17 research outputs found
Monitoring Progression of Amyotrophic Lateral Sclerosis Using Ultrasound Morpho-Textural Muscle Biomarkers: A Pilot Study.
The need is increasing for progression biomarkers that allow the loss of motor neurons in amyotrophic lateral sclerosis (ALS) to be monitored in clinical trials. In this prospective longitudinal study, muscle thickness, echointensity, echovariation and gray level co-occurrence matrix textural features are examined as possible progression ultrasound biomarkers in ALS patients during a 5-mo follow-up period. We subjected 13 patients to 3 measurements for 20 wk. They showed a significant loss of muscle, an evident tendency to loss of thickness and increased echointensity and echovariation. In regard to textural parameters, muscle heterogeneity tended to increase as a result of the neoformation of non-contractile tissue through denervation. Considering some limitations of the study, the quantitative muscle ultrasound biomarkers evaluated showed a promising ability to monitor patients affected by ALS.Universidad Caólica San Antonio de Murcia.Medicin
Quantitative muscle ultrasonography using textural analysis in amyotrophic lateral sclerosis
Background: To analyze differences in grey level co-ocurrence matrix (GLCM) parameters, as assessed by muscle ultrasound (MUS), between amyotrophic lateral sclerosis (ALS) patients and healthy controls. To compare the diagnostic accuracy of these GLCM parameters with first order MUS parameters (echointensity, EI; echovariation, EV; and muscle thickness, MTh) in different muscle groups. Methods: Twenty-six patients with ALS and twenty-six healthy subjects underwent bilateral and transverse ultrasound of the biceps/brachialis, forearm flexor, quadriceps femoris and tibialis anterior muscle groups. MTh was measured with electronic callipers and EI, EV and GLCM were obtained using Image J (v.1.48) software. Sensitivity, specificity, likelihood ratios and area under
the curve (AUC) were performed by logistic regression models and ROCcurves. Results: GLCM parameters showed reduced granularity in the muscles of ALS patients compared with the controls. Regarding the discrimination capacity, the best single diagnostic parameter in forearm flexors and quadriceps was GLCM and in biceps brachialis and tibialis anterior was EV. The respective combination of these two parameters with MTh resulted in the best AUC (over 90% in all muscle groups and close to the maximum combination model). Conclusions:
The use of new textural parameters (EV and GLCM) combined with usual quantitative MUS variables are a promising biomarker in ALS.Universidad Católica de Murcia.MedicinaTerapia y Rehabilitació
Muscular echovariation: a new biomarker in amyotrophic lateral sclerosis
The purpose is to assess the characteristics of echovariation in amyotrophic lateral sclerosis (ALS) compared with other MUS parameters. Twenty-six ALS patients (8 women, mean age 58.9 years, SD 12.02 yr) and 26 healthy controls (17 women; mean age 59.6 years, SD 6.41 yr) were included in this observational study. They underwent bilateral and transverse ultrasound of the biceps/brachialis, forearm flexor group, quadriceps femoris and tibialis anterior. Muscular thickness, echointensity and echovariation were analyzed. Muscles affected by ALS showed increased echointensity, decrease in thickness, and decrease echovariation. Echovariation in all muscles but
quadriceps femoris, strongly correlated with muscle strength (explained variance between 21.8% in the biceps/brachialis and 37.5% in tibialis anterior) and the ALSFRS-R score (explained variance between 26% in the biceps/brachialis and 36.7% in the forearm flexor group). Echovariation is an easy to obtain QMUS parameter that could distinguish ALS from healthy controls more accurately than previous described biomarkers.UCAMMedicinaTerapia y Rehabilitació
Biomechanic and reeducation of the march after arthroscopy of knee
Una vez se ha adquirido una marcha bípeda equilibrada, ésta pasa a convertirse en un acto involuntario, lo que la
hace del mismo modo arriesgada, ya que puede alterarse por diversos factores como es una lesión o la práctica de
una intervención quirúrgica como es la artroscopia de rodilla. Por esta razón, hemos creído conveniente establecer
unos criterios de normalidad articular durante el ciclo de la marcha y conocer la patomecánica y la efectividad de la
reeducación de la misma tras una intervención mediante artroscopia de rodilla.
Para la realización de este trabajo, previo consentimiento informado, hemos contado con 50 sujetos (30 dentro
de un grupo control y 20 dentro de un grupo de trabajo), llegando a la conclusión que, todos los sujetos del grupo
de trabajo que llevaron a cabo una específica reeducación de la marcha, en base a unos datos obtenidos en una
primera fase de tratamiento, mejoraron en mayor o menor medida frente a los que no la realizaron.Terapia y Rehabilitació
Textural Analysis by Means of a Grey Level Co-Occurrence Matrix Method on Patellar Tendon Ultrasonography is Useful for the Detection of Histological Changes after Whole-Body Vibration Training
Introducción: Las matrices de co-ocurrencia del nivel
de gris (GLCM) son útiles para el análisis textural de
imágenes ya la discriminación de patrones pero hasta
ahora no se han aplicado sobre imágenes ecográficas
del tendón. Objetivo: Análisis textural ecográfico del
tendón rotuliano. Método: Estudio longitudinal analítico
con 16 sujetos (8 mujeres y 8 hombres) jóvenes,
sanos y sedentarios entrenados con una plataforma de
vibración vertical (Fitvibe Medical) 2 días x 14 semanas.
Se tomaron cortes ecográficos transversales del tendón
rotuliano antes y después del entrenamiento con un
ecógrafo Sonosite-180 (Lineal 5-10 MHz). Mediante el
algoritmo GLCM de Image J v1.38 se calcularon las variables
texturales Uniformidad (ASM), Contraste, Correlación,
Homogeneidad (IDM) y la Entropía para cuatro
orientaciones (0º, 90º, 180º y 270º) y tres distancias (d=1,
5 y 10 px). Se aplicó la prueba de Wilcoxon (i.c.95%)
para muestras relacionadas (SPSS 15.0). Resultados: la
Entropía (d=5) fue la más sensible a los cambios texturales;
quizá la variable ASM, pueda resultar también de
interés junto con el Contraste. Conclusiones: Ante la
falta de referencias con el uso de la GLCM en el análisis
textural de ecografía de tendón son necesarios más análisis
que estudien cómo afectan los distintos parámetros
a las variables texturales, cómo se relacionan entre sí y
cuáles pueden ser los mejores ajustes del algoritmo para
detectar cambios en el patrón textural.Actividad Física y DeporteTerapia y RehabilitaciónMedicin
Principles of Physiotherapy in osteoporosis
La osteoporosis, considerada actualmente como una pandemia, afecta a un amplio número de personas, tanto
mujeres como hombres, lo que implica elevadas consecuencias económicas y sociales, de entre las cuales destacamos
el dolor, la incapacidad y el riesgo de fractura.
Su etiología es diversa, pudiendo ser primaria (postmenopáusica, senil,…) y secundaria (tras inmovilización, desequilibrios
endocrinos y metabólicos, o bien, enfermedades de tipo digestivo). En todas ellas, una vez instaurada la
patología, la fisioterapia desempeña un papel incuestionable, pero es en la prevención de la aparición de la osteoporosis
donde esta profesión debe actuar, evitando la afectación del hueso sano.Terapia y Rehabilitació
Degenerative asymtomatic processes of the long head of biceps brachii
El tendón largo del bíceps braquial es considerado el pilar de contención del complejo articular del hombro. Su
correcta biomecánica dependerá, además de sí mismo, de las estructuras con las que se relaciona, en especial
con el tendón del subescapular y la corredera bicipital. El sobreuso de estas estructuras, aún sin sintomatología,
desencadenará compensaciones morfológicas y morfométricas en el tendón largo del bíceps braquial e
inestabilidad articular. Un sobreuso del subescapular se encuentra relacionado con: (1). Una mayor angulación
interna del tendón largo del bíceps, (2). Una mayor angulación, menor profundidad y mayor anchura de la
corredera bicipital. Esto supone que el 35% de las luxaciones del tendón largo del bíceps se encuentren
relacionadas con rotura del tendón del subescapular.Terapia y Rehabilitació
Monitoring Progression of Amyotrophic Lateral Sclerosis Using Ultrasound Morpho-Textural Muscle Biomarkers: A Pilot Study.
The need is increasing for progression biomarkers that allow the loss of motor neurons in amyotrophic lateral sclerosis (ALS) to be monitored in clinical trials. In this prospective longitudinal study, muscle thickness, echointensity, echovariation and gray level co-occurrence matrix textural features are examined as possible progression ultrasound biomarkers in ALS patients during a 5-mo follow-up period. We subjected 13 patients to 3 measurements for 20 wk. They showed a significant loss of muscle, an evident tendency to loss of thickness and increased echointensity and echovariation. In regard to textural parameters, muscle heterogeneity tended to increase as a result of the neoformation of non-contractile tissue through denervation. Considering some limitations of the study, the quantitative muscle ultrasound biomarkers evaluated showed a promising ability to monitor patients affected by ALS.Universidad Caólica San Antonio de Murcia.Medicin
Biomechanics of the Median Nerve During Stretching as Assessed by Ultrasonography
The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7–.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4–27.7 and ORdor = 8.3; 95% CI = 1.6–44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise.Actividad Física y DeporteMedicinaTerapia y Rehabilitació
Biomechanics of the Median Nerve During Stretching as Assessed by Ultrasonography
The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7–.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4–27.7 and ORdor = 8.3; 95% CI = 1.6–44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise.Actividad Física y DeporteMedicinaTerapia y Rehabilitació