Purpose: The purpose of this study were to analyze ultrasonography on both sides of gastrocnemius medialis of stroke patient. Methods: In fourteen subjects with stroke, the gastrocnemius medialis(GM) muscle were scanned with ultrasonography at the muscle belly at rest at ankle angles of 0 degree (neutral position) and it were measured with ultrasonography on both sides of the leg. Muscle architecture (thickness, pennation angle, fascicle length, density, white area index) was examined using real-time B-mode ultrasonography with 7.5MHz linear-array prob. Results: Thickness of non-paratic side was significantly thicker than paratic side. Pennation angle of non-paratic side was significantly larger than paratic side. Fascicle length of non-para tic side was significantly smaller than paratic side. Density of non-paratic side was significantly smaller than paratic side. White area index of non-paranc side was significantly smaller than paratic side. Conclusion: This study showed that stroke have influenced on mechanical properties and quality properties of skeletal muscle architecture.
Purpose : The purpose of this study was to perform the calf-raise exercise on the stable support surface and unstable support surface for comparing deference of the gastrocnemius thickness changes that measured by ultrasonography. Method : Subjects stand on unstable support surface and a stable support surface with both feet. Keeping calf-raise position in the 3 seconds, and then had to return back to the starting position. Total of 3 sets of 15 repetitions performed and give a 30-second rest between each set. In this way, exercise performed 3 times a week, performed a total of 6 weeks. Result : 1. gastrocnemius muscle thickness before and after exercise in experimental group A was significantly different(p<.05). 2. gastrocnemius muscle thickness before and after exercise in experimental group B was significantly different(p<.05). 3. gastrocnemius muscle thickness in experimental group A and experimental group B was significantly difference(p<.05). Conclusion : In conclusion, calf-raise exercise on unstable support surface was more efficient than stable support surface for increasing thickness of gastrocnemius.
The purpose of this study was to determine the effect of DHEA on Type I(soleus) and II muscles(plantaris, gastrocnemius) in a focal brain ischemia model rat. Thirty-seven male Sprague-Dawley rats with $200{\sim}250g$ body weights were randomly divided into four groups : CINS(cerebral ischemia + normal saline), CIDH(cerebral ischemia + DHEA), SHNS(sham + normal saline), SHDH (sham + DHEA). Both the CINS and CIDH groups were undergone a transient right middle cerebral artery occlusion operation. In the SHNS and SHDH groups, a sham operation was done. DHEA was administered daily at a dose of 0.34mmol/kg, and normal saline was administered daily at the same dose by intraperitoneal injection for 7days after operation. Cerebral infarction in the CINS and CIDH groups was identified by staining with 2% triphenyltetrazolium chloride solution for 60 minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. The results were summarized as follows: 1) The muscle weights of soleus(Type I), plantaris and gastrocnemius(Type II) in CINS group were significantly less than those of the SHNS group(p<.01). The muscle fiber cross-sectional area of the CINS group was significantly less than that of the SHNS group in Type I muscle fiber of the soleus and Type II muscle fiber of the plantaris and gastrocnemius(p<.05). The myofibrillar protein content of the CINS group was significantly less than that of the SHNS group in the left gastrocnemius and right soleus(p<.05). 2) The muscle weights of the soleus, plantaris and gastrocnemius except the unaffected side of the plantaris in the CIDH significantly increased compared to those of the CINS group(p<.05). The muscle fiber cross-sectional area of the CIDH group significantly increased compared to that of the CINS group in Type II muscle fiber of the plantaris and gastrocnemius(p<.05). The myofibrillar protein content of the CIDH group significantly increased compared to that of the CINS group in the left soleus(p<.05). 3) On the post-op 8 day, the body weight of the CINS group was significantly less than that of the CIDH, SHNS and SHDH groups(p<.01). Total diet intake of the CINS and CIDH groups was significantly less than that of the SHNS and SHDH groups(p<.01). Based on these results, it was identified that muscle atrophy could be induced during the 7 days after cerebral infarction, and DHEA administration during the early stage of cerebral infarction might attenuate muscle atrophy.
Purpose: This study aimed to investigate the effects of eccentric training applied to the calf muscles on muscle tone, muscle strength, and gait variables in patients with chronic stroke. Methods: Twenty-two participants were divided into experimental (n=12; eccentric training) and control (n=10; static stretching and stretching board) groups. The participants completed 30-minute physical therapy sessions five times a week for three weeks. Calf muscle tone, muscle strength, and gait variables were measured using MyotonPRO, a hand-held dynamometer, and Optogait, respectively, before and after each intervention. Results: Two-way analysis of variance (ANOVA) indicated a significant interaction effect between measurement points and groups in frequency, stiffness, and decrement of the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05). Paired t-tests showed that the experimental group exhibited significantly decreased frequency and stiffness scores for the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05), as well as significantly increased decrement and muscle strength scores, gait speed, step length, and stride length (p<.05). Conclusion: The application of eccentric training to the calf effectively reduced muscle tone, increased muscle strength, and improved the gait speed, step length, and stride length of patients with chronic stroke.
Purpose : The purpose of this study was to determine the changes in ultrasound imaging of the lower limbs in patients with degenerative osteoarthritis who received a total knee replacement (TKR). Methods : The participants for the study were ten patients who were to receive a total knee replacement. Measurements were taken a total of three times: before receiving a total knee replacement, and one week and two weeks after receiving a total knee replacement. The vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle were measured using ultrasound imaging. Results : Muscle thickness of the vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. White area index (WAI) and density of vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. Conclusion : In conclusion, lower quality muscles were due to a decrease in muscle fiber and an increase in fat fiber. Therefore, initial physical therapy after total knee replacement should consider this point and be designed appropriately as a therapeutic approach for total knee replacement patients.
Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of $2{\times}3.5cm^2$ on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.
Purpose: The purpose of this study is to analyze the effect of arm leg flexion patterns of proprioceptive neuromuscular facilitation on the muscle activation of the contralateral lower extremity. Methods: In this study, Electromyogram MP150(Biopac system, USA) was applied to 20 healthy male subjects. Unilateral arm flexion- abduction- external rotation pattern and Unilateral leg flexion- adduction- external rotation with knee flexion pattern were applied within mid range of the supine position for measurement. The muscle activation of vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius(medialis) muscle of the contralateral lower extremity were compared and analyzed during the applications. Results: The results of this study were summarized as follows: There was a statistically significant difference in the muscle activation of vastus lateralis and biceps femoris between the arm and leg patterns(P<0.05). There was a statistically significant difference in the muscle activation of gastrocnemius and tibialis anterior between the arm and leg patterns(P<0.05). Conclusion: contralateral vastus lateralis, biceps femoris, gastrocnemius and tibialis anterior muscles show the higher muscle activation in the leg pattern than one in the arm pattern.
The purpose of this study was to identify hindlimb muscle atrophy in stroke induced rat and determine the effect of endurance exercise on body weight, weight of hindlimb muscle during 7 days after stroke induction. Thirty four male Sprague-Dawley rats with 200-270g body weight were divided into four groups : control, control+exercise(Con+Ex), stroke, and exercise after stroke(St+Ex) group. The control group and Con+Ex group received sham operation and the stroke group and St+Ex group received right MCA occlusion operation by using silicon-coated probe. The Con+Ex and St+Ex groups ran on a treadmill for 20min/day at 10m/min and $10^{\circ}grade$. Daily body weight and diet intake were measured every morning for 7 days. Cerebral infarction of stroke and St+Ex groups were identified by staining with TCC for 30minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. Body weight of the control group at the 7th day increased by 18.3% significantly from the first day of experiment, that of the stroke group at the 7th day decreased by 6.7% significantly compared to the day of receiving right MCA occlusion operation. Body weight of the Con+Ex group at the 7th day increased by 10.3% significantly form the first day of experiment, that of St+Ex group at the 7th day also increased by 13.4% significantly compared to the day of receiving right MCA occlusion operation. The total amount of diet in stroke group decreased significantly compared to that of St+Ex and that of control group. In stroke group the wet weight of both sides of soleus, plantaris, and gastrocnemius muscles decreased significantly compared to that of control group. The relative weight of affected(left) plantaris and gastrocnemius muscles decreased significantly compared to that of the control group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in stroke group. The wet weight of right gastrocnemius muscles in Con+Ex group increased compared to that of control group. The relative weight of right gastrocnemius muscle increased significantly compared to that of the control group. The wet weight of St+Ex group increased significantly compared to that of the stroke group in both sides of soleus, plantaris, and gastrocnemius muscles. The relative weight of affected plantaris muscle increased significantly compared to that of the stroke group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in St+Ex group. Body weight and wet weight of soleus, plantaris, and gastrocnemius muscles in the St+Ex group did not recover to the values of control group. Based on these results, it can be suggested that endurance exercise during acute stage of stroke can reduce muscle atrophy related to denervation, inactivity and undernutrition.
Objective: Transient receptor potential vanilloid subfamily type 1 (TRPV1), a most specific marker of the nociceptive primary afferent, is expressed in peptidergic and non-peptidergic primary afferents innervating skin and viscera. However, its expression in sensory fibers to skeletal muscle is not well known. In this study, we studied the neurochemical characteristics of TRPV1-positive primary afferents to skeletal muscles. Methods: Sprague-Dawley rats were injected with total $20{\mu}l$ of 1% fast blue (FB) into the gastrocnemius and erector spinae muscle and animals were perfused 4 days after injection. FB-positive cells were traced in the L4-L5 (for gastrocnemius muscle) and L2-L4 (for erector spinae muscle) dorsal root ganglia. The neurochemical characteristics of the muscle afferents were studied with multiple immunofluorescence with TRPV1, calcitonin gene-related peptide (CGRP) and $P2X_3$. To identify spinal neurons responding to noxious stimulus to the skeletal muscle, 10% acetic acids were injected into the gastrocnemius and erector spinae muscles and expression of phospho extracellular signal-regulated kinase (pERK) in spinal cords were identified with immunohistochemical method. Results: TRPVl was expressed in about 49% of muscle afferents traced from gastrocnemius and 40% of erector spinae. Sixty-five to 60% of TRPV1-positive muscles afferents also expressed CGRP. In contrast, expression of $P2X_3$ immnoreaction in TRPV1-positive muscle afferents were about 20%. TRPV1-positive primary afferents were contacted with spinal neurons expressing pERK after injection of acetic acid into the muscles. Conclusion: It is consequently suggested that nociception from skeletal muscles are mediated by TRPV1-positive primary afferents and majority of them are also peptidergic.
Background: Flat feet can be identified by assessing the collapse of the medial longitudinal arch (MLA) and these conditions can trigger epidemiological changes in the feet. Many of previous studies compared the muscle activity of lower body in terms of intervention and dynamics to treat the structural defect of flat feet. However, few studies have investigated or analyzed the muscle activity of gastrocnemius muscle in the subjects with flat feet. Objects: This study investigated the differences in changes of medial and lateral plantar flexors in subjects with flat feet during bipedal heel-rise (BHR) task and analyzed the differences in muscle activity between two groups by measuring the electromyography (EMG) of abductor hallucis (AH), tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG). Methods: A total of Twenty one adult females participated in this experiment. Subjects were assigned to groups according to the navicular drop test. The task was applied to the leg, where the heel lifting action prevailed. The muscle activity of the medial and lateral feet plantar flexors was evaluated, and the % maximum voluntary isometric contractions (%MVIC) of these were compared. Results: For the difference between groups the muscle activity (%MVIC) of LG muscle was statistically significantly low in flat feet group compared to healthy feet group (flat feet: 64.57, healthy feet: 90.17; p < 0.05). Conclusion: The results of this study will contribute to identifying the muscle activities of medial and lateral feet plantar flexors among subjects with flat feet, which can cause abnormal epidemiological changes in the feet.
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