Rehabilitative Ultrasound Imaging to Study the Gastrocnemius Muscles Morphology in Patients with Genu Varum and Valgum Deformities

Introduction: Genu varum and genu valgum deformities are highly prevalent in Iran. These deformities bring about changes in the structure and function of muscles around the knees. The aim of the present investigation was to study the structure of medial and lateral gastrocnemius muscles in patients with primary genu varum and genu valgum deformities and individuals with normal knee alignment, using rehabilitative ultrasound imaging. Method and Materials: : A Honda 2100 (Honda Co., Japan) real time ultrasound scanner was used in the current the study. The dominant legs of 18 women, 6 with genu varum (mean age: 22.00±1.78 years), 6 with genu valgum (mean age: 21.67±1.03 years), and 6 with normal alignment (mean age: 21.83±1.72 years) were examined. The morphological parameters like muscle thickness, pennation angle and fascicle length of medial and lateral gastrocnemius muscle were compared among groups. Results: In participants with genu varum, the medial gastrocnemius was thinner, closer and shorter in terms of muscle thickness, pennation angle, and fascicle lengths when compared to the lateral gastrocnemius (P<0.05). However, in participants with genu valgum, it was the other way around (P<0.05). In participants with normal alignment, there was no statistically significant difference between the medial and lateral gastrocnemius muscle structures. Conclusions: The rehabilitative ultrasound imaging is highly recommended for studying the structure of gastrocnemius muscle. The structural differences between medial and lateral gastrocnemius muscles may be due to the long term neuromuscular adaptation to knee joint alignment in both genu varum and genu valgum deformities.Key words: Genu, Valgum, Varum, Rehabilitative, Ultrasound, Imagin

Investigation of the Strength and Thickness of Upper Posterior Cervical Muscles in Women with Tension Headache

Introduction: In the etiology of tension type headache, the weakness of the upper posterior cervical muscles is associated to myofascial pain in cranio-cervical area. The aim of this study was to compare the strength and the thickness of the upper posterior neck muscles in women with chronic tension type headache and healthy control. Materials and methods: The strength and the thickness of upper posterior neck muscles were measured in 33 women (16 women with chronic tension type headache and 16 healthy controls). The strength of the upper cervical extensor muscles and the thickness of semispinalis capitis, splenius capitis, rectus capitis posterior major and oblique capitis superior muscles were measured by a custom made isometric device and a real-time ultrasonography machine. Pain was assessed by a visual analogue scale. Results: The strength of the muscles was significantly lower in patients with chronic tension type headache than the control group (P<0.001). Only, the thicknesses of rectus capitis posterior major and oblique capitis superior muscles were significantly smaller in patients compare to the healthy controls (P<0.001). A statistical negative correlation had been found between the levels of pain and the strength of upper posterior neck muscles (r=-0.65, P=0.006). Conclusion: The results have indicated that rectus posterior major and oblique capitis superior muscles may be weaker in patients with chronic tension type headache than controls. The results may be useful when evaluating the patients with chronic tension type headache by means of the level of upper cervical muscle strength and the muscle thickness measurements.Keywords: Strength, Thickness, Tension Chronic Headache, Upper Posterior Neck Muscle

An Ultrasonographic Investigation of Craniocervical Extensor Muscles in Patients with Chronic Non-specific Neck Pain

Introduction: The purpose of the present study was to measure the thickness and the strength of craniocervical extensor muscles in men with chronic non-specific neck pain and healthy controls. Materials and Methods: Fifteen men with chronic non-specific neck pain (CNNP) and 15 healthy controls were participated in this study. The thicknesses of the craniocervical extensor muscles (rectus capitis posterior major(RCPM)) and oblique capitis superior (OCS) in addition to the strength of upper cervical extensor muscles were measured at resting position and during maximal voluntary isometric contraction (MVIC) of craniocervical extensor muscles using ultrasonography device and a dynamometer which was designed for the purpose of study. Results: The thicknesses of RCPM and OCS muscles were significantly smaller in the patients group than the healthy controls at resting position and during maximal isometric contraction (P<0.001). There was a significant reduced MVIC in patients with CNNP when compared to controls (P=0.008). Conclusion: The reduced craniocervical extensor muscles strength and thickness in patients with CNNP may be due to pain and reflex inhibition which is originating from cervical neuromusculoskeletal structures. Craniocervical muscles assessments may be needed while evaluating patients with CNNP.Keywords: Craniocervical, Muscle, Neck, Pain, Strength, Thickness, Ultrasonograph