RESUMEN
The skeletal muscle contraction is determined by cross-bridge formation between the myosin heads and the actin active sites. When the muscle contracts, it shortens, increasing its longitudinal shear elastic modulus ([Formula: see text]). Structurally, skeletal muscle can be considered analogous to the molecular receptors that form receptor-ligand complexes and exhibit specific ligand-binding dynamics. In this context, this work aims to apply elastography and the ligand-binding framework to approach the possible intrinsic mechanisms behind muscle synergism. Based on the short-range stiffness principle and the acoustic-elasticity theory, we define the coefficient [Formula: see text], which is directly related to the fraction saturation of molecular receptors and links the relative longitudinal deformation of the muscle to its [Formula: see text]. We show that such a coefficient can be obtained directly from [Formula: see text] estimates, thus calculating it for the biceps brachii, brachioradialis, and brachialis muscles during isometric elbow flexion torque (τ) ramps. The resulting [Formula: see text] curves were analyzed by conventional characterization methods of receptor-ligand systems to study the dynamical behavior of each muscle. The results showed that, depending on muscle, [Formula: see text] exhibits typical ligand-binding dynamics during joint torque production. Therefore, the above indicates that these different behaviors describe the longitudinal shortening pattern of each muscle during load sharing. As a plausible interpretation, we suggested that this could be related to the binding kinetics of the cross-bridges during their synergistic action as torque increases. Likewise, it shows that elastography could be useful to assess contractile processes at different scales related to the change in the mechanical properties of skeletal muscle.
Asunto(s)
Diagnóstico por Imagen de Elasticidad , Articulación del Codo , Diagnóstico por Imagen de Elasticidad/métodos , Ligandos , Músculo Esquelético/fisiología , Contracción Muscular/fisiología , Articulación del Codo/fisiología , Contracción Isométrica/fisiologíaRESUMEN
This study is aimed to estimate and measure reference values in the normal range of motion of extremity joints in females and to provide a database for the assessment of impairments related to the mobility of the joints. This observational cross-sectional study was conducted at seven major educational institutes areas of Rawalpindi and Islamabad in Pakistan from January to June 2020 with a sample size of 600 healthy females aged 15 to 45 years and divided into three groups through non-probability sampling technique. In study Instruments, an electronic Goniometer was used for the measurement of the range of motions for different joints and then those ranges were recorded. The questionnaire had two sections demographic characteristics and ROM for both upper and lower limbs. Data was analyzed using SPSS V21. A p < 0.05 was considered statistically significant.In the result,Out of 600 participants,there was a statistically significant difference of (p < 0.001) in both upper and lower extremities motion between all the three groups for the measurements and noticeably no significant difference (p > 0.005) between group 1, 2 comparisons for the knee joint extension.To conclude, In most joints, the range of motion increases with age. The transition from group 1 to group 2 was aided by increased hormone participation in growth, an active lifestyle, and generally good health. Because of degenerative changes and joint stiffness, group 3's range of motion deteriorated, leading to a sedentary lifestyle and lack of physical activity. Standardized biomechanical measurements can help health practitioners, such as physiotherapists, choose appropriate therapy interventions to assess musculoskeletal disorders. To resolve the inconsistencies in the reliability and validity of goniometry values, more research is required.
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Valores de Referencia , Rango del Movimiento Articular , Articulación del Hombro/fisiología , Fenómenos Biomecánicos/fisiología , Ejercicio Físico/fisiología , Índice de Masa Corporal , Estudios Transversales/métodos , Estudio Multicéntrico , Articulación del Codo/fisiología , Artrometría Articular , Conducta Sedentaria , Fisioterapeutas , Cadera/fisiología , Articulación de la Rodilla/fisiología , Estilo de VidaRESUMEN
Barbalho, M, Gentil, P, Raiol, R, Fisher, J, Steele, J, and Coswig, V. Influence of adding single-joint exercise to a multijoint resistance training program in untrained young women. J Strength Cond Res 34(8): 2214-2219, 2020-The aim of the present study was to investigate the effects of adding single-joint (SJ) exercises to a multijoint (MJ) resistance training (RT) program on muscle strength and anthropometric measures of young women. Twenty untrained women were divided into a group that performed only MJ exercises or a group that performed both SJ and MJ exercises (MJ + SJ). Before and after 8 weeks of training, the participants were tested for 10 repetition maximum (10RM). Flexed arm circumference and triceps and biceps skinfold thickness were also measured. Both groups significantly decreased biceps (-3.60% for MJ and -3.55% for MJ + SJ) and triceps skinfold (-3.05% for MJ and -2.98% for MJ + SJ), with no significant difference between them. Flexed arm circumference significantly increased in both groups; however, increases in MJ + SJ (4.39%) were significantly greater than MJ (3.50%). Increases in 10RM load in elbow extension (28.2% for MJ and 28.0% for MJ + SJ), elbow flexion (29.8% for MJ and 28.7% for MJ + SJ), and knee extension (26.92% for MJ and 23.86% for MJ + SJ) were all significant and not different between groups. The results showed that adding SJ exercises to an MJ RT program resulted in no additional benefits in muscle performance, whilst differences in flexed arm circumference were small, but significant, in untrained women.
Asunto(s)
Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos , Pesos y Medidas Corporales , Articulación del Codo/fisiología , Femenino , Humanos , Articulación de la Rodilla/fisiología , Extremidad Inferior/fisiología , Masculino , Extremidad Superior/fisiología , Adulto JovenRESUMEN
BACKGROUND: Concurrent training (CT) has been recommended to minimize the deleterious effects of aging. However, few studies have investigated whether this type of training reduces blood pressure in the elderly. Therefore, our objective was to evaluate the effects of CT on the hemodynamic, cardiorespiratory, and muscle strength responses in medicated hypertensive patients. METHODS: Twenty-three hypertensives (62.65 ± 6.4 years) of both sexes were allocated to the concurrent training group (CTG) or control group (CG). The CTG performed aerobic training (70-85% of reserve heart rate) combined with resistance training with elastic tubes (2sets × 15 repetitions) for 8 weeks. Resting blood pressure (BP), peak oxygen consumption (VO2peak), and right knee and elbow flexion strength were evaluated. RESULTS: A reduction of 6.37% was observed in BP and increases of 16.68% in VO2peak and 16% in muscle strength for right elbow flexion in the CTG compared to CG (p < .05). Intragroup comparisons showed reduction of 5% for BP, and increases of 6.79% for VO2peak, 24.79% for elbow flexion, and 16.47% for knee flexion in the CTG (p < .05), without significant improvement in the CG. CONCLUSION: CT promoted a reduction in BP, and increased cardiorespiratory fitness and muscular strength of the upper limbs in the hypertensive older adults.
Asunto(s)
Envejecimiento/fisiología , Hipertensión/rehabilitación , Entrenamiento de Fuerza , Anciano , Articulación del Codo/fisiología , Femenino , Humanos , Hipertensión/fisiopatología , Articulación de la Rodilla/fisiología , Masculino , Persona de Mediana Edad , Fuerza Muscular , Músculo Esquelético/fisiologíaRESUMEN
BACKGROUND: Brachial plexus injury is a complex entity that often results in partial recovery. Most studies to date have focused on improving shoulder abduction. However, a recent technique has been outlined-one that transfers the lower trapezius to improve the external rotation of the shoulder. The primary objective of this study was to evaluate the gains in external rotation of the shoulder in patients who have undergone transfer of the lower trapezius; secondarily, we assessed the range of motion in the elbow and shoulder joints, as well as the muscle strength and quality of life. METHODS: This article presents a prospective cohort study of 10 patients who underwent transfer of the lower trapezius. During the preoperative period and at 6 months after the operation, both active and passive goniometric measurements were assessed, as were muscle strength, Mallet's classification, and patients' responses to the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: External rotation exhibited an improvement of 17° in the active range of motion and 14° the passive range, which was not statistically significant. Flexion and active abduction of the shoulder, as well as the responses to the DASH, showed positive results. The Mallet's classification and muscle strength measurement results were not significant. CONCLUSIONS: The procedure might be an alternative for restoration of shoulder function and glenohumeral stabilization and mainly to improve quality of life. However, additional studies are required to define and refine this surgical technique.
Asunto(s)
Neuropatías del Plexo Braquial/cirugía , Plexo Braquial/lesiones , Músculos Superficiales de la Espalda/cirugía , Neuropatías del Plexo Braquial/etiología , Estudios de Cohortes , Evaluación de la Discapacidad , Articulación del Codo/fisiología , Humanos , Masculino , Fuerza Muscular/fisiología , Rango del Movimiento Articular/fisiología , Rotación , Articulación del Hombro/fisiología , Adulto JovenRESUMEN
We report the study of the anatomical feasibility of transferring the nerve to the brachialis muscle to the upper medial head motor branch that innervate the triceps, and outcomes of such transfers in restoring elbow extension in five patients with posterior cord lesion of the brachial plexus. The length of the branches to the brachialis muscle measured 7.6 cm and the triceps upper medial head motor branch was 5 cm in 10 adult cadavers. Five male patients were treated with this transfer 5 months after the injury (range 4 to 6 months) after posterior cord injury of the brachial plexus with a mean follow-up of 31 months (range 28 to 36 months). Elbow extension scored M4 in all cases. No complications occurred. These preliminary results suggest that transferring the nerve to the brachialis muscle is an effective technique for the reconstruction of elbow extension after posterior cord brachial plexus injuries. LEVEL OF EVIDENCE: IV.
Asunto(s)
Brazo/inervación , Plexo Braquial/lesiones , Articulación del Codo/fisiología , Músculo Esquelético/inervación , Nervio Musculocutáneo/trasplante , Adulto , Brazo/anatomía & histología , Plexo Braquial/cirugía , Humanos , Masculino , Rango del Movimiento Articular , Adulto JovenRESUMEN
Castanheira, RPM, Ferreira-Junior, JB, Celes, RS, Rocha-Junior, VA, Cadore, EL, Izquierdo, M, and Bottaro, M. Effects of synergist vs. nonsynergist split resistance training routines on acute neuromuscular performance in resistance-trained men. J Strength Cond Res 31(12): 3482-3488, 2017-The aim of this study was to evaluate the effects of synergist (SN) vs. nonsynergist (NS) split resistance training routines on the acute neuromuscular performance of the elbow flexors in resistance-trained men. Fifteen resistance-trained men (age: 23.2 ± 4.0 years, height: 173.0 ± 0.08 cm, and body mass: 78.38 ± 9.31 kg) randomly performed 3 training routines separated by an interval of 7 days: (a) pull-pull exercises (SN), which included 6 sets of 10 repetition maximum (RM) of a seated row exercise followed by 4 sets of 10RM of the preacher biceps curl exercise; (b) push-pull exercises (NS), which included 6 sets of 10RM of the bench press exercise followed by 4 sets of 10RM of the preacher biceps curl exercise; and (c) Control, which included 4 sets of 10RM of the preacher biceps curl exercise. Elbow flexors peak torque, total work, and the amplitude of electromyography signal (EMG root mean square) were measured during the elbow flexor isokinetic exercise. Peak torque was 10.2 and 3.9% higher during Control condition when compared with the SN and NS conditions, respectively (p ≤ 0.05). Peak torque was also 6.0% greater in the NS condition than the SN condition (p ≤ 0.05). Moreover, total work was 5.1% greater in the NS condition than the SN condition. Additionally, EMG findings did not differ among conditions (p > 0.05). In conclusion, a push and pull NS split routine is recommended to maximize elbow flexor training performance (i.e., lower acute loading effect) in trained subjects.
Asunto(s)
Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos , Adolescente , Adulto , Fenómenos Biomecánicos , Articulación del Codo/fisiología , Electromiografía , Humanos , Masculino , Torque , Adulto JovenRESUMEN
Baroni, BM, Pompermayer, MG, Cini, A, Peruzzolo, AS, Radaelli, R, Brusco, CM, and Pinto, RS. Full range of motion induces greater muscle damage than partial range of motion in elbow flexion exercise with free weights. J Strength Cond Res 31(8): 2223-2230, 2017-Load and range of motion (ROM) applied in resistance training (RT) affect the muscle damage magnitude and the recovery time-course. Because exercises performed with partial ROM allow a higher load compared with those with full ROM, this study investigated the acute effect of a traditional RT exercise using full ROM or partial ROM on muscle damage markers. Fourteen healthy men performed 4 sets of 10 concentric-eccentric repetitions of unilateral elbow flexion on the Scott bench. Arms were randomly assigned to partial-ROM (50-100°) and full-ROM (0-130°) conditions, and load was determined as 80% of 1 repetition maximum (1RM) in the full- and partial-ROM tests. Muscle damage markers were assessed preexercise, immediately, and 24, 48, and 72 hours after exercise. Primary outcomes were peak torque, muscle soreness during palpation and elbow extension, arm circumference, and joint ROM. The load lifted in the partial-ROM condition (1RM = 19.1 ± 3.0 kg) was 40 ± 18% higher compared with the full-ROM condition (1RM = 13.7 ± 2.2 kg). Seventy-two hours after exercise, the full-ROM condition led to significant higher soreness sensation during elbow extension (1.3-4.1 cm vs. 1.0-1.9 cm) and smaller ROM values (97.5-106.1° vs. 103.6-115.7°). Peak torque, soreness from palpation, and arm circumference were statistically similar between conditions, although mean values in all time points of these outcomes have suggested more expressive muscle damage for the full-ROM condition. In conclusion, elbow flexion exercise with full ROM seems to induce greater muscle damage than partial-ROM exercises, even though higher absolute load was achieved with partial ROM.
Asunto(s)
Articulación del Codo/fisiología , Músculo Esquelético/fisiología , Mialgia/fisiopatología , Rango del Movimiento Articular/fisiología , Entrenamiento de Fuerza/métodos , Adolescente , Adulto , Brazo , Ejercicio Físico/fisiología , Humanos , Masculino , Torque , Adulto JovenRESUMEN
We investigated the responses of indirect markers of exercise-induced muscle damage (EIMD) among a large number of young men (N=286) stratified in clusters based on the largest decrease in maximal voluntary contraction torque (MVC) after an unaccustomed maximal eccentric exercise bout of the elbow flexors. Changes in MVC, muscle soreness (SOR), creatine kinase (CK) activity, range of motion (ROM) and upper-arm circumference (CIR) before and for several days after exercise were compared between 3 clusters established based on MVC decrease (low, moderate, and high responders; LR, MR and HR). Participants were allocated to LR (n=61), MR (n=152) and HR (n=73) clusters, which depicted significantly different cluster centers of 82%, 61% and 42% of baseline MVC, respectively. Once stratified by MVC decrease, all muscle damage markers were significantly different between clusters following the same pattern: small changes for LR, larger changes for MR, and the largest changes for HR. Stratification of individuals based on the magnitude of MVC decrease post-exercise greatly increases the precision in estimating changes in EIMD by proxy markers such as SOR, CK activity, ROM and CIR. This indicates that the most commonly used markers are valid and MVC orchestrates their responses, consolidating the role of MVC as the best EIMD indirect marker.
Asunto(s)
Ejercicio Físico , Contracción Muscular , Músculo Esquelético/lesiones , Adulto , Análisis por Conglomerados , Creatina Quinasa/sangre , Articulación del Codo/fisiología , Humanos , Masculino , Músculo Esquelético/fisiología , Mialgia , Rango del Movimiento Articular , Estudios Retrospectivos , Torque , Adulto JovenRESUMEN
The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach.
Asunto(s)
Articulación del Codo/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos , Extremidad Superior/fisiología , Adulto , Análisis de Varianza , Humanos , Articulaciones/fisiología , Masculino , Distribución AleatoriaRESUMEN
Automatic and accurate identification of elbow angle from surface electromyogram (sEMG) is essential for myoelectric controlled upper limb exoskeleton systems. This requires appropriate selection of sEMG features, and identifying the limitations of such a system.This study has demonstrated that it is possible to identify three discrete positions of the elbow; full extension, right angle, and mid-way point, with window size of only 200 milliseconds. It was seen that while most features were suitable for this purpose, Power Spectral Density Averages (PSD-Av) performed best. The system correctly classified the sEMG against the elbow angle for 100% cases when only two discrete positions (full extension and elbow at right angle) were considered, while correct classification was 89% when there were three discrete positions. However, sEMG was unable to accurately determine the elbow position when five discrete angles were considered. It was also observed that there was no difference for extension or flexion phases.
Asunto(s)
Brazo/fisiología , Electromiografía/métodos , Adulto , Tirantes , Codo/fisiología , Articulación del Codo/fisiología , Diseño de Equipo , Femenino , Humanos , Masculino , Músculo Esquelético/fisiología , Músculos/fisiología , Reconocimiento de Normas Patrones Automatizadas , Rango del Movimiento Articular , Reproducibilidad de los Resultados , Programas InformáticosRESUMEN
The aim of this study was to compare the effects of low- and high-volume strength training on strength, muscle activation and muscle thickness (MT) of the lower- and upper-body, and on muscle quality (MQ) of the lower-body in older women. Twenty apparently healthy elderly women were randomly assigned into two groups: low-volume (LV, n=11) and high-volume (HV, n=9). The LV group performed one-set of each exercise, while the HV group performed three-sets of each exercise, twice weekly for 13 weeks. MQ was measured by echo intensity obtained by ultrasonography (MQEI), strength per unit of muscle mass (MQST), and strength per unit of muscle mass adjusted with an allometric scale (MQAS). Following training, there was a significant increase (p≤0.001) in knee extension 1-RM (31.8±20.5% for LV and 38.3±7.3% for HV) and in elbow flexion 1-RM (25.1±9.5% for LV and 26.6±8.9% for HV) and in isometric maximal strength of the lower-body (p≤0.05) and upper-body (p≤0.001), with no difference between groups. The maximal electromyographic activation for both groups increased significantly (p≤0.05) in the vastus medialis and biceps brachii, with no difference between groups. All MT measurements of the lower- and upper-body increased similarly in both groups (p≤0.001). Similar improvements were also observed in MQEI (p≤0.01), MQST, and MQAS (p≤0.001) for both groups. These results demonstrate that low- and high-volume strength training promote similar increases in neuromuscular adaptations of the lower- and upper-body, and in MQ of the lower-body in elderly women.
Asunto(s)
Envejecimiento/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Esfuerzo Físico/fisiología , Entrenamiento de Fuerza/métodos , Adaptación Fisiológica/fisiología , Anciano , Articulación del Codo/fisiología , Electromiografía , Femenino , Humanos , Articulación de la Rodilla/fisiología , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Rango del Movimiento Articular/fisiología , UltrasonografíaRESUMEN
PURPOSE: We examined the effects of creatine supplementation on the response to repeated bouts of resistance exercise. METHODS: Young men (24.1 ± 5.2 yr) were divided into Creatine (CM, n = 9) and Placebo (PL, n = 9) groups. On day (D) 1 and D15, subjects performed four sets of bicep curls at 75% 1-RM to concentric failure. On D8-D13, subjects consumed either 20g/d creatine monohydrate or placebo. Muscle soreness and elbow joint range of motion (ROM) were assessed on D1-D5 and D15-D19. Serum creatine kinase activity (CK) was assessed on D1, D3, D5, D15, D17, and D19. RESULTS: The first exercise bout produced increases in muscle soreness and CK, and decreases in ROM in both groups (p < .001). The second bout produced lesser rises in serum CK, muscle soreness, and a lesser decrease in ROM (bout effect, p < .01 for all), with greater attenuation of these damage markers in CM than PL. CK levels on D17 were lower (+110% over D15 for CM vs. +343% for PL), muscle soreness from D15-19 was lower (-75% for CM vs. -56% for PL compared with first bout), and elbow ROM was decreased in PL, but not CM on D16 (p < .05 for all). CONCLUSIONS: Creatine supplementation provides an additive effect on blunting the rise of muscle damage markers following a repeated bout of resistance exercise. The mechanism by which creatine augments the repeated bout effect is unknown but is likely due to a combination of creatine's multifaceted functions.
Asunto(s)
Creatina/administración & dosificación , Creatina/sangre , Suplementos Dietéticos , Ejercicio Físico/fisiología , Entrenamiento de Fuerza , Fenómenos Fisiológicos en la Nutrición Deportiva , Administración Oral , Adolescente , Adulto , Creatina Quinasa/sangre , Articulación del Codo/efectos de los fármacos , Articulación del Codo/fisiología , Voluntarios Sanos , Humanos , Masculino , Contracción Muscular/efectos de los fármacos , Contracción Muscular/fisiología , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/fisiología , Evaluación Nutricional , Rango del Movimiento Articular/efectos de los fármacos , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to evaluate the objective and subjective results achieved after double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions in adults. METHODS: Nine patients presenting six fractures and three nonunions of the distal humerus, treated with double tension band wiring between 1998 and 2011, were retrospectively evaluated. Two fractures were type A2 and four type A3, and the nonunions were oligotrophic; all nine lesions had a supracondylar intracapsular transverse orientation, that passed through the olecranon fossa, in a direction parallel to the joint line, and they compromised both columns of the distal humerus. Patient's age averaged 70 years (range, 56-82). RESULTS: Follow-up averaged 24.6 months (range, 12-53). All fractures and nonunions united; there were no infections, elbow stiffness or heterotopic bone formations. DASH score at final follow-up averaged 14.2 points (range, 4-22). The analog scale of pain averaged 1.1 points (range, 0-3). Elbow range of motion averaged 100° (range, 100-120°). Flexion averaged 123° (range, 115-130°) and elbow extension loss averaged 15.5° (range, 10-25°). CONCLUSIONS: The results achieved with double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions are comparable to the results that can be expected when using other available fixation methods; this technique is faster, less demanding and cheaper, and surgeons should have it in mind when leading with these particular types of distal humerus fractures and nonunions.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Fracturas no Consolidadas/cirugía , Húmero/lesiones , Anciano , Anciano de 80 o más Años , Placas Óseas , Articulación del Codo/diagnóstico por imagen , Articulación del Codo/fisiología , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/diagnóstico por imagen , Fracturas no Consolidadas/diagnóstico por imagen , Humanos , Húmero/diagnóstico por imagen , Húmero/cirugía , Masculino , Persona de Mediana Edad , Radiografía , Rango del Movimiento Articular/fisiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. METHODS: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6). The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. RESULTS: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. CONCLUSION: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.
Asunto(s)
Traumatismos del Nacimiento/fisiopatología , Neuropatías del Plexo Braquial/diagnóstico , Plexo Braquial/lesiones , Hipoestesia/diagnóstico , Umbral del Dolor/fisiología , Pulgar/fisiopatología , Traumatismos del Nacimiento/complicaciones , Plexo Braquial/fisiopatología , Neuropatías del Plexo Braquial/fisiopatología , Articulación del Codo/fisiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pronóstico , Rango del Movimiento Articular , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. METHODS: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6). The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. RESULTS: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. CONCLUSION: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.
OBJETIVO: Avaliar o valor prognóstico da hipoestesia dolorosa no polegar em recém-nascidos e lactentes jovens com plexopatia braquial obstétrica. MÉTODOS: Avaliamos 131 pacientes com plexopatia braquial obstétrica com menos de dois meses de idade. A sensação dolorosa foi provocada pela compressão do leito ungueal do polegar para avaliar fibras sensitivas do tronco superior (C6). Os pacientes foram seguidos mensalmente. Prognóstico desfavorável foi atribuído aos pacientes sem força antigravitacional para flexão do cotovelo aos seis meses de idade. RESULTADOS: Trinta pacientes apresentaram hipoestesia dolorosa do polegar, dos quais 26 tiveram prognóstico desfavorável. A sensibilidade do teste foi de 65% e a especificidade 96%. CONCLUSÃO: A avaliação da sensibilidade dolorosa do polegar deve ser incluída na avaliação clínica de pacientes com plexopatia braquial obstétrica.
Asunto(s)
Femenino , Humanos , Lactante , Recién Nacido , Masculino , Traumatismos del Nacimiento/fisiopatología , Neuropatías del Plexo Braquial/diagnóstico , Plexo Braquial/lesiones , Hipoestesia/diagnóstico , Umbral del Dolor/fisiología , Pulgar/fisiopatología , Traumatismos del Nacimiento/complicaciones , Neuropatías del Plexo Braquial/fisiopatología , Plexo Braquial/fisiopatología , Articulación del Codo/fisiología , Pronóstico , Rango del Movimiento Articular , Sensibilidad y EspecificidadRESUMEN
OBJECT: Classically, C5-7 root injuries of the brachial plexus have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. However, current myotome maps generally indicate that C-8 participates in the innervation of thumb and finger extensors. Therefore, the authors have hypothesized that, for palsies of the thumb and finger extensors, the injury should affect the C-5 through C-8 roots. METHODS: The authors tested their hypothesis in 30 patients with upper-type palsies of the brachial plexus. They traced a correlation between clinical findings and root injury, as documented by CT myelography, direct visualization during surgery, and electrophysiological studies. RESULTS: In C5-8 root injuries, shoulder abduction and external rotation were paralyzed, and in all patients, wrist extensors were paralyzed. However, in 22 of the 30 patients, wrist extension was possible, because of contraction of the extensor digitorum communis and extensor pollicis longus. Wrist flexion and pronation also were preserved. The T-1 root contributed significantly to innervation of the thumb and finger flexors, ensuring 34% grasping and 40% pinch strength relative to the normal side. Hand sensation was largely preserved. CONCLUSIONS: Based on the authors' observations, they suspect that the clinical scenario previously attributed to a C5-7 root injury is, in fact, a C5-8 root injury. The authors propose referring to this partial palsy of the brachial plexus as a "T-1 hand."
Asunto(s)
Neuropatías del Plexo Braquial/fisiopatología , Plexo Braquial/lesiones , Plexo Braquial/fisiopatología , Parálisis/fisiopatología , Raíces Nerviosas Espinales/lesiones , Raíces Nerviosas Espinales/fisiopatología , Adolescente , Adulto , Neuropatías del Plexo Braquial/etiología , Neuropatías del Plexo Braquial/cirugía , Vértebras Cervicales , Articulación del Codo/inervación , Articulación del Codo/fisiología , Femenino , Dedos/inervación , Dedos/fisiología , Fuerza de la Mano/fisiología , Humanos , Masculino , Parálisis/etiología , Parálisis/cirugía , Articulación del Hombro/inervación , Articulación del Hombro/fisiología , Pulgar/inervación , Pulgar/fisiología , Articulación de la Muñeca/inervación , Articulación de la Muñeca/fisiología , Adulto JovenRESUMEN
The purpose of this study was to evaluate the time course responses of strength, delayed-onset muscle soreness (DOMS), muscle thickness (MT), circumference (CIRC), and ultrasonography echo intensity (EI) after a traditional hypertrophic isoinertial resistance training session in young women. Ten (22.0 ± 3.2 years) healthy, untrained volunteers participated in the study. The resistance exercise session consisted of 4 sets of 10 repetitions at 80% of 1 repetition maximum (1RM) of the dominant arm elbow flexors. Maximum isometric elbow flexion peak torque (PT) at 90°, MT, and EI were recorded for both arms at baseline (PRE), immediately after exercise (0 hours) and at 24, 48, and 72 hours after exercise. Comparisons were made using a 2 × 5 mixed factor analysis of variance. There was a significant (p < 0.05) loss in PT and increase in MT at 0, 24, 48, and 72 hours. In contrast, EI increased only after 24, 48, and 72 hours, not at 0 hours. There were no significant changes in PT, DOMS, MT, and EI in the nondominant (control) arm after the exercise protocol. Our data suggest that after 4 sets of 80% of 1RM of unilateral elbow flexion resistance exercise, nonresistance trained women need >72 hours to fully recover muscle strength, MT, CIRC, and EI. Furthermore, the EI appears to be a sensitive and reliable method to assess MD.
Asunto(s)
Brazo , Fuerza Muscular/fisiología , Músculo Esquelético/diagnóstico por imagen , Entrenamiento de Fuerza , Antropometría , Articulación del Codo/fisiología , Femenino , Humanos , Músculo Esquelético/anatomía & histología , Músculo Esquelético/fisiología , Dimensión del Dolor , Ultrasonografía , Adulto JovenRESUMEN
BACKGROUND: A walker is a common device prescribed for ambulatory assistance for individuals with balance difficulties or to reduce lower extremity demands following injury or surgery. The long-term use of a walker imposes significant demands on the patient's upper extremities that may lead to increased risk for development of secondary conditions such as wrist, elbow or shoulder pain. OBJECTIVE: To describe the joint kinematics, forces and moments of the wrist, elbow and shoulder in a sample of twenty patients that were using a walker as a result of total joint surgery of the hips and knees. METHODS: Three-dimensional upper extremity kinematics were recorded using a motion capture system synchronized with forces and torques transmitted through a walker instrumented with force transducers in the handles. RESULTS: Compressive forces were found to be nearly 20% of the body weight at each of the upper extremity joints, both surgical and non-surgical sides, being the greatest force at the wrist and decreasing proximally. Compression forces were greater in the non-surgical side limb at the wrist and at the elbow. CONCLUSION: Our findings indicated that loads on upper extremity joints associated with the use of a walker for assisted ambulation are high and further studies are needed to address the cause-effect relationship between the actual joint loading and the development of secondary musculoskeletal upper extremity complaints in more frail patients.
Asunto(s)
Articulación del Codo/fisiología , Articulación del Hombro/fisiología , Andadores , Caminata/fisiología , Articulación de la Muñeca/fisiología , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Femenino , Articulación de la Cadera/cirugía , Humanos , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Estrés MecánicoRESUMEN
BACKGROUND: A walker is a common device prescribed for ambulatory assistance for individuals with balance difficulties or to reduce lower extremity demands following injury or surgery. The long-term use of a walker imposes significant demands on the patient's upper extremities that may lead to increased risk for development of secondary conditions such as wrist, elbow or shoulder pain. OBJECTIVE: To describe the joint kinematics, forces and moments of the wrist, elbow and shoulder in a sample of twenty patients that were using a walker as a result of total joint surgery of the hips and knees. METHODS: Three-dimensional upper extremity kinematics were recorded using a motion capture system synchronized with forces and torques transmitted through a walker instrumented with force transducers in the handles. RESULTS: Compressive forces were found to be nearly 20 percent of the body weight at each of the upper extremity joints, both surgical and non-surgical sides, being the greatest force at the wrist and decreasing proximally. Compression forces were greater in the non-surgical side limb at the wrist and at the elbow. CONCLUSION: Our findings indicated that loads on upper extremity joints associated with the use of a walker for assisted ambulation are high and further studies are needed to address the cause-effect relationship between the actual joint loading and the development of secondary musculoskeletal upper extremity complaints in more frail patients.
CONTEXTUALIZAÇÃO: Um andador é um dispositivo frequentemente prescrito para auxiliar a marcha de indivíduos com dificuldades de equilíbrio ou para reduzir demandas à extremidade inferior após cirurgia ou lesão. O uso prolongado de um andador impõe significante demanda para a extremidade superior do paciente, o que pode levar a um risco aumentado de desenvolver condições secundárias, como dor no punho, cotovelo e ombro. OBJETIVO: Descrever a cinemática articular, forças e momentos do punho, cotovelo e ombro de uma amostra de 20 pacientes que faziam uso de um andador após cirurgia de substituição articular do joelho ou quadril. MÉTODOS: A cinemática tridimensional foi registrada usando um sistema de captura de movimento sincronizado com o registro de transdutores de força, que mediam a força transmitida através do andador. RESULTADOS: Este estudo revelou forças de até 20 por cento do peso corporal nos transdutores, com forças compressivas maiores do lado do membro inferior não operado, no punho e no cotovelo. CONCLUSÃO: Os achados indicam que demandas no membro superior associadas ao uso de andador como dispositivo auxiliar da marcha são grandes, e mais estudos são necessários para averiguar relações de causa-efeito entre as reais sobrecargas articulares e o desenvolvimento de queixas musculoesqueléticas no membro de pacientes em condições de debilidade.