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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 1998 September;34(3):121-4

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: English

Ultrasound imaging for monitoring muscle atrophy in rehabilitation patients. A pilot study

Capodaglio P. 1-2, Minetti A. E. 2-3, Ferrari-Bardile A. 4, Bertone G. 5, Gorini M. 6, Felicetti G. 6, Arrigoni N. 6, Maini M. 6, Narici M. V. 2-3

1 Ergonomics Unit, Rehabilitation Center of Montescano (Pavia), Italy; 2 Center for the Study of Motor Activities (CSAM), Institute of Pavia, Italy, “S. Maugeri” Foundation IRCCS; 3 Institute of Advanced Biomedical Technologies (ITBA), National Council of Research (CNR), Milan, Italy; 4 Service of Angiology, Rehabilitation Center of Montescano (Pavia), Italy, “S. Maugeri” Foundation IRCCS; 5 Service of Radiology, Rehabilitation Center of Montescano (Pavia), Italy, “S. Maugeri” Foundation IRCCS; 6 Department of Rehabilitation, Rehabilitation Center of Montescano (Pavia), Italy, “S. Maugeri” Foundation IRCCS


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BACKGROUND: Recent research has ­shown ­that ultra­sound imag­ing can pro­vide a ­means of inves­ti­gat­ing ­fibre orien­ta­tion in ­vivo. Measured by ultra­sound, the pen­na­tion ­angle in the quad­ri­ceps was ­found to be high­ly cor­re­lat­ed ­with the mus­cle ­cross-sec­tion­al ­area (CSA). Kawakami et al. (1993) dem­on­strat­ed ­that the pen­na­tion ­angle in the tri­ceps bra­chii mus­cle of pro­fes­sion­al ­body-build­ers and nor­mal sub­jects who com­plet­ed a strength­en­ing pro­gramme was sig­nif­i­cant­ly great­er ­than ­that meas­ured in sed­en­tary sub­jects. In the cur­rent ­research, we ­were inter­est­ed in deter­min­ing wheth­er mus­cle atro­phy ­would ­lead to decreas­es in the pen­na­tion ­angle of mus­cle ­fibres and vari­a­tions in ­fibre ­length. If ­this ­were so, it ­would pro­vide reha­bil­i­ta­tion spe­cial­ists ­with a reli­able non-inva­sive meth­od for mon­i­tor­ing mus­cle atro­phy and chang­es in mus­cle archi­tec­ture dur­ing reha­bil­i­ta­tion.
METHODS: Ten ­male ­patients ­with uni­lat­er­al atro­phy of the leg musc­les (dif­fer­ence in cir­cum­fer­ence of at ­least 1.5 cm ­between, the two ­legs at the ­upper two-­thirds of tibi­al ­length) due to dif­fer­ent caus­es par­tic­i­pat­ed in the ­study. Scanning was per­formed ­with a ­real ­time com­pu­ter­ized son­o­graph. A 7.5 MHz 4 cm ­long ultra­sound ­probe was ­placed nor­mal to the sur­face of the gas­troc­ne­mi­us medi­al­is mus­cle in ­both the affect­ed and the unaf­fect­ed leg, and orient­ed ­along the ­median lon­gi­tu­di­nal ­axis of the mus­cle.
RESULTS: The ­results ­showed ­that the con­sis­tent decreas­es ­observed in the pen­na­tion ­angles of the mus­cle ­fibres cor­re­spond­ed to the ­degree of mus­cle atro­phy. Specifi-cally, the ­decrease in the ana­tom­i­cal CSA of the ­injured leg of ­each of our 10 ­patients was high­ly cor­re­lat­ed to a ­decrease in pen­na­tion ­angle, ­which, on aver­age, was 16% small­er ­than that in the ­uninjured leg. Atrophy ­also ­caused a ­decrease in ­fibre ­length of 13%.
CONCLUSIONS: Skeletal mus­cle atro­phy ­involves ­both struc­tu­ral and func­tion­al chang­es. Variations in mus­cle ­size ­entail not ­only a ­decrease in ­ACSA but ­also an inter­nal rear­range­ment of ­fibre ­length and pen­na­tion ­angle. A ­major advan­tage of ­this tech­nique is ­that imag­es can be ­acquired dynam­i­cal­ly and an ­instant pic­ture of the mus­cle archi­tec­ture can be ­obtained ­even dur­ing a mus­cle con­trac­tion.

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