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At least 919 records · Page 51Linked to original sources

PubMed1985

Duration of stretching effect on range of motion in lower extremities.

The duration of the effect of contract-relax stretching on range of motion (ROM) in the lower extremities was measured on eight male volunteers. The stretching procedure was performed as one isometric contraction, followed by relaxation and then a passive extension of the muscle being stretched. The treated muscle groups were the adductors, hamstrings, rectus femoris, iliopsoas, gastrocnemius, and soleus. The total stretching time was 15min. Six ROMs were tested 0, 30, 60, and 90min after the stretching procedure. There was a significant increase in hip abduction (+17% +/- 3), knee flexion (+4% +/- 1), hip flexion (+4% +/- 2), ankle dorsiflexion with knee flexed (+18% +/- 7), and ankle dorsiflexion with knee straight (+16% +/- 5). The increase remained for 90min for all ROMs except for ankle dorsiflexion with the knee straight.

Humans↗

PubMedDate not supplied

Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons.

PURPOSE: The purpose of this study was to evaluate active knee flexion range of motion and hamstring strength following hamstring anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Case control study, consecutive sample. METHODS: Seventy-four consecutive patients who had undergone hamstring ACL reconstruction underwent isokinetic muscle strength testing at 2 years post surgery. Measurements of the maximum standing active knee flexion angle with the hip extended were also taken. During isokinetic testing, we evaluated flexion torque at 90 degrees of knee flexion, in addition to the peak flexion torque. We further compared these parameters of muscle strength around the knee for the patients in whom only semitendinosus tendon was harvested as a graft source (ST group), and those from whom the semitendinosus tendon and the gracilis tendon were harvested (ST/G group). RESULTS: Isokinetic testing showed that, in both the ST and ST/G groups, the knee flexor strength of the involved leg was less effectively restored at 90 degrees of knee flexion than at the angle at which the peak torque was generated. Conversely, no significant difference was seen in the side-to-side ratio in either the peak flexion torque or the 90 degrees flexion torque between the groups. The side-to-side ratio in mean maximum standing knee flexion angle was significantly lower in the ST/G group than in the ST group. CONCLUSIONS: This study suggests that the loss of knee flexor strength following the harvest of the hamstring tendons may be more significant than has been previously estimated. Furthermore, multiple tendon harvest may affect the range of active knee flexion.

Adult↗

PubMed1993

MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings.

OBJECTIVE: The purpose of this study was to describe the musculoskeletal MR findings in childhood dermatomyositis and to correlate MR findings with indicators of disease activity such as muscle strength and serum levels of muscle enzymes. SUBJECTS AND METHODS: This prospective study included 24 children: 19 children with dermatomyositis and five control subjects. The diagnosis of dermatomyositis was established by clinical findings and serum levels of muscle enzymes in all patients, electromyography in six patients, and biopsy in four patients. At the time of the initial MR evaluation, patients were classified on the basis of clinical findings as having active (n = 15) or inactive (n = 4) disease. A total of 44 MR evaluations of patients with dermatomyositis were included in the study: 19 initial MR examinations and 12 examinations repeated after 4-6 months of therapy in patients with active disease. An additional 13 examinations were performed on five patients. Conventional T1-weighted (SE 600/20) and T2-weighted (SE 2500/80) spin-echo and fat-suppressed MR images were obtained. The T2-weighted images (TE = 80) were used for comparison. In addition to the visual assessment, ratios between the signal intensity of muscles (gluteus, adductors, quadriceps, and hamstrings) and the signal intensity of subcutaneous fat in the same tomographic section were calculated. RESULTS: All patients with clinically active disease (n = 15) had abnormal findings on MR studies, whereas those with inactive disease (n = 4) had normal MR findings. Signal-intensity ratios of patients with active disease were greater than those in control subjects, whereas the ratios in patients with inactive disease were not different from those in control subjects. After 4-6 months of therapy, the average signal-intensity ratios of treated patients with repeated MR evaluations (n = 12) differed from ratios obtained before therapy in the same patients, but were not different from the ratios in control subjects. Other MR findings observed were perimuscular edema, enhancement of the chemical-shift artifact, and inflammatory changes of subcutaneous fat. Fat-suppressed imaging enhanced visualization of abnormalities. Markedly abnormal signal intensities of muscle were associated with marked elevations of serum levels of muscle enzymes; however, abnormal MR findings were visualized with normal serum levels of muscle enzymes. CONCLUSION: Findings of active childhood dermatomyositis on T2-weighted MR images include increased signal intensity in affected muscle, perimuscular edema, enhanced chemical-shift artifact, and increased signal intensity in subcutaneous fat. After therapy, signal intensity of muscle returns to normal. These MR findings are enhanced on fat-suppressed images.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗

PubMed1994

Augmentation of transfers for a quadriplegic patient using an implanted FNS system. Case report.

A 22 year old man with incomplete quadriplegia (C6-7) was unable to perform either a sliding or a pivot transfer. He was instrumented with an implanted functional neuromuscular stimulation (FNS) system, radio frequency-linked to a belt-worn controller. The system activated eight muscles selected from among quadriceps, hamstrings, posterior portion of the adductor magnus, gluteus maximus, and erector spinae, bilaterally. The two-stage implantation procedure included electrode implantation with percutaneous leads followed by stimulator implantation and removal of the percutaneous leads. All implants were well tolerated with no adverse effects. The subject was able independently to put on the external controller portion of the system and to perform a standing pivot transfer with only standby assistance. An unexpected outcome of the FNS system use was increased voluntary upper body strength that resulted in improvement of the sliding transfer from 'inability' to 'independent'.

Adult↗

PubMedDate not supplied

Flexibility and anterior knee pain in adolescent elite figure skaters.

To investigate the relationship between thigh muscle flexibility and anterior knee pain in adolescent athletes, we examined 46 skaters. We taught them flexibility exercises and later retested 28 of them. Three fourths of the skaters who improved their quadriceps flexibility eliminated their pain. Two of the three skaters who lost flexibility developed pain. Analysis of all examinations showed that skaters with pain had tighter quadriceps muscles than those without pain. Poor hamstring flexibility was correlated with patellofemoral pain. This study shows that adolescent athletes may improve their flexibility after counseling and indicates a clear relationship between thigh muscle flexibility and anterior knee pain.

Adolescent↗

PubMed2001

Anterior positioning of tibia during motion after anterior cruciate ligament injury.

PURPOSE: The purpose of this study was to describe the sagittal tibial translation and EMG activity of muscles v. medialis and lateralis, gastrocnemius, and hamstrings, during common locomotion, in patients with an anterior cruciate ligament deficiency (ACL-def) and uninjured controls. METHODS: In 12 ACL-def patients and 17 controls, sagittal tibial translation was registered with the CA-4000 electrogoniometer during level walking, cutting, and stair walking. Tibial position at each flexion angle was expressed relative to the femuro-tibial position at passive knee extension. EMG activity, measured with ME-4000, was normalized to the individual maximum isometric voluntary contraction for each muscle. RESULTS: During the weight-bearing phase of motion, the tibia was anteriorly positioned in all legs. In the injured leg, the tibia translated more rapidly to an anterior position that was maintained for a longer time during the gait cycle. In the noninjured knees, motions with increased load lead to an increased anterior tibial translation in contrast to the injured knees, where the maximum displacement was already reached during level walking. The quadriceps and gastrocnemius muscles were simultaneously active during stance phase. Hamstrings were mainly active when the knee was close to extension and translation increased in spite of this activity. CONCLUSIONS: The mechanism of the anterior positioning of tibia is qualitatively similar in the normal and the injured knee, but that position is obtained much further forward in the ACL deficient knee. Quadriceps and gastrocnemius muscles seem to work synergistically to stabilize the knee by maintaining the anterior position of tibia during weight-bearing motion. The role of hamstrings to restrict anterior translation is questioned.

Adolescent↗

PubMed2006

Synergistic muscle activation during maximum voluntary contractions in children with and without spastic cerebral palsy.

We examined muscle recruitment patterns in children with cerebral palsy (CP) and comparison children without CP under conditions of maximum voluntary contractions. Three groups of children participated in the study: (1) 12 children with diplegic CP (eight males, four females; age range 4-10 y, mean age 7 y [SD 2 y 4 mo]); (2) six children with hemiplegic CP (four males, two females; age range 5-10 y, mean age 7 y 4 mo [SD 2 y]); and (3) 13 comparison children with normal motor function (seven males, six females; age range 4-11 y, mean age 7 y 2 mo, [SD 2 y]). The children with CP were classified according to the Gross Motor Function Classification System: eight were Level I, five were Level II, four were Level III, and one was Level IV. Surface electromyography was recorded from four proximal and distal lower extremity (LE) muscles. Children with CP more frequently activated a muscle other than the intended prime mover first, compared with the comparison children, especially when the prime mover was a distal muscle. For example, during ankle plantar flexion, when the lateral gastrocnemius muscle was the prime mover, children with hemiplegia showed preactivation of the tibialis anterior muscle and children with diplegia showed medial hamstring coactivation. In conclusion, children with CP showed considerable differences to the comparison children in how LE muscles were voluntarily activated. Greater understanding of muscle recruitment patterns under a variety of tasks may provide new directions for motor control retraining or other forms of intervention.

Cerebral Palsy↗

PubMed1992

[X-ray computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy].

X-rays computed tomographic (CT) scans of muscles of the lower limbs and the trunk in 14 patients with facioscapulohumeral muscular dystrophy (FSH) were studied. The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle. The CT scans in FSH demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others.

Adolescent↗

PubMed1988

An electromyography in spastic diplegia.

To evaluate the pathologic state accurately and objectively, fifteen patients with spastic diplegia were examined with surface electromyography (EMG) of the rectus femoris, medial hamstring, anterior tibial and gastrocnemius muscles. Seven showed disturbed reciprocal innervation (disturbed group) and 8 showed reciprocal innervation (non disturbed group). The disturbance of reciprocal innervation on EMG showed a positive correlation with delay in onset of crawling by 10 months (p less than 0.05), a low level of motor development (p less than 0.005) and more abnormal CT findings. Four patients in the disturbed group showed various abnormalities in X-rays of the hips. Surface EMG findings of crawling muscle may be useful for understanding the pathologic state of crawling in spastic diplegia.

Cerebral Palsy↗

PubMed1999

Heart failure-related myopathy. Clinical and pathophysiological insights.

AIMS: To evaluate the relationship of skeletal and respiratory muscular dysfunction with the degree of clinical severity, cardiac impairment and exercise intolerance in patients with chronic heart failure. METHODS AND RESULTS: Ninety-one patients (age 52.7+/-8 years) on standard therapy and in a stable clinical condition with normal nutritional status underwent evaluation of (1) clinical severity and metabolic status (NYHA class, weight, albuminaemia, natraemia, cortisol, insulin, neurohormones), (2) cardiac function (Echo, right heart catheterization), (3) exercise tolerance (peak VO(2)), (4) dynamic isokinetic forces of the quadriceps and hamstring (Cybex method), and respiratory muscle strength (maximal inspiratory and expiratory pressures). Fifty patients had a peak VO(2)<14 ml x kg(-1) x min(-1)(10.6+/-2) and 41 had values >/=14 (18.3+/-4). In the former group, leg and respiratory strength were significantly lower (extensors: 80+/-24 vs 100.9+/-22 Nm; flexors: 48.5+/-24 vs 75.3+/-22, both P<0.001; maximal expiratory pressure: 85.5+/-30 vs 104.8+/-31, P<0.01). Muscular strength was not related to indices of clinical severity, metabolic status, neurohormones or to the degree of systolic/diastolic cardiac function, but it was related to weight and age. Multivariate analysis of the peak VO(2)with clinical, haemodynamic and peripheral indicators showed weight (beta= 0.32, P = 0.007), muscular strength (beta= 0.32, P = 0.01) and NYHA class (beta= 0.31, P = 0.001) as the only independent predictors. The joint adjusted R(2)value was 0.48 (P<0.001). CONCLUSION: Muscular dysfunction is part of the syndrome of heart failure. Together with symptom perception, it predicts nearly half of the variation in exercise tolerance.

Female↗

PubMed1985

The growth of stability: postural control from a development perspective.

This study compared central nervous system organizational processes underlying balance in children of three age groups: 15-31 months, 4-6 years, and 7-10 years, using a movable platform capable of antero-posterior (A-P) displacements or dorsi-plantar flexing rotations of the ankle joint. A servo system capable of linking platform rotations to A-P sway angle allowed disruption of ankle joint inputs, to test the effects of incongruent sensory inputs on response patterns. Surface electromyography was used to quantify latency and response patterns. Surface electromyography was used to quantify latency and amplitude of the gastrocnemius, hamstrings, tibialis anterior, and quadriceps muscle responses. Cinematography provided biomechanical analysis of the sway motion. Results demonstrated that while directionally specific response synergies are present in children under the age of six, structured organization of the synergies is not yet fully developed since variability in timing and amplitude relationships between proximal and distal muscles is high. Transition from immature to mature response patterns was not linear but stage-like with greatest variability in the 4- to 6- year-old children. Results from balance tests under altered sensory conditions (eyes closed and/or ankle joint inputs altered) suggested that: (a) with development a shift in controlling inputs to posture from visual dependence to more adult-like dependence on a combination of ankle joint and visual inputs occurred in the 4- to 6-year-old, and reached adult form in the 7- to 10-year-old age group. It is proposed that the age 4-6 is a transition period in the development of posture control. At this time the nervous system (a) uses visual-vestibular inputs to fine tune ankle-joint proprioception in preparation for its increased importance in posture control and (b) fine tunes the structural organization of the postural synergies themselves.

Journal Article↗

PubMed1986

Gains in range of ankle dorsiflexion using three popular stretching techniques.

Among modern stretching techniques none has clearly been shown to be the most effective for increasing range of motion. The most common stretching method comparisons are between static stretching (SS) and one or more Proprioceptive Neuromuscular Facilitation (PNF) technique(s). The two most frequently implemented PNF techniques are: contract-relax (CR); and contract-relax-antagonist-contract (CRAC). Previous comparative investigations among stretching methods have primarily observed changes in straight-leg hip flexion as a result of lengthening the hamstrings, a two-joint muscle. The present study observed gains in range of motion among three stretching methods (SS, CR, CRAC) of a joint limited by a single joint muscle, the soleus. Twelve subjects performed each of the three methods on separate days. Significant differences were observed among all methods (p = .001). Further analysis revealed the CRAC method was superior to the CR method (p less than .01), and the CR method was superior to the SS method (p less than .01). Significant pre-post-treatment gains in range of motion were observed as a result of the CR and CRAC methods, but not the SS method. The results of this study support the findings of those previous investigations for two-joint muscles in which PNF techniques were more effective than static stretching for increasing range of motion. Also, a reciprocal activation (CRAC in the present study) was the most effective for increasing range of motion.

Adult↗

PubMedDate not supplied

Congenital subluxation of the knee--an anatomic dissection.

The knee of an infant born with congenital subluxation was dissected to delineate the pathology involved. The primary findings of importance included isolated fibrosis of the vastus intermedius muscle, absence of the gastrocnemius muscle, anterior displacement of the hamstrings and contracture of the anterior joint capsule. Comparison with previously described pathology is discussed.

Humans↗

PubMed1976

Electromyographic temporal analysis of gait: hemiplegic locomotion.

The telemetered electromyographic (EMG) activity of quadriceps, hamstrings, triceps surae and pretibial muscles on the affected side of 20 adult hemiplegic subjects was examined during locomotion. The subjects ranged in age from 29 to 68 years (mean, 52.1). Duration of the lesions ranged from 1 month to 8 years: in 11 subjects the duration of the lesions ranged from 1 to 9 months (mean, 4.9 months), and in the remaining 9 subjects from 1 to 8 years (mean, 4 years 2 months). Shoes with five microswitches, two in the heel and three in the sole, were used to correlate the EMG activity with eight specific components of the gait cycle. The results of the study showed a loss of the phasic pattern associated with normal locomotion. The hemiplegic subjects showed the greatest activity in the period of midstance. Expressed as a percentage of the total cycle, the mean stance time of the paretic lower limb was 67% and the mean swing time was 33%. The unaffected lower limb showed a stance phase of 80% and a swing phase of 20%.

Adult↗

PubMedDate not supplied

Effects of varying acceleration of platform translation and toes-up rotations on the pattern and magnitude of balance reactions in humans.

Different movement synergies used to restore balance in response to sudden support surface displacements have been described, which include the ankle movement synergy and a number of multisegmental movement synergies. The purpose of this study was to extend the analysis of the effects of stimulus magnitude on the pattern and scaling of balance reactions to larger magnitudes of balance disturbances, and to other types of balance disturbances, in particular, forward translations (FT), backward translations (BT), and toes-up rotations (RT). In addition, we examined whether the timing and magnitude of center of body mass (CM) displacement is an invariant feature of corrective responses to varying magnitudes of balance disturbances. Thirteen healthy adults were subjected to FT, BT, and RT of varying acceleration/velocity. The balance disturbance induced by FT and BT was fundamentally different from that induced by RT. The balance requirement during FT and BT was to rapidly translate the CM forward/backward to the new position within the displaced base of support. For RT, the requirement was to minimize the backward displacement of the CM. As evidenced from the initial phase of ankle, knee, and hip angular displacements and anterior-posterior (A-P) center of foot pressure displacement, the magnitude of the balance disturbance increased with increasing platform acceleration/velocity. For FT and BT, the present findings are consistent with the view that trajectory of CM is a control variable, as the timing, peak magnitude, and time to peak CM displacement did not vary as a function of platform acceleration/velocity. However, for RT, the peak magnitude and time to peak CM displacement did increase with increasing platform acceleration/velocity. The results demonstrate that in response to FT, BT, and RT, stability was restored by distinct multisegmental movement synergies. The corrective response to FT consisted of early knee flexion then ankle dorsiflexion and hip extension. The corrective response to BT consisted of hip flexion and ankle plantar flexion. For RT early hip flexion and knee flexion was observed. All muscles recorded (tibialis anterior, soleus, gastrocnemius, hamstrings, and quadriceps) were activated within a range of 60 to 170 ms from onset of platform displacement. For FT, BT, and RT, the pattern and timing of angular displacements and muscle responses did not vary as a function of platform acceleration/velocity, while there was a significant effect of platform acceleration/velocity on the magnitude of the corrective response, that is, peak magnitude of corrective hip, knee, and ankle angular displacements and magnitude of muscle responses. The present findings indicate that multiple sources of spatial information are necessary for the selection and initiation of the appropriate corrective response to meet the requirements of the different balance tasks. The present results strongly endorse the concept of a postural control network for recovery of standing balance, as opposed to positive feedback through local segmental or long loop reflex circuits.

Acceleration↗

PubMed1986

Co-activation of sprinter and distance runner muscles in isokinetic exercise.

The purpose of this study was to investigate the extent of co-activation of quadriceps and hamstring musculature in sprinters and distance runners. Nine female intercollegiate track athletes performed maximal knee extensions and flexions on a modified orthotron isokinetic dynamometer at two speeds (100 degrees and 400 degrees X s-1). Simultaneous recordings of torque, joint position, and agonist/antagonist electromyographic activity from the quadriceps and hamstrings were computer-processed. The results revealed the hamstrings to be considerably more active during knee extension than the quadriceps during flexion. The integrated electromyographic activity of co-contracting hamstrings and quadriceps, throughout the joint range, averaged 33 and 6%, respectively, of the same muscle group during its agonist phase. Hamstring co-activation increased sharply during the last 25% of knee extension, generating 58% of the integrated electromyographic agonist activity. Co-activation of the sprinters' hamstrings was four times that of distance runners (57/14%), however, the faster speed of movement (400 degrees X s-1) increased hamstring coactivation of distance runners more acutely than sprinters in the final phase of extension. The data suggest that the hamstrings are used to a much greater extent than quadriceps for limb deceleration and that the distraction of antagonist muscle tension should be considered when analyzing agonist isokinetic torques. Furthermore, the relatively high co-activation of the hamstrings, particularly during the last 25% of extension, may induce hamstring soreness or strain in vulnerable subjects.

Adult↗

PubMed2003

Muscle fatigue induced by exercise simulating the work rate of competitive soccer.

Fatigue represents a reduction in the capability of muscle to generate force. The aim of the present study was to establish the effects of exercise that simulates the work rate of competitive soccer players on the strength of the knee extensors and knee flexors. Thirteen amateur soccer players (age 23.3+/-3.9 years, height 1.78+/-0.05 m, body mass 74.8+/-3.6 kg; mean+/-s) were tested during the 2000-2001 soccer season. Muscle strength of the quadriceps and hamstrings was measured on an isokinetic dynamometer. A 90 min soccer-specific intermittent exercise protocol, incorporating a 15 min half-time intermission, was developed to provide fatiguing exercise corresponding in work rate to a game of soccer. The exercise protocol, performed on a programmable motorized treadmill, consisted of the different intensities observed during soccer match-play (e.g. walking, jogging, running, sprinting). Muscle strength was assessed before exercise, at half-time and immediately after exercise. A repeated-measures analysis of variance showed significant reductions (P < 0.001) in peak torque for both the quadriceps and hamstrings at all angular velocities (concentric: 1.05, 2.09, 5.23 rad x s(-1); eccentric: 2.09 rad x s(-1)). The peak torque of the knee extensors (KE) and knee flexors (KF) was greater before exercise [KE: 232+/-37, 182+/-34, 129+/-27, 219+/-41 N x m at 1.05, 2.09 and 5.23 rad x s(-1) (concentric) and 2.09 rad x s(-1) (eccentric), respectively; KF: 126+/-20, 112+/-19, 101+/-16, 137+/-23 N x m] than at half-time (KE: 209+/-45, 177+/-35, 125+/-36, 214+/-43 N x m; KF: 114+/-31, 102+/-20, 92+/-15, 125+/-25 N x m) and greater at half-time than after exercise (KE: 196+/-43, 167+/-35, 118+/-24, 204+/-43 N x m; KF: 104+/-25, 95+/-21, 87+/-13, 114+/-27 N x m). For the hamstrings:quadriceps ratio, significant changes were found (P < 0.05) for both legs, the ratio being greater before than after exercise. For fast:slow speed and left:right ratios, no significant changes were found. We conclude that there is a progressive reduction in muscle strength that applies across a range of functional characteristics during exercise that mimics the work rate in soccer.

Adult↗

PubMed1989

Reflex inhibition of thigh muscles in knee injury. Causes and treatment.

There are several common findings and contradictions noted in the research related to thigh muscle reflex inhibition and sequelae that occur with knee joint injury. Reflex inhibition may be measured directly by electromyography, or the sequelae of reflex inhibition may be measured, as commonly occurs in the clinic setting. Electromyography is useful in determining the causes of reflex inhibition. The most frequently cited causes of thigh muscle reflex inhibition in knee injury are pain, joint effusion and knee immobilisation. The other measurement methods described vary from thigh circumference measurement to muscle biopsy. These methods are useful in determining the magnitude and duration of the deleterious sequelae that affect the thigh muscles after reflex inhibition. Finally, there is selectivity of reflex inhibition after knee joint injury: the quadriceps versus the hamstrings, the different components of the quadriceps muscle group, and the different types of muscle fibres. In light of these findings, several suggestions have been offered for prevention of reflex inhibition and for techniques that can be applied to rehabilitate the most affected muscle group: the quadriceps femoris. Techniques used to prevent or limit the amount of reflex inhibition include cryotherapy, transcutaneous electrical nerve stimulation, iontophoresis, phonophoresis, joint mobilisation, rest and proper positioning of the knee in rest and exercise. Electromyostimulation, electromyographic biofeedback and traditional exercise training are 3 methods used to rehabilitate the quadriceps.

Humans↗