Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > Europa Medicophysica 1998 September;34(3) > Europa Medicophysica 1998 September;34(3):121-4



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Europa Medicophysica 1998 September;34(3):121-4


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


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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