Anatomic Localization of Motor Points in Gastrocnemius and Soleus Muscles

Kim, Minwook; Kim, Jong-Hyun; Yang, Yoo-Jin; Ko, Young-Jin

doi:10.1097/01.phm.0000176341.85398.a9

Cited by 47 publications

(42 citation statements)

References 5 publications

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“…The same authors also localized, in healthy subjects, the motor points of the medial and lateral gastrocnemius at *12 and *10% of the same distance, respectively (Lee et al 2009). Further, Kim et al (2005) showed that the motor points of the medial and lateral gastrocnemius were diffusely distributed along the longitudinal bulk of the two muscle heads: the range of motor point locations was from *10 to *37% of the distance between the intercondylar and the intermalleolar line for the medial gastrocnemius, and from *12 to *38% of the same distance for the lateral gastrocnemius. Consistently, we found an average (2) subbranches of the proximal primary branch of the vastus lateralis; middistal (3) and distal (4) sub-branches of the distal primary branch of the vastus lateralis (adapted from Becker et al 2010).…”

Section: Motor Point Location and Uniformitymentioning

confidence: 98%

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

et al. 2011

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The aim of the study was to investigate the uniformity of the muscle motor point location for lower limb muscles in healthy subjects. Fifty-three subjects of both genders (age range: 18-50 years) were recruited. The muscle motor points were identified for the following ten muscles of the lower limb (dominant side): vastus medialis, rectus femoris, and vastus lateralis of the quadriceps femoris, biceps femoris, semitendinosus, and semimembranosus of the hamstring muscles, tibialis anterior, peroneus longus, lateral and medial gastrocnemius. The muscle motor point was identified by scanning the skin surface with a stimulation pen electrode and corresponded to the location of the skin area above the muscle in which an electrical pulse evoked a muscle twitch with the least injected current. For each investigated muscle, 0.15 ms square pulses were delivered through the pen electrode at low current amplitude (<10 mA) and frequency (2 Hz). 16 motor points were identified in the 10 investigated muscles of almost all subjects: 3 motor points for the vastus lateralis, 2 motor points for rectus femoris, vastus medialis, biceps femoris, and tibialis anterior, 1 motor point for the remaining muscles. An important inter-individual variability was observed for the position of the following 4 out of 16 motor points: vastus lateralis (proximal), biceps femoris (short head), semimembranosus, and medial gastrocnemius. Possible implications for electrical stimulation procedures and electrode positioning different from those commonly applied for thigh and leg muscles are discussed.

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Section: Motor Point Location and Uniformitymentioning

confidence: 98%

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

et al. 2011

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“…In the anatomic angle, the location of the MEP with respect to the flexor digitorum profundus (Hwang et al, 2007), triceps surae muscles (Kim et al, 2002(Kim et al, , 2005, posterior compartment of the leg (Apaydin et al, 2008), thumb in the palm (Im et al, 2008), and biceps brachii and brachialis muscles (Lee et al, 2010) have been well described. In contrast, studies describing the MEP of the PL and PB based on cadaver dissection of the leg have received less attention.…”

Section: Introductionmentioning

confidence: 98%

Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Lee

et al. 2010

Clinical Anatomy

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This study examined the anatomic location of the motor entry point (MEP) and branching point at the proximal and distal points of the tendon of the peroneal muscle by visual observation. Forty-three fresh legs of 25 adult bodies which had been donated to science were investigated in this study. The mean length of the reference line between the most proximal point of the head of the fibula (PHF) and the most distal point of the malleolus of the fibula (DMF) was 33.4 ± 2.5 cm. The MEPs of the peroneus longus (PL) and peroneus brevis (PB) gathered from 20 to 40% (7.0-13.0 cm) and 40 to 60%, respectively. The branching point where the nerve was divided to innervate the PL and PB was 10% and 28% from the PHF, respectively. These anatomic results suggest appropriate areas where to inject phenol or other agents for a MEP block in the case of a spastic lower extremity as well as guidelines for an electromyography conduction test.

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“…However, mammalian skeletal muscles, such as the trapezius 1 , the extensor carpi radialis longus and brevis 2 , the tibialis anterior 3 , the brachialis anterior 4 , the long head of triceps 5 , the sartorius 6 , the medial gastrocnemius and the soleus 7 , and the peroneus longus 8 , possess multiple actions that correlate with their muscular architecture and neural organization 9 . In 1974, Letbetter 10 characterized the subdivisions of the medial gastrocnemius in the cat, establishing the basis for the investigation of other muscles in animals and humans.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry

Méndez

Gatica

Guzmán

et al. 2013

Braz. J. Phys. Ther.

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| Background: Muscles are innervated exclusively by a nerve branch and possess definite actions. However, mammalian skeletal muscles, such as the trapezius, the medial gastrocnemius, and the peroneus longus, are compartmentalized. In the peroneus longus muscle, multiple motor points, which innervate individual neuromuscular compartments (NMC), the superior (S-NMC), anteroinferior (AI-NMC), and posteroinferior (PI-NMC), have been described. The contribution of each neuromuscular compartment to the final action of the muscle is fundamental for the rehabilitation of patients afflicted by neurological and muscle dysfunctions. Interventions are often based on electrical principles that take advantage of the physiological characteristics of muscles and nerves to generate therapeutic effects. Objective: To compare the effects of stimulating the different neuromuscular compartments (NMCs) of the peroneus longus muscle on the motor threshold (MT) and acceleration of the foot. Method: This is a cross-sectional study comprising 37 subjects. The three NMCs of the peroneus longus muscle were stimulated, and the acceleration of the foot and the motor threshold of each NMC were evaluated. A repeated measures analysis of variance with Bonferroni corrections of two intra-subjects factors was performed. Results: The stimulation of the different NMCs did not result in any differences in MT (F=2.635, P=0.079). There were significant differences between the axes of acceleration caused by the stimulation of the different NMCs (F=56,233; P=0.000). The stimulation of the posteroinferior compartment resulted in the greatest acceleration in the X-axis (mean 0.614; standard deviation 0.253). Conclusions: The posteroinferior compartment primarily contributes to the eversion movement of the foot. NMCs have specific functional roles that contribute to the actions of the muscles to which they belong.Keywords: neuromuscular compartment; peroneus longus muscle; accelerometry; motor threshold; motor point; physical therapy. HOW TO CITE THIS ARTICLEMéndez GA, Gatica VF, Guzmán EE, Soto AE. Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry. Braz J Phys Ther. 2013 Sept-Oct; 17(5):427-434. http://dx

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Anatomic Localization of Motor Points in Gastrocnemius and Soleus Muscles

Abstract: The present study defined the longitudinal distribution pattern of terminal motor points in the triceps surae muscles. This concept can be helpful for further studies evaluating the effectiveness of the botulinum toxin injection method.

Cited by 47 publications

References 5 publications

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry

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