Loss of muscle mass occurs rapidly during critical illness and negatively affects quality of life. The incidence of clinically significant muscle wasting in critically ill patients is unclear. This study aimed to assess the incidence of and identify predictors for clinically significant loss of muscle mass in this patient population. This was a single-center observational study. We used ultrasound to determine the rectus femoris cross-sectional area (RFcsa) on the first and seventh day of ICU stay. The primary outcome was the incidence of significant muscle wasting. We used a logistic regression model to determine significant predictors for muscle wasting. Ultrasound measurements were completed in 104 patients. Sixty-two of these patients (59.6%) showed ≥ 10% decreases in RFcsa. We did not identify any predictor for significant muscle wasting, however, age was of borderline significance (p = 0.0528). The 28-day mortality rate was higher in patients with significant wasting, but this difference was not statistically significant (30.6% versus 16.7%; p = 0.165). Clinically significant muscle wasting was frequent in our cohort of patients. Patient age was identified as a predictor of borderline significance for muscle wasting. The results could be used to plan future studies on this topic.Trial registration: ClinicalTrials.gov NCT03865095, date of registration: 06/03/2019.
- MeSH
- Quadriceps Muscle diagnostic imaging MeSH
- Incidence MeSH
- Intensive Care Units MeSH
- Critical Illness * MeSH
- Quality of Life * MeSH
- Humans MeSH
- Prospective Studies MeSH
- Muscular Atrophy diagnostic imaging epidemiology etiology MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
ABSTRACT: Merrigan, JJ, Jones, MT, Malecek, J, Padecky, J, Omcirk, D, Xu, N, Peñailillo, L, and Tufano, JJ. Comparison of traditional and rest-redistribution sets on indirect markers of muscle damage following eccentric exercise. J Strength Cond Res 36(7): 1810-1818, 2022-The purpose was to investigate the effect of rest-redistribution (RR) on muscle damage after eccentric knee extensions. After 2 weeks of eccentric familiarization, 11 resistance-trained men performed 2 work-matched isokinetic unilateral eccentric knee extension protocols at 60°·s-1 using a crossover design, separated by 7 days. Subjects performed 40 repetitions with 285 seconds of rest using traditional sets (TS; 4 sets of 10 with 95 seconds of interset rest) and RR (RR; 20 sets of 2 with 15 seconds of interset rest). Muscle morphology, tensiomyography, range of motion, perceived soreness, and strength were measured before and 0, 24, 48, 72, and 96 hour after RR and TS. There were no protocol × time interactions (p < 0.05). When collapsed across protocol and compared to baseline, echo intensity of the proximal vastus lateralis was 7 ± 9% greater at 0 hour (p = 0.042), echo intensity of the distal vastus lateralis was 6 ± 7% and 9 ± 7% greater at 0 hour (p = 0.048) and 24 hour (p < 0.001), respectively, and passive ROM was 2 ± 1% lower at 48 hour (p = 0.043) after exercise. No other differences existed over time for any other variable. Thus, contrary to concentric performance where RR likely plays a large role in maintaining performance, RR during eccentric isokinetic resistance training does not strongly influence exercise performance and indications of subsequent muscle damage.
- MeSH
- Quadriceps Muscle * diagnostic imaging MeSH
- Critical Illness * MeSH
- Humans MeSH
- Observer Variation MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Acute changes in muscle architecture influenced by muscle swelling might be associated with chronic adaptations to resistance exercise, including skeletal muscle growth. Concentric (CON) and eccentric (ECC) muscle actions both play a role in hypertrophic processes, but the influence of each on acute indices of muscle swelling (i.e., muscle thickness (MT) and pennation angle (PA)) remains relatively unknown. Therefore, this study compared the acute changes in MT and PA in response to work-matched CON versus ECC isokinetic exercise. Twelve university-aged students performed 2 bouts of maximal isokinetic knee extensions at 120°·s-1 on the same day: 50 CON followed by a work-matched ECC bout (∼5000 J; 28 ± 5 reps) with the contralateral limb. Ultrasound images were captured from the middle and distal sites of the vastus lateralis before and immediately after each exercise bout. From these images, MT and PA were measured. Middle and distal MT (11% and 14%, respectively; p < 0.001) and middle PA (39%, p < 0.001) increased only after CON. In addition, changes in MT were strongly related to the amount of total work performed (r = 0.76) during CON. Our results suggest that when the workload is matched between CON and ECC muscle actions performed at a moderate velocity, CON actions seem to be a more potent stimulus for inducing acute changes in MT and PA.
- MeSH
- Time Factors MeSH
- Quadriceps Muscle diagnostic imaging physiology MeSH
- Exercise physiology MeSH
- Adaptation, Physiological MeSH
- Humans MeSH
- Young Adult MeSH
- Resistance Training * MeSH
- Muscle Contraction * MeSH
- Muscle Strength Dynamometer MeSH
- Muscle Strength MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
Článek popisuje techniky periferních nervových blokád "femoral triangle block" a "adductor canal block" používané pro operace kolenního kloubu. Významnou výhodou těchto blokád je zachování motorické funkce musculus quadriceps femoris. Ukazuje, jak rozlišit femorální trojúhelník od adduktorového kanálu, a vysvětluje jednotlivé rozdíly mezi nimi. Obsahuje recentní anatomické informace z publikovaných kadaverózních studií a poskytuje jednoduchý návod na provedení obou technik v klinické praxi.
This review describes the "femoral triangle" and "adductor canal" peripheral nerve blocks used for knee joint surgery. A significant advantage of these blockades is their preserving of the quadriceps motor function. This article shows how to distinguish the femoral triangle from the adductor canal and it explains the differences between them. It contains recent anatomical information from published cadaveric studies and it provides a simple guideline how to perform both techniques in clinical practice
- Keywords
- femoralní trojúhelník, adduktorový kanál,
- MeSH
- Quadriceps Muscle diagnostic imaging innervation MeSH
- Knee Joint * innervation MeSH
- Humans MeSH
- Anesthesia, Local * MeSH
- Nerve Block methods MeSH
- Pain, Postoperative MeSH
- Postoperative Care MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Objectives: The main objective of this study is to explore the prevalence and distribution of entheseal US changes in a cohort of SLE patients, taking as controls a group including both PsA patients and healthy subjects. The secondary objective is to investigate the correlation between the US findings and the clinical and serological data in SLE patients. Methods: Clinical and US assessment of quadriceps, patellar and Achilles tendons, and plantar fascia entheses were performed by independent rheumatologists on 65 patients with SLE, 50 patients with PsA and 50 healthy subjects. US findings were identified according to the OMERACT definitions. In SLE patients, the correlation between the US changes and the clinical and laboratory findings was evaluated. Results: US revealed one or more abnormalities in at least one enthesis in 44 out of 65 SLE patients (67.7%), 47 out of 50 PsA patients (94.0%) and 22 out of 50 healthy subjects (44.0%). In SLE patients, US findings indicating active inflammation were significantly more frequently detected than in healthy subjects (P < 0.001). The distal enthesis of the patellar tendon was the most commonly involved. The presence of power Doppler signal at the enthesis was an independent predictor of SLE disease activity (SLEDAI-2k P < 0.001, β = 0.52; musculoskeletal-BILAG P < 0.001, β = 0.56). Conclusion: The burden of entheseal sonographic changes was significantly higher in SLE patients than in healthy subjects, especially as regards active inflammation. The presence of power Doppler signal at the enthesis may represent a potential biomarker of SLE disease activity.
- MeSH
- Achilles Tendon diagnostic imaging MeSH
- Quadriceps Muscle diagnostic imaging MeSH
- Adult MeSH
- Enthesopathy diagnostic imaging etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Patellar Ligament diagnostic imaging MeSH
- Foot diagnostic imaging MeSH
- Arthritis, Psoriatic complications diagnostic imaging MeSH
- Case-Control Studies MeSH
- Severity of Illness Index MeSH
- Lupus Erythematosus, Systemic complications diagnostic imaging MeSH
- Ultrasonography, Doppler methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Our paper presents a unique case of a 64-year-old patient after a fall, treated with oral antidiabetic drugs for type II diabetes mellitus. Following a series of examinations, a bilateral injury was diagnosed - patellar ligament tear on the right side and rupture of quadriceps femoris muscle on the left side. It is a rare injury, complicated by simultaneous involvement of both knee joints. The used therapy consisted of a bilateral surgery followed by gradual verticalisation, first with the support of a walking frame and later with the use of forearm crutches. During the final examination, the patient demonstrated full flexion at both knees, while an extension deficit of approx. 5 degrees was still present on the left side. The right knee X-ray showed a proper position of the patella after the removal of temporary tension band wire. Although the clinical results of operative treatment of both the patellar ligament rupture and rupture of quadriceps femoris muscle are in most cases good, early operative treatment, proper technique and post-operative rehabilitation are a prerequisite for success. Key words: knee injuries, patellar ligament, quadriceps muscle, rupture.
- MeSH
- Quadriceps Muscle diagnostic imaging injuries surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Patellar Ligament diagnostic imaging injuries surgery MeSH
- Disease Management MeSH
- Rupture surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
