Abstract:The contractile property of the supraspinatus muscles decreased with an increase in the modified Goutallier stage. Real-time tissue elastography can measure the contractile property of the muscles before surgery and thus may be a predictor for the resulting restoration of lost muscle function.
“…23,24 Gerber et al and Yuri et al independently demonstrated that the contractility of the torn supraspinatus muscle decreased with increasing fat infiltration. 17,27 These evidences suggest postoperative contractile recovery to be associated with fat infiltration.…”
Section: Discussionmentioning
confidence: 97%
“…Many studies have revealed that elasticity decreased with increasing fat infiltration. 17,[23][24][25] Valencia et al demonstrated that interstitial fibrosis advanced with increasing fat infiltration, especially dense collagenous tissue surrounded the marked 26 Theoretically, the collagenous tissue content ratio will be highest in the AR area, modest in the whole area and lowest in the AM-p area.…”
Section: Discussionmentioning
confidence: 99%
“…The patients were instructed to sit on a chair with the affected arm resting on a table with the shoulder abducted to 60° and with neutral rotation in the scapular plane. 17 RTE measurements were obtained with the arm resting on the table and during muscle contraction, accomplished by having the patient hold the affected arm 1 cm against gravity for approximately ten seconds. We used a diagnostic ultrasound system (Noblus; Hitachi-Aloka Medical Japan, Tokyo, Japan) with a linear array probe (L-64; Hitachi-Aloka Medical Japan) combined with an acoustic coupler (EZU-TECPL1; Hitachi-Aloka Medical Japan).…”
Section: Muscle Activity Measurement By Real-time Tissue Elastographymentioning
Ultrasound elastography has been used to evaluate the skeletal muscle stiffness as a biomarker for sarcopenia assessment. However, there is no consensus with respect to the size and location of the region of interest in assessing such fat infiltrated muscle. The objective of this study was to determine which cross-sectional area should be measured in torn disuse muscle with fat infiltration to accurately measure muscle activity using real-time tissue elastography (RTE). Methods: Twenty-seven patients, whose rotator cuff muscle with torn tendon was successfully repaired, were followed by programmed rehabilitation. RTE measurements of the supraspinatus muscle were obtained during muscle contraction before and one-year after surgery so that the activity value was defined as the difference between elastography measurements at rest and elastography measurements during contraction. Given that the patients with successfully repaired and completed rehabilitation showed an increased activity value, the sensitivity for three regions of interest; posterior portion of the anterior-middle subregion (AM-p), anterior region (AR), and whole cross-sectional area of the supraspinatus (whole) were compared with the number of patients showing an increase in activity values as sensitivity analysis. Results: The sensitivity showing an increase in activity values was 74.1% for the AM-p area, 70.4% for the AR area, and 81.5% for the whole area. Intraclass correlation coefficient 1,3 was 0.87-0.97 for the AM-p area, 0.88-0.98 for the AR area and 0.92-0.99 for the whole area.
Conclusion:The whole cross-sectional area is suitable to measure muscle activity in muscle with fat infiltration. The results in this study will provide some beneficial information when ultrasound elastography is used for the assessment of sarcopenia muscle with fat infiltration.
“…23,24 Gerber et al and Yuri et al independently demonstrated that the contractility of the torn supraspinatus muscle decreased with increasing fat infiltration. 17,27 These evidences suggest postoperative contractile recovery to be associated with fat infiltration.…”
Section: Discussionmentioning
confidence: 97%
“…Many studies have revealed that elasticity decreased with increasing fat infiltration. 17,[23][24][25] Valencia et al demonstrated that interstitial fibrosis advanced with increasing fat infiltration, especially dense collagenous tissue surrounded the marked 26 Theoretically, the collagenous tissue content ratio will be highest in the AR area, modest in the whole area and lowest in the AM-p area.…”
Section: Discussionmentioning
confidence: 99%
“…The patients were instructed to sit on a chair with the affected arm resting on a table with the shoulder abducted to 60° and with neutral rotation in the scapular plane. 17 RTE measurements were obtained with the arm resting on the table and during muscle contraction, accomplished by having the patient hold the affected arm 1 cm against gravity for approximately ten seconds. We used a diagnostic ultrasound system (Noblus; Hitachi-Aloka Medical Japan, Tokyo, Japan) with a linear array probe (L-64; Hitachi-Aloka Medical Japan) combined with an acoustic coupler (EZU-TECPL1; Hitachi-Aloka Medical Japan).…”
Section: Muscle Activity Measurement By Real-time Tissue Elastographymentioning
Ultrasound elastography has been used to evaluate the skeletal muscle stiffness as a biomarker for sarcopenia assessment. However, there is no consensus with respect to the size and location of the region of interest in assessing such fat infiltrated muscle. The objective of this study was to determine which cross-sectional area should be measured in torn disuse muscle with fat infiltration to accurately measure muscle activity using real-time tissue elastography (RTE). Methods: Twenty-seven patients, whose rotator cuff muscle with torn tendon was successfully repaired, were followed by programmed rehabilitation. RTE measurements of the supraspinatus muscle were obtained during muscle contraction before and one-year after surgery so that the activity value was defined as the difference between elastography measurements at rest and elastography measurements during contraction. Given that the patients with successfully repaired and completed rehabilitation showed an increased activity value, the sensitivity for three regions of interest; posterior portion of the anterior-middle subregion (AM-p), anterior region (AR), and whole cross-sectional area of the supraspinatus (whole) were compared with the number of patients showing an increase in activity values as sensitivity analysis. Results: The sensitivity showing an increase in activity values was 74.1% for the AM-p area, 70.4% for the AR area, and 81.5% for the whole area. Intraclass correlation coefficient 1,3 was 0.87-0.97 for the AM-p area, 0.88-0.98 for the AR area and 0.92-0.99 for the whole area.
Conclusion:The whole cross-sectional area is suitable to measure muscle activity in muscle with fat infiltration. The results in this study will provide some beneficial information when ultrasound elastography is used for the assessment of sarcopenia muscle with fat infiltration.
“…The measurements were conducted by a single sonographer (KH). Muscle activity was defined as the difference in stiffness values between the resting positions and those during muscle contraction (Δ E = stiffness at contraction − stiffness at rest) [ 20 , 32 , 33 ]. Fig.…”
Purpose
The purpose of this study was to investigate if the three partitions (superior, middle, and inferior partitions) of the infraspinatus muscle previously described in anatomical studies will present different behavior during scapular plane abduction (scaption) as described using shear-wave elastography, especially during initial range of motion.
Methods
Eight volunteers held their arm against gravity 15° intervals from 30° to 150° in scaption. Shear-wave elastography was implemented at each position to measure shear modulus at rest and during muscle contraction, as a surrogate for muscle stiffness, of each partition. Muscle activity was defined as the difference in stiffness values between the resting positions and those during muscle contraction (ΔE = stiffness at contraction—stiffness at rest).
Results
The activity value for the middle partition was 25.1 ± 10.8 kPa at 30° and increased up to 105° (52.2 ± 10.8 kPa), with a subsequent decrease at larger angle positions (p < .001). The superior partition showed a flatter and constant behavior with smaller activity values except at higher angles (p < .001). Peak activity values for the superior partition were observed at 135° (23.0 ± 12.0 kPa). Increase activity for inferior partition began at 60° and showed a peak at 135° (p < .001; 32.9 ± 13.8 kPa).
Conclusion
Stiffness measured using shear-wave elastography in each partition of the infraspinatus muscle demonstrated different behavior between these partitions during scaption. The middle partition generated force throughout scaption, while the superior and inferior partitions exerted force at end range.
“…The supraspinatus is the most common rotator cuff tendon that is involved in a rotator cuff tear [4][5][6]. Yuri et al demonstrated that the pre-operative contractility of the torn supraspinatus muscle can be measured with real-time tissue elastography (RTE), non-invasively and quantitatively [7]. While functional recovery of the supraspinatus muscle itself is not responsible for entire shoulder functional outcome, it will provide us with important information in the setting of rotator cuff tear and repair.…”
Background
The purpose of this study was to evaluate the effect of fat infiltration, tear size, and post-operative tendon integrity, on post-operative contractility.
Methods
Thirty-five patients who underwent rotator cuff repair were included. The fat infiltration, tear size, and post-operative tendon integrity were evaluated by Goutallier stage, Cofield classification, and Sugaya classification, respectively. The muscle elasticity at rest and at contraction was assessed by real-time tissue elastography pre- and one-year post-operatively. We defined the difference in elasticity between at rest and at contraction as the activity value which reflects muscle contractility.
Results
The activity value in patients with Sugaya Type I tended to increase regardless of Cofield classification, whereas those with Sugaya Type III and IV tended to decrease. While the activity value in the patients classified as stage 1 and Type I tended to increase, patients classified as stage 2 showed decreased or constant in contractility even in those subjects classified as Type I. Stepwise multiple regression analysis showed both pre- (p = 0.004, r = -0.47) and post-operative activity values (p = 0.022, r = -0.39) to be significantly correlated only with the Goutallier stage.
Conclusion
Multiple regression analysis indicated only the Goutallier stage was a significant independent factor for contractility of the supraspinatus muscle. Supraspinatus muscle contractility in patients classified as Types III and IV based on the Sugaya classification tended to decrease post-operatively, while patients whose contractility increased post-operatively were characterized by having a Type I tendon integrity.
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