ABSTRACT
BACKGROUND: Alterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated. METHODS: Participants aged 9-18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs. FINDINGS: Children with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (ß = 31.02, p = 0.04). INTERPRETATION: These new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.
Subject(s)
Charcot-Marie-Tooth Disease , Humans , Adolescent , Child , Charcot-Marie-Tooth Disease/rehabilitation , Cross-Sectional Studies , Vibration , FootABSTRACT
The present study seeks to systematize morphological and morphometrical parameters and brings new data on the main branch of the lumbosacral plexus i.e., sciatic nerve in Wistar rats aged four and seven weeks. Sixteen female were divided into two groups, namely animals aged four weeks, and animals aged seven weeks. The specimens were studied at proximal and distal segments of the right hind limb sciatic nerves. Semi-thin transverse sections (0.25 µm thickness) were stained with 1 % toluidine blue, and the morphometric analysis was processed through the KS 400 software. Except for the number of fascicles and fascicular diameter, no differences were found between the proximal and distal segments. We observed differences when morphometric values were compared between 4- and 7- week old animals, with some exceptions (number of fascicles and myelinated fibers, and capillary area and number). The macroscopic data disagree with a previous description of the sciatic nerve being composed by two fascicles. Instead, sciatic nerve's only fascicle trifurcates or quadrifurcates at the distal third of the thigh. The total capillary area and density were calculated, and these are the first referential data for the sciatic nerve. Histograms of myelinated fiber and axons considering the animal ages were built. The results presented here are important because experimental studies, mainly studies on nerve regenerations require comparison with normal reliable data.
El objetivo fue sistematizar los parámetros morfológicos y morfométricos y traer nuevos datos sobre el ramo principal del plexo lumbosacro - es decir nervio ciático - en ratas Wistar de 4 a 7 semanas. Dieciséis ratas fueron divididas en dos grupos, con 4 y 7 semanas de edad. Las muestras estudiadas fueron los segmentos proximal y distal del nervio ciático derecho. Secciones delgadas (espesor 0,25 mm) fueron teñidas con azul de toluidina al 1 % y el análisis morfométrico se llevó a cabo utilizando el programa KS 400. Excepto para el número de fascículos y diámetro fascicular, no se encontraron diferencias entre los segmentos proximal y distal. Fueron observadas diferencias cuando se compararon los valores morfométricos entre animales de 4 y 7 semanas, con algunas excepciones (número de fascículos y fibras mielinizadas, área y número de capilares). Los datos macroscópicos no están de acuerdo con la descripción anterior del nervio ciático siendo compuesto por dos fascículos. En cambio, sólo trifurcación o cuadrifurcación fueron encontrados en el tercio distal del muslo. El área total capilar y la densidad fueron calculadas y estos constituyen los primeros datos de referencia para el nervio ciático. Se construyeron histogramas de fibras mielínicas y axones, teniendo en cuenta las edades de los animales. Los resultados presentados aquí son importantes porque los estudios experimentales, en especial aquellos sobre la regeneración nerviosa, requieren comparación con datos confiables normales.