(28Males&12Females). The limbs were made available in the Anatomy department for dissection purpose atSGRDIMSAR, Amritsar, Punjab. The length and width of the PL-Muscle Belly(PL-MB) and PL-Tendon(PL-T) weremeasured with the help of digital Vernier caliper. The unpaired t test was used to study the significance of thedifferences in male and females and right and left PLM.Results: The mean MBL and MBW of the PL was more (6.195+1.788cm & 2.095+0.723cm) on right side than(5.895+1.748cm & 1.920+0.740cm) on the left side. The mean TL on left side (15.690+1.336cm) was slightly morethan the right side (15.625+1.489cm) whereas TW on right side (0.435+0.099cm) was found to be slightly morethan the left side (0.426+0.108cm). It was also observed that the mean MBL, MBW, TL and TW was more in malecadavers as compared to female cadavers.Conclusion: PLM has importance in medical clinic, surgery, radiological analysis and has great significancewhen used as a donor tendon in reconstructive surgeries. Thus there are advantages to know the length and widthof the PL tendon for being the ideal choice for tendon graft procedures.

An Anatomical Study Of Gracilis Muscle & Its Role In Clinical Reconstruction Surgeries

Introduction: It is the most superficial of the adductor group of muscles. Gracilis muscle is used oftenly inreconstructive plastic surgery,because ofits reliable vascular and neurological pedicles and the minimal donorsite morbidity.Materials and Methods: The present study was conducted on 40 cadaveric lower limbs (22 males and 18 females)in the Deptartment of Anatomy of VIMS&RC.Metrical and non-metrical characteristics of gracilis muscle andvascular pedicles were analyzed.Results: All the parameter were more in males compared to females. distal tendon length was more than proximaltendon length. P value was significant in all the measurements. The ratios between various components ofmuscle remain fairly constant. Main vascular primary pedicle was arising from profund femoral artery in 60 %& 40% from Medial circumflex femoral artery .Presence of proximal secondary pedicle was only in 30% of thespecimens arising from profunda femoral artery or Medial circumflex femoral artery. Distal secondary pediclesarising from 5% of femoral artery.Conclusion: These parameters will help the reconstructive surgeon in assessing the length of muscle belly ortendon available for reparative procedures before undertaking surgery like Anterior Cruciate Ligament graft,Restoration of sphincteric function in anogenital area, Repair of ano-vaginal or recto-vaginal fistulas, Facialrehabilitation, Upper limb and lower limb defects, Groin wounds and autologous breast reconstruction.

A Novel Method for the Assessment of Muscle Injuries / 대한스포츠의학회지

Muscle injuries are very common in sports fields so diagnosis and prevention of them are as important as treatment in sports medicine. Many other devices for muscle diagnostics are provided, but non-invasiveness, cost, validity and reliability become a good measure of diagnosing and monitoring athletes. Tensiomyography (TMG) has been developed in the late 1980s to evaluate deficient muscle initially, and it was introduced into sports medicine and athletic training. It is a simple to use selective and non-invasive for measuring a skeletal muscle response. The method is based on the measurement of the radial displacement of muscle belly, which is caused by an electrical stimulator. The displacement is measured with an electric sensor which is connected to a computer system. It gives the information of maximal displacement of the belly (Dm) with following time parameters: delay time, contraction time (Tc), sustain time, and relaxation time. TMG studies usually focus on two common parameters: Tc and Dm. An increase in Tc indicates a muscle with a predominance of slow-twitch fibers. A decrease in Dm indicates an increase in muscle stiffness or tone. Other studies have been mainly associated with physiological characteristics of muscles, risk factors for muscle or ligament injuries, muscle fatigue, and muscle diseases such as multiple sclerosis. We think the application of TMG to the sports field can reduce the risk of sports injuries and increase performance of athletes. In medical field, it allows functional diagnosis of muscle strain, monitoring rehabilitation, and modifying treatment strategy effectively.

Evaluation and Application of Muscle Injuries Using Tensiomyography / 대한스포츠의학회지

Tensiomyography (TMG) is known as non-invasive method which assesses the muscular characteristics such as contraction velocity or maximal displacement of the belly. The aim of this study was to evaluate muscular responses by TMG after muscle injury and to introduce using TMG first in Korea. This study was performed with a subject who was diagnosed with muscular injury and consent measuring and following up TMG analyses. A female patient, who was diagnosed left hip adductor muscle strain, underwent magnetic resonance imaging (MRI) and TMG at intervals of two weeks. We obtained decreased in displace maximum (Dm, 4.14 vs. 5.69) and altered curve shape in the injured muscle at the initial TMG assessment in comparison to the non-injured side. After two weeks, MRI findings and symptom were improved and Dm in the injured side increased as in the non-injured muscle. These findings suggest that a decrease in Dm indicate increased in muscle stiffness after muscle injury, and an increase in Dm as in the non-injured side after two weeks indicate recovered status. TMG may be useful as a simple and non-invasive device for monitoring muscle function after muscle injury and during the recovery.

The anatomical study of the ratio of muscle belly length to the remaining length of tendon.

Electrode placement in electrotherapy in physical is very important. Two methods are commonly used, around motor point area or between the two ends of muscle belly. In order to get the best outcome from the stimulation, the approximation of the location of motor point which is about upper third has been presently used so far. The purpose of this study is to provide data base of the ratio between muscle belly length and the remaining length of tendon. The study was done in the muscle of both upper and lower extremities of cadavers. By using two methods of measurement: direct length between the origin-insertion and the actual along the course of muscle. It was found out there is no statistically significant differences.