Biomedical subjects
Publications and source records attributed to G Tardieu.
Studies in animals and in children with cerebral palsy (CP) allow precise evaluation of the physiologic and pathophysiologic adaptations in muscle and tendon. In the individual child with CP, clinical evaluation must be much more precise than a routine examination in order to clearly define the nature of the contractures and select the correct therapeutic program.
Soleus muscle has, to as great an extent as possible, been functionally isolated in man. A device previously described permitted measurement of the soleus torque as a function of the tibia-calcaneum angle, and not as a function of tibia-foot angle. This latter angle cannot be correctly related to soleus length, since the arch of the foot can not be considered as rigid throughout the experiment. Ankle movements were performed on a horizontal plane by successive increments of 5 degrees from full extension (plantar flexion) up to full flexion (dorsiflexion). Passive torques were measured for every angle. At the same angles, the total torques were recorded while the subject exerted a voluntary constant contraction which corresponded to 45% of the maximum integrated electromyographical activity of soleus muscle. The active torque-angle curve was obtained by subtracting, for the same angle, the passive from the total torques. It must be stressed that, when the muscle is maximally shortened, little or no torque was measured. For the angle corresponding to the top of the sub-maximal active curve (integrated electromyographic activity 45% of the maximum), the passive torque was about 1.75 Nm and showed no significant interindividual variations. This result contrasted with the marked interindividual shifts which affect both passive and active curves. This interdependence of passive and active curves in human soleus muscle is compatible with the results of a previous study in the cat showing the concomitant adaptations of sarcomere number and connective tissue length.
A decrease in sarcomere number and hypoextensibility of ankle extensors was observed in certain children with congenital cerebral lesions. This phenomenon was reproducible and reversible in normal animals, i.e. trophic regulation adapted the muscle to the imposed length. The form of the torque-ankle angle curve was studied in 30 children. Its modification after treatment was considered as a sign of muscle adaptation. This adaptation was present in one group of 14 children. The steepness of the curve increased or diminished depending on the initial disorder and the treatment administered. In another group, treatment failed to modify the shape of the curve. In certain cases trophic regulation of the muscle appeared to be absent.
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Clinical assessment of equinus in children before and after operation was made over a twenty-year period (1958-1978), and three groups were defined. Forty-three muscles (Group I) had abnormal shortening without spasticity and the deformity progressed steadily despite immediate improvement after operation; this was considered to be the result of a lack of muscle growth during bone growth. Forty-one muscles (Group II) had both shortening and spasticity with an imbalance which might be unchanged after operation, or reversed or improved. Fourteen muscles (Group III) had spasticity only and progression was unpredictable and could not be defined. Improvement in gait was regularly observed in Group I in the early years after operation. In Groups II and III the results were variable. These results did not depend on surgical technique but on differences in pathophysiology.
Previous papers gave some methods for the reliable measurement of the tibia-calcaneum angle. It is of common use to evaluate the physical properties of triceps surae on the basis of torque-angle curves. However this method is reliable only if each tibia-calcaneum angle corresponds to a defined distance between the insertions of the muscle in subjects of the same height. Evidence is given by radiological measurements that this correspondance is correct in normal children. However, this is no longer true in certain cerebral palsied children because of abnormal translation of the calcaneum and/or abnormal ratio of bone sizes. In this case the torque-angle curves do not define properly the torque-length curves. A method of correction is given. This correction may be as high as 15 degrees.
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Sarcomere number and sarcomere length were studied in six groups of kittens ranging in age from 10 minutes to 5 months and compared with those of adult cats. Although the soleus muscle is a slow contracting muscle and the tibialis anterior a fast contracting muscle, both have previously been shown to have the same range relative to ankle movement. For a given angle of articulation the sarcomere length was found to be the same at all ages except perhaps for the newly born. In contrast, the sarcomere number differed considerably, being much higher in the older animals. The relationship between active tension and muscle length was also measured, and again no difference was found between the muscles at any age, although the shape of the curves for the soleus and tibialis anterior was different.
1. The apparatus and method described give the relationship of triceps surae torque to the absolute tibio-tarsal angle. Data of the anatomy of the foot and the axis of the ankle are taken into consideration. They make complementary measurements necessary, which in certain cases enable the angle recorded by the apparatus to be corrected so as to obtain the true angle. 2. The reliability of the apparatus and the technique of linkage of subject to apparatus are judged by examination of the torque-angle plots obtained by passive stretching of the triceps in 7 subjects for whom correction is monor. Good reliability was observed during the session and from one session to another. The plot is exponential. The merits of the method of correcting angles are illustrated in three subjects with the same protocol: when plots are not corrected, they are more dispersed during the session and no longer exponential. These results justify the considerable correction of the angle that we propose in the study of isometric contractions.
1. Physiological and histological data were obtained from soleus and tibialis anterior muscles of normal adult cats to study to what extent fibre length and sarcomere number varied between animals and how this was related to the physiological characteristics of the muscles. 2. For a given muscle, the variation in the sarcomere number of individual muscle fibres between animals was found to be about 25%. These difference could partly be explained by comparing the number of sarcomeres and the length of the fibula, which was chosen as an index of the size of the animal. The average sarcomere number in the tibialis anterior muscle was about 60% greater than in the soleus. The variations between animals and between the anterior tibialis and soleus muscles were significantly greater than the variations observed within the same muscle. 3. The sarcomere length is dependent upon the articular angle, that is to say, the length change imposed on the muscle. These length changes are more extensive in the soleus muscle (100%) than in the tibialis anterior muscle (60%). A very significant correlation was found between articular angle and sarcomere length (for soleus r = 0.98, for tibialis anterior r = 0.94). 4. Although fibre length did vary considerably within a given muscle, the sarcomere length showed only minor variations at any given angle. This suggests that sarcomere number is determined in each individual muscle fibre. Such an adaptation implies a concomitant adaptation of the tendinous part of the fibre. This adaptation, resulting in definite sarcomere length at a definite angle, has obvious physiological implications. 5. Conventional length vs. active tension curves were established for the soleus and the tibialis anterior muscles. It is suggested that the difference between the sarcomere number of the two muscles may result in the difference between the shape of curves of these two muscles. 6. Active torque-angle curves were established for the two muscles in situ. The shapes of the curves for soleus and tibialis anterior are similar in spite of the different mechanical conditions of the two muscles. This fact helps to explain why the two muscles, despite their similar articular range, had very different sarcomere number.
1. The effects of denervation on the response of the cat soleus muscle to immobilization at different lengths by plaster casts has been investigated for a period of 4 weeks.2. The passive length-tension properties of the denervated immobilized muscles were not significantly different from those of non-denervated muscles. Muscles immobilized in the shortened position showed a marked decrease in extensibility whether they were denervated or not. In all the other cases the length-tension curves were not significantly differetn from those of normal muscles.3. The denervated soleus muscle immobilized in the lengthened position was found to produce 25% more sarcomeres in series, whilst those immobilized in the shortened position lost 35%. This adaptation was essentially the same as in muscles that had been immobilized but not denervated.4. Denervation was found to have no effect on the recovery of muscles that had been subjected to 4 weeks immobilization in the shortened position. In these muscles the sarcomere increased back to the normal level within 4 weeks after removal of the plaster cast.5. The adjustment of sarcomere number to the functional length of the muscles does not therefore seem to be directly under neuronal control. It appears to be a myogenic response to the amount of passive tension the muscle is subjected to.
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1. Passive length-tension curves were established for cat soleus muscles that had been immobilized in different positions. Muscles that had been immobilized in the lengthened position showed no difference in their length-tension properties to those of normal muscles. However, those immobilized in the shortened position showed a considerable decrease in extensibility.2. Muscle fibre length, sarcomere length and the total number of sarcomeres along single teased fibres were also determined for muscles immobilized in different positions. Soleus muscles immobilized in the lengthened position were found to have 20% more sarcomeres in series than normal muscles whilst those immobilized in the shortened position had 40% less than normal muscles.3. When the plaster casts were removed from muscles that had been immobilized in the shortened position, the length-tension curves and sarcomere number returned to normal within 4 weeks. Muscles that were immobilized in a shortened position and then immobilized in a second position were found to rapidly adjust to the second position with respect to their passive length-tension properties and sarcomere number.4. A change in the number of sarcomere in series seems to be the way in which the sarcomere length of the muscle is adjusted to its new functional length. The change in the length-tension properties which accompanies a decrease in sarcomere number appears to be the mechanism which prevents the muscle from being overstretched.
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