Home > Riviste > European Journal of Physical and Rehabilitation Medicine > Fascicoli precedenti > Europa Medicophysica 1999 June;35(2) > Europa Medicophysica 1999 June;35(2):69-73





Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

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)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063




Europa Medicophysica 1999 June;35(2):69-73

lingua: Inglese

Ultrasound mon­i­tor­ing of ­patients ­with leg mus­cle atro­phy

Capodaglio P., Ciuffreda L., Susta D., Faccioli M., Notarangelo G., Narici M. V.

Center for the Study of Motor Activities ­CSAM, “S. Maugeri Foundation” ­IRCCS, Institute of Pavia, Italy


BACKGROUND: So far, the descrip­tion of mus­cle atro­phy in ­humans has ­been most­ly ­based on chang­es in ana­tom­i­cal ­cross-sec­tion­al ­area (­ACSA) meas­ured at spe­cif­ic ­sites ­along the mus­cle bel­ly by imag­ing tech­niques. However, ­there is experi­men­tal evi­dence of region­al dif­fer­enc­es in mus­cle atro­phy and there­fore chang­es in the inter­nal archi­tec­ture of the mus­cle ­could go unde­tect­ed on the ­basis of ­ACSA cal­cu­la­tions. Skeletal mus­cles can be divid­ed ­into rough­ly two cat­e­go­ries: par­allel mus­cles, ­whose mus­cle ­fibres are par­allel to the ten­don ­attached to the ­bone and are there­fore on the trac­tion ­axis of the mus­cle, and pen­nated mus­cles, ­whose ­fibres are con­nect­ed to the ten­di­nous ­sheet ­with an ­angle ­defined as the “pen­na­tion ­angle”. In a pre­vi­ous ­study, we dem­on­strat­ed ­that mus­cle atro­phy led to a ­decrease in pen­na­tion ­angle and ­fibre ­length. The ­present ­study aimed dem­on­strate ­that to ultra­sound may rep­re­sent a sim­ple, disposable non-inva­sive meth­od to be used in rehabilitation medicine to assess­ mus­cle atro­phy and mon­i­tor­ing chang­es in mus­cle archi­tec­ture ­after rehabilitation.
EMTHODS: Ten ­patients (6 ­males, 4 ­females, 21-41 yrs.) ­with uni­lat­er­al mus­cle atro­phy ­were admit­ted to ­this ­study. Maximum ana­tom­i­cal CSA of the gas­troc­ne­mi­us medi­al­is (GM) was deter­mined ­with CT ­scans of ­both ­legs. GM mus­cle ­fiber pen­na­tion ­angle and ­fiber ­length ­were meas­ured in ­both ­legs in the ­same ­region of max­i­mum CSA by ­real-­time ultra­sound ­with a 7.5 MHz, 4 cm ­long, lin­e­ar ­probe. Maximal vol­un­tary and electri­cal­ly ­evoked ­torque of the plan­tar flex­or mus­cles ­were meas­ured. The ­twitch inter­po­la­tion tech­nique was ­also ­used. The meas­ure­ments ­were repeat­ed ­after a one ­month reha­bil­i­ta­tion period in all of subject.
RESULTS: The ­mean pre-reha­bil­i­ta­tion CSA was 17.8 cm2 in the unaf­fect­ed ­limb and 16.7 cm2 in the affect­ed ­limb; the ­post-reha­bil­i­ta­tion val­ues ­were 19.8 cm2 in the unaf­fect­ed ­limb and 18.2 cm2 in the affect­ed ­limb. Mean pen­na­tion ­angles dif­fered by 11% (25.5% in the unaf­fect­ed ­limb and 22.8% in the affect­ed ­limb, p<0.02) at pre-reha­bil­i­ta­tion, ­while no sig­nif­i­cant dif­fer­enc­es ­were ­observed at ­post-reha­bil­i­ta­tion. No chang­es in ­fiber ­length ­were ­observed at pre- and ­post-reha­bil­i­ta­tion. Affected to unaf­fect­ed dif­fer­enc­es in max­i­mal vol­un­tary ­strength var­ied ­from 32.4% at pre-reha­bil­i­ta­tion to 9.6% at post­re­ha­bil­i­ta­tion.
CONCLUSIONS: This ­study ­showed ­that US pro­vides a sim­ple non-inva­sive ­means of quan­ti­fy­ mus­cle atro­phy and mon­i­tor­ing chang­es fol­low­ing reha­bil­i­ta­tion. Structural chang­es in CSA and pen­na­tion ­angle as mon­i­tored by US, and func­tion­al chang­es in mus­cle max­i­mal ­strength pro­vide an “up to ­date” pro­file of the mus­cu­lar archi­tec­ture and per­for­mance capac­ity. US rep­re­sents a sen­si­tive-to-­change meth­od to evaluate the ­degree of mus­cle atro­phy in reha­bil­i­ta­tion ­patients.

inizio pagina

Publication History

Per citare questo articolo

Corresponding author e-mail