1,721,125 research outputs found
Rehabilitative ultrasound imaging of the lumbar multifidus muscle: measuring morphology
No full textWhat Is Known?The lumbar multifidus muscle has been characterized using rehabilitative ultrasound imaging (RUSI) in normal populations, and people with spinal pathology. The reliability1, and validity of the technique have been demonstrated. Morphological features quantified for multifidus include cross-sectional area (CSA), linear dimensions (muscle depth/thickness and width) and shape ratios, with normal reference ranges established. Multifidus shape at the fourth lumbar vertebra (L4) is usually round or oval but a triangular muscle may indicate hypertrophy. At L5 the muscle usually appears triangular due to the shape of adjacent bonysurfaces.Linear dimensions are predictive of CSA but the strength of this relationship is influenced by regularity of shape and wasting. The CSA is symmetrical sides) in normal populations and marked asymmetry occurs with acute low back pain (LBP)5 and idiopathic scoliosis.6 Recovery of size after LBP is not automatic and requires specific rehabilitation of multifidus. Size measurements and description of shape are potentially useful for clinical evaluation, and research into the effects of pathology and interventions.What Is Unknown?While data on multifidus morphology are increasing, different normal populations need to be studied to document the effects of factors such as ethnicity and habitual physical activity, particularly in sporting groups.Size is highly correlated with strength in some muscles but this relationship is difficult to quantify in multifidus, as isolated force cannot be measured. The relationship between changes in muscle thickness and electrical activity is also unknown. The quality of the image can be poor in the presence of spinal pathology and in older people, possibly due to infiltration of fat and other noncontractile tissue, which needs to be quantified. The mechanism of wasting and whether it is a cause or effect of injury are unknown.What Are the Future Directions and Research Priorities?If RUSI is to become a routine aid to physical therapy practice and a robust research tool, standardized protocols for obtaining measurements are needed. The validity of using linear measurements to assess the CSA of irregularly shaped muscles requires attention. Comprehensive studies of different normal populations are needed to generate reference databases for assessing changes due to pathology and effects of interventions. Longitudinal epidemiological studies of multifidus are needed to determine those at risk of developing LBP, whether wasting occurs before the onset of injury/pain and to help elucidate the mechanisms of wasting. The contribution of noncontractile tissue to CSA needs to be quantified to determine true muscle size, particularly with pathology and aging. The sonographic technique of elastography is potentially useful for distinguishing the biomechanical behavior of these tissues
Physical management in neurological rehabilitation: 2nd edition
No full textProvides a comprehensive introduction to the basic concepts of neurology, specific neurological conditions and the related PT treatment approaches used in neurological rehabilitation.ContentsSection 1. Basic Concepts in Neurology
Applied neuroanatomy and neurophysiology Normal motor control. Medical diagnosis of neurological conditions. Principles of physiotherapy assessment and outcome measures. Abnormalities of muscle tone and movement. Plasticity
Section 2. Neurological and Neuromuscular Conditions
Stroke. Brain injury. Spinal cord injury. Peripheral nerve injuries. Multiple sclerosis. Parkinson's disease. Huntington's disease. Disorders of nerve I: Motor neurone disease. Disorders of Nerve II: Polyneuropathies. Disorders of muscle.
Section 3. Lifetime Disorders of Childhood Onset
General introduction to paediatric neurology. Developmental neurology. The cerebral palsies and motor learning disorders. Neural tube defects: Spina bifida and hydrocephalus. Muscle disorders in childhood
Section 4. Treatment Approaches to Neurological Rehabilitation
Theoretical basis of treatment concepts. Musculoskeletal treatment concepts applied to neurology. 1. Adverse neural tension. 2. Muscle imbalance. Specific treatment techniques . Physical management of abnormal tone and movement. Pain management in neurological rehabilitation. Clinical psychology in neurological rehabilitation. Glossary of drug treatments in neurological rehabilitation
A comparison between the acromion marker cluster and scapular locator techniques for measuring scapular kinematics during upper limb elevation and lowering
No full textThe aim of the present study was to compare scapular kinematics whilst using the ‘silver standard’ scapular locator (SL) method and the acromion marker cluster (AMC) method during arm elevation and, for the first time, the lowering phase. Participants completed arm elevation and lowering in the sagittal plane to 5 discrete angles (0°, 30°, 60°, 90°, 120°). At each angle, concurrent SL and AMC recordings of scapular position were made using a Vicon MX T-series motion analysis system. There was no significant difference (p>0.05) between methods for scapular internal and upward rotation (max mean differences of -1.6°±5.7 and 2.2°±5.0) during both arm elevation and arm lowering. There was a significant difference (p=0.03) between methods for posterior tilt during both elevation and lowering phases (max mean difference = 5.7°±8.0). The AMC method for measuring scapular kinematics is comparable to the ‘silver standard’ SL method for internal rotation and upward rotation when measuring scapular kinematics during both arm elevation and lowering
Managing faecal retention and incontinence in neurodisability
No full textThe large number of patients with faecal retention and/or incontinence in continuing care wards and rehabilitation units presents a considerable challenge. In order to maintain dignity and minimize the unpleasant odour so commonly associated with these wards and units, effective bowel management should be planned for individual patients. For an effective bowel management regime a team approach should be adopted, involving, where possible, the patient and carer as well as all the health professionals administering the care. Two case studies illustrate the use of assessment and management of bowel problems in patients with severe complex neurodisability. Bowel dysfunction in this patient population, in general, is poorly covered in the literature. The present article, by relating theory to practice, offers information and guidance for nurses working with patients who have bowel-related problems
Testing muscle tone and mechanical properties of rectus femoris and biceps femoris using a novel hand held MyotonPRO device: relative ratios and reliability
No full textPurpose: To use a novel, non-invasive hand held device (MyotonPRO) to quantify ratios of relative non-neural tone and mechanical properties of the rectus femoris (RF) and biceps femoris (BF) muscles, and to assess reliability of a novice user.Relevance: The device offers rapid, objective testing of mechanical parameters of muscle in clinical or sports settings.Participants: 21 healthy males (20-35 years)Methods: Relaxed muscle parameters of RF and BFwere obtained using the MyotonPRO. The device applies a brief mechanical impact, producing muscle oscillations from which tone (state of intrinsic tension, indicated by frequency [Hz]) and mechanical properties of elasticity (logarithmic decrement) and stiffness (N/m) are measured. Data were collected on two days, one week apart. Two series of 10 single measurements on each muscle were used to test within-day reliability. The mean of the two sets was used for between-day reliability. Analysis: The relative parameters between RF and BF were expressed as a ratio. Reliability was assessed using intra-class correlation coefficients (ICCs).Results: The mean (±SD) RF:BF ratios for resting muscle were: frequency 1:0.96 (±0.05), decrement 1:1.10 (±0.17) and stiffness 1:0.95 (±0.07). Reliability of all three parameters was excellent within-sessions (ICCs 3,2 >0.99) and good between-days (ICCs 3,1 0.72-0.87).Conclusions: The relative resting tone and mechanical properties of RF and BF has been characterised in young males, with ratios close to 1:1. Measures made by a novice user were reliable, indicating that the MyotonPRO has the potential for assessing changes in muscle properties objectively over time. Studies are needed in large healthy cohorts of different ages, activity levels and genders to produce reference data for assessing patients.Implications: The relative tone and mechanical properties of RF and BF could potentially be used as a rapid method for assessing risk of injury is sporting populations and presence of abnormality in musculoskeletal and neurological conditions, once normal values have been established in relevant groups
Assessment of knee kinematics and kinetics during gait in healthy older people using optimised motion capture and musculoskeletal modelling
No full textMuscle strength, functional endurance and health related quality of life in active older female golfers
No full textBackground: Grip strength is a reliable predictor of whole body strength in older adults, but muscle characteristics of people with different activity levels have not been studied previously. The present study examined the relationship between grip strength (GS), quadriceps peak torque (QPT), functional endurance, and health-related quality of life (HRQoL) in older female golfers.
Methods: Twenty-nine healthy female golfers (mean age 69.1 years, SD 3.4) participated. The ISOCOM and JAMAR dynamometers were used to assess QPT and GS, respectively. Functional endurance tests included 1-min sit-to-stand test (1MSTS), 30-s wall press (30SWP), and 2-min stair climb (2MSC). HRQol was assessed using the SF-36 questionnaire.
Results: Mean GS and QPT were 27.5 ± 4 kg/f and 103.7 ± 25.1 N m, respectively. Mean scores for the 1MSTS, 30SWP, and 2MSC were 31 ± 7.7, 17.4 ± 3.5, and 237.5 ± 48.6 repetitions, respectively. GS was moderately correlated with QPT (r = 0.44), 1MSTS (r = 0.36), and 2MSC (r = 0.36), but had weak correlation with 30SWP (r = 0.003). Moderate correlation was observed between quadriceps peak torque and the 1MSTS (r = 0.50; p = 0.01), 2MSC (r = 0.44; p = 0.02) and 30SWP (r = 0.33). 30SWP and 2MSC had moderate correlations with PF r = 0.41 (p = 0.03) and r = 0.61 (p < 0.0005) and general physical well-being r = 0.47 (p = 0.01) and r = 0.39 (p = 0.04), respectively.
Conclusion: Quadriceps strength was more closely associated with functional endurance than grip strength. A single strength measure may not reflect overall muscle characteristics in active older females, and hence, assessment of both upper and lower limb strengths may be appropriate
Reliability and symmetry of Myoton-Pro measurements of viscoelastic properties of biceps brachii in young adult males
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