Contribution of components of the quadriceps femoris muscle for producing external torque in patients with patellofemoral pain syndrome

IntroductionDifferent muscular activities of the quadriceps components for producing necessary torque may change in patients with patellofemoral pain syndrome (PFPS). The aim of the current study, therefore, was to assess the contribution of each component of the quadriceps femoris muscle for producing external torque in patients with PFPS.MethodTwelve females with PFPS (24.7 ± 2.3 years) and twelve healthy matched females (25.4 ± 2.4 years) performed three consecutive knee flexion and extension movements with maximum effort at 45°/s and 300°/s using a Biodex system 3 dynamometer. Simultaneously, electromyographic (EMG) activities of the vastus medialis oblique (VMO), RF (rectus femoris) and vastus lateralis (VL) muscles were recorded using a DataLog instrument. Standard multiple regressions were used to assess the ability of EMG activities of the VMO, RF and VL muscles to predict normalized quadriceps femoris isokinetic concentric and eccentric torques at 45°/s and 300°/s in the normal and patient groups.ResultsIn the normal group, the VL and the VMO were the good predictors of quadriceps concentric torque at 45°/s and 300°/s, respectively. The VL and the RF were the good predictors of quadriceps eccentric torque at 300°/s in the patient group. No other conditions showed a considerable prediction for quadriceps torque in the normal or patient group.ConclusionFemales with PFPS differ with normal females in terms of the contribution of each component of the quadriceps femoris for producing external torque. Training the VMO for concentric contraction at both high and low velocities should be included in the management of the patients with PFPS.     

Classification and cyclic fatigue evaluation of new kinematics for endodontic instruments

This study evaluated the effect of new motions of the motor TriAuto ZX2 on the cyclic fatigue of endodontic instruments. Vortex Blue 35.06 instruments were divided into four groups (n = 10) and tested for fatigue in a curved artificial canal (90° and 2 mm radius) using the following motions: continuous rotation (CR), Optimum Torque Reverse (OTR) set at 180° and the Optimum Glide Path (OGP), which was tested at 90° and 240°. The time to fracture (TTF) and the lengths of the fractured fragments were recorded. The mean TTF was significantly different among the groups (anova , P < 0.05): OGP 90° (213.39 ± 27.45), OTR 180° (121.24 ± 17.03), OGP 240° (45.24 ± 5.61) and CR (8.43 ± 1.27). Weibull analysis confirmed the shortest life expectancy for CR and the longest survival for OGP at 90°. The resistance to fatigue was affected by motions and pre‐set angles. The proprietary movements that are currently available for endodontic instruments were classified according to their kinematics.     

通用型脊柱内固定系统椎弓根螺钉翻修作用的生物力学研究

目的测试自行设计的通用型脊柱内固定系统(generalspinesystem,GSS)椎弓根螺钉以及SOCON、TSRH和Diapason螺钉置入椎体的拔出力及旋入力矩,评价GSS螺钉的翻修作用。方法将36个正常成人腰椎椎体标本随机分为三组,每组12个椎体(24侧椎弓根)。各组标本每个椎体的每侧椎弓根均先拧入CCD螺钉(直径6.0mm,长45mm),行螺钉拔出试验,测试并记录螺钉的最大旋入力矩和最大轴向拔出力。然后各组标本每个椎体均随机选择一侧椎弓根经原钉道拧入GSS螺钉(直径6.5mm,长45mm);第一组另一侧拧入SOCON螺钉(直径7.0mm,长45mm),第二组另一侧拧入TSRH螺钉(直径7.0mm,长45mm),第三组另一侧拧入Diapason螺钉(直径6.7mm,长45mm)。分别测试螺钉最大旋入力矩及最大轴向拔出力。结果第一组GSS螺钉最大轴向拔出力为CCD螺钉的114%,SOCON螺钉为CCD螺钉的108%;GSS螺钉最大轴向拔出力大于SOCON螺钉,差异无显著性(P>0.05);GSS螺钉最大旋入力矩小于SOCON螺钉,差异无显著性(P>0.05)。第二组GSS螺钉最大轴向拔出力为CCD螺钉的127%,TSRH螺钉为CCD螺钉的64%;GSS螺钉最大轴向拔出力大于TSRH螺钉,差异有显著性(P<0.01);GSS螺钉最大旋入力矩大于TSRH螺钉,差异有显著性(P<0.01)。第三组GSS螺钉最大轴向拔出力为CCD螺钉的122%,Diapason螺钉为CCD螺钉的8     

Isokinematic muscle mechanics in four groups of women of increasing age

Summary The purpose of this study was to evaluate the effects of age on dynamic muscle attributes of the knee extensors and flexors in postmenopausal women. Young healthy women (3rd decade,n = 15; 4th decade,n = 5) and older healthy women (6th decade,n = 9; 7th decade,n = 6) were tested at six angular velocities from 60° · s^–1 to 400° · s^–1. The 3rd and 4th decade groups produced greater extensor and flexor values for strength related variables at all angular velocities (peak torque, angle specific torque, work, power) than both the 6th and 7th decade groups (P<0.05). However, relative changes in these variables, with increments in angular velocity, were equivalent among the groups. Analysis of the flexor: extensor ratios for these variables demonstrated a differential loss in flexor function with increased age, perhaps indicative of type II motor unit loss or muscle fibre atrophy. It is suggested that such changes may be present even within 4th decade subjects.     

Specific tension of elbow flexor and extensor muscles based on magnetic resonance imaging

Series cross-section images of the upper extremity were obtained for four men by magnetic resonance imaging (MRI) and anatomical cross-sectional areas (ACSA) of elbow flexor muscles [biceps brachii (BIC), brachialis (BRA), brachioradialis (BRD)] and extensor muscles [triceps brachii (TRI)] were measured. Physiological cross-sectional area (PCSA) was calculated from the muscle volume and muscle fibre length, the former from the series ACSA and the latter from the muscle length multiplied by previously reported fibre/muscle length ratios. Elbow flexion/extension torque was measured using an isokinetic dynamometer and the force at the tendons was calculated from the torque and moment arms of muscles measured by MRI. Maximal ACSA of TRI was comparable to that of total flexors, while PCSA of TRI was greater by 1.9 times. Within flexors, BRA had the greatest contribution to torque (47%), followed by BIC (34%) and BRD (19%). Specific tension related to the estimated velocity of muscle fibres were similar for elbow flexors and extensors, suggesting that the capacity of tension development is analogous between two muscle groups.     

Dynamic relationship between EMG and torque at the human ankle: Variation with contraction level and modulation

Stochastic system identification techniques were used to determine the dynamic relationship between the electromyogram (EMG) and torque in the ankle muscles of normal human subjects. EMG and torque were recorded while subjects modulated ankle torque by tracking a computer-generated stochastic waveform. Nonparametric impulse response functions (IRFs) relating EMG to ankle torque were computed and parameterised by determining the parameters of the second-order system which provided the best least-squares fit. Two sets of experiments were carried out. In the first, the mean level of torque was varied from 5 per cent of the maximum voluntary contraction (MVC) to 30 per cent MVC while the depth of modulation was held constant at ±5 per cent of MVC. In the second series of experiments the mean torque was held constant at 25 per cent MVC while the depth of modulation was varied from ±2.5 per cent to ±25 per cent. The major findings were: (1) A second-order, low-pass filter provided a good quasilinear model of the EMG/force dynamics under all conditions; (2) The model parameters depended only weakly on the mean level of torque; (3) In contrast, the model parameters depended strongly on the amplitude with which the contraction was modulated; the natural frequency increased significantly with the depth of modulation.     

The development of goal-directed reaching in infants II. Learning to produce task-adequate patterns of joint torque

 Nine young infants were followed longitudinally from 4 to 15 months of age. They performed multijoint reaching movements to a stationary target presented at shoulder height. Time-position data of the hand, shoulder, and elbow were collected using an optoelectronic measurement system. In addition, we recorded electromyographic activity (EMG) from arm extensors and flexors. This paper documents how control problems of proximal torque generation may account for the segmented hand paths seen during early reaching. Our analysis revealed the following results: first, muscular impulse (integral of torque) increased significantly between the ages of 20 (reaching onset) and 64 weeks. That is, as infants got older they produced higher levels of mean muscular flexor torque during reaching. Data were normalized by body weight and movement time, so differences are not explained by anthropometric changes or systematic variations in movement time. Second, while adults produced solely flexor muscle torque to accomplish the task, infants generated flexor and extensor muscle torque at shoulder and elbow throughout a reach. At reaching onset more than half of the trials revealed this latter kinetic profile. Its frequency declined systematically as infants got older. Third, we examined the pattern of muscle coordination in those trials that exhibited elbow extensor muscle torque. We found that during elbow extension coactivation of flexor and extensor muscles was the predominant pattern in 67% of the trials. This pattern was notably absent in comparable adult reaching movements. Fourth, fluctuations in force generation, as measured by the rate of change of total torque (NET) and muscular torque (MUS), were more frequent in early reaching (20–28 weeks) than in the older cohort (52–64 weeks), indicating that muscular torque production became increasingly smoother and task-efficient. Our data demonstrate that young infants have problems in generating smooth profiles of proximal joint torques. One possible reason for this imprecision in infant force control is their inexperience in predicting the magnitude and direction of external forces. That infants learned to consider external forces is documented by their increasing reliance on these forces when performing voluntary elbow extensions. The patterns of muscle coordination underlying active elbow extensions were basically the same as during the prereaching phase, indicating that the formation of functional synergies is based on a basal repertoire of innervation patterns already observable in very early, spontaneous movements. Received: 5 January 1996 / Accepted: 19 August 1996     

Identification of the neural component of torque during manually-applied spasticity assessments in children with cerebral palsy

Clinical assessment of spasticity is compromised by the difficulty to distinguish neural from non-neural components of increased joint torque. Quantifying the contributions of each of these components is crucial to optimize the selection of anti-spasticity treatments such as botulinum toxin (BTX). The aim of this study was to compare different biomechanical parameters that quantify the neural contribution to ankle joint torque measured during manually-applied passive stretches to the gastrocsoleus in children with spastic cerebral palsy (CP). The gastrocsoleus of 53 children with CP (10.9 ± 3.7 y; females n = 14; bilateral/unilateral involvement n = 28/25; Gross Motor Functional Classification Score I–IV) and 10 age-matched typically developing (TD) children were assessed using a manually-applied, instrumented spasticity assessment. Joint angle characteristics, root mean square electromyography and joint torque were simultaneously recorded during passive stretches at increasing velocities. From the CP cohort, 10 muscles were re-assessed for between-session reliability and 19 muscles were re-assessed 6 weeks post-BTX. A parameter related to mechanical work, containing both neural and non-neural components, was compared to newly developed parameters that were based on the modeling of passive stiffness and viscosity. The difference between modeled and measured response provided a quantification of the neural component. Both types of parameters were reliable (ICC > 0.95) and distinguished TD from spastic muscles (p < 0.001). However, only the newly developed parameters significantly decreased post-BTX (p = 0.012). Identifying the neural and non-neural contributions to increased joint torque allows for the development of individually tailored tone management.     

Clinical significance of changes in Torque teno virus DNA titer after chemotherapy in patients with primary lung cancer

Background

Several studies have reported that viral infections are related to lung cancer. We previously reported the involvement of Torque teno virus (TTV) in patients with lung cancer and idiopathic pulmonary fibrosis. However, the role of TTV in lung cancer growth, and its influence on changes in TTV DNA titers due to idiopathic pulmonary fibrosis (IPF) in lung cancer patients are poorly understood.