PubMed Health⌕ Search

PubMed · 11415747

The relationship between elbow flexor volume and angular stiffness at the elbow.

Abstract

OBJECTIVE: The purpose of this experiment was to determine if a correlation exists between the volume of the elbow flexors and angular stiffness at the elbow, and to determine the contribution of the biceps brachii and the brachialis muscles to angular stiffness. DESIGN: This study is a descriptive, correlational study and presents a graphical model of the passive properties of muscle. BACKGROUND: The correlation between arm volume and angular stiffness has been shown, but the measurement of arm volume was not specific to the structures being strained. Pre-positioning a bi-articular muscle by stretching over one joint decreases the range of motion at the other joint and may affect the stiffness. METHODS: Angular stiffness at the elbow of 14 female and 15 male volunteers was measured, and the volume of the elbow flexors was calculated from compounded ultrasound imaging. Initial biceps length was set by pre-positioning the shoulder in two different positions. RESULTS: A significant linear relationship was observed between the slope of phase 1 of the stiffness curve and volume of the elbow flexors in both horizontal flexion (r = 0.92) and horizontal extension (r = 0.79) of the shoulder. Phase 2 of the stiffness curve showed no linear relationship to muscle volume in either shoulder position (flexion, r = 0.22; extension r = 0.33). The slopes of phases 1 and 2 were significantly greater with the shoulder in horizontal extension than in horizontal flexion. CONCLUSION: The volume of the elbow flexor muscles is a good predictor of angular stiffness in phase 1 of the curve. A model of the additive contribution of the biceps and brachialis muscles is presented to account for the increased stiffness in the shoulder extended position. RELEVANCE: Recognition of the correlation between muscle volume and stiffness, coupled with understanding that pre-positioning a bi-articular muscle may affect muscle stiffness may aid the clinician in accurately assessing muscle stiffness in patients with connective tissue disorders, neurological dysfunction and contractures.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Gary S. Chleboun, John N Howell, Robert R Conatser, Jeffrey J Giesey. 1997. The relationship between elbow flexor volume and angular stiffness at the elbow.. https://doi.org/10.1016/s0268-0033(97)00027-2

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Effectiveness of high-dose versus standard-dose influenza vaccines against hospitalisation according to frailty risk: a prespecified analysis of the randomised trial DANFLU-2.

BACKGROUND: Frailty is a major risk factor for influenza-related complications and can influence vaccine effectiveness. We aimed to assess the relative vaccine effectiveness (rVE) of high-dose (HD-IIV) versus standard-dose inactivated influenza vaccine (SD-IIV) in older adults aged 65 years or older according to frailty risk. METHODS: This study was a prespecified analysis of DANFLU-2, an open-label, individually randomised trial, conducted in Denmark during three consecutive influenza seasons (2022-23, 2023-24, and 2024-25). Adults aged 65 years or older were randomised (1:1) to the HD-IIV or SD-IIV group. The primary endpoint was hospitalisation for influenza or pneumonia. Frailty was defined according to the validated Hospital Frailty Risk Score (HFRS) based on ICD-10 codes within 10 years before randomisation. Participants were stratified into three HFRS categories, namely low (<5 points), intermediate (5-15 points), and high (>15 points) frailty risk. The rVE of HD-IIV versus SD-IIV against the primary endpoint was assessed across prespecified HFRS categories and treating HFRS as a continuous variable. Pearson's chi-square test was used to compare safety events across frailty risk groups and randomisation groups. FINDINGS: Among 332&#x2009;438 randomised participants (mean age 73&#xb7;7 years [SD 5&#xb7;8]; 161&#x2009;538 [48&#xb7;6%] were female), 276&#x2009;173 (83&#xb7;1%) had low frailty risk, 52&#x2009;395 (15&#xb7;8%) had intermediate frailty risk, and 3861 (1&#xb7;2%) had high frailty risk. The primary endpoint of hospitalisation for influenza or pneumonia occurred in 1424 (0&#xb7;5%) of 276&#x2009;173 participants with low frailty risk, 761 (1&#xb7;5%) of 52&#x2009;395 with intermediate frailty risk, and 163 (4&#xb7;2%) of 3861 with high frailty risk (relative risk [RR] for intermediate vs low frailty risk 2&#xb7;8 [95% CI 2&#xb7;6-3&#xb7;1]; RR for high vs low frailty risk 8&#xb7;2 [7&#xb7;0-9&#xb7;6]). HFRS as a continuous variable significantly modified the effect of HD-IIV versus SD-IIV against the primary endpoint with higher rVE estimates with increasing HFRS (pinteraction=0&#xb7;020). The rVE was 0&#xb7;2% (95% CI -10&#xb7;8 to 10&#xb7;2) among those with low frailty risk, 13&#xb7;1% (-0&#xb7;4 to 24&#xb7;8) among those with intermediate frailty risk, and 19&#xb7;9% (-10&#xb7;3 to 42&#xb7;1) among those with high frailty risk. No significant interaction was observed when HFRS was assessed according to the prespecified categorical frailty groups (pinteraction=0&#xb7;17). The proportion of participants with at least one serious adverse event increased across frailty risk groups (13&#x2009;366 [4&#xb7;8%] of 275&#x2009;795 for low frailty risk, 5475 [10&#xb7;5%] of 52&#x2009;315 for intermediate frailty risk, and 777 [20&#xb7;2%] of 3850 for high frailty risk; p<0&#xb7;0001), with similar proportions of serious adverse events in the HD-IIV and SD-IIV groups for each frailty risk group. INTERPRETATION: Among adults aged 65 years or older in Denmark, frailty risk might modify the effects of HD-IIV versus SD-IIV against hospitalisation for influenza or pneumonia, with higher rVE estimates with increasing frailty risk. These findings might support considering high-dose influenza vaccines for frail older adults. However, effect modification was not evident when frailty was assessed using prespecified categorical subgroups, and subgroup-specific estimates were imprecise, with 95% CIs crossing the null. These results should be considered exploratory, warranting further investigation. FUNDING: The DANFLU-2 trial was funded by Sanofi.

Journal Article↗