EMG and MRI are Independently Related toShoulderExternal Rotation Function inNeonatalBrachial Plexus Palsy

Talbert, Robert J.; Michaud, Linda J.; Mehlman, Charles T.; Kinnett, Douglas G.; Laor, Tal; Foad, Susan L.; Schnell, Beverly; Salisbury, Shelia

doi:10.1097/bpo.0b013e3182092892

Cited by 8 publications

(13 citation statements)

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“…The greater atrophy in the current participants, relative to past studies 6,12,10,11,9 , is likely due to the older age of the current participants. Specifically, Talbert and colleagues 12 demonstrated a correlation between age and I-tm atrophy in a group of patients with OBPP (age 1.1 to 13.2 years). Of note is the 23% loss of volume in the PM, which contrasts past reports 9 that assumed the PM was “unaffected”.…”

Section: Discussionmentioning

confidence: 59%

“…One possible explanation of this difference might be atrophy induced by a lack of use of the arm. The 3D muscle models take into account the entire volume and geometrical complexity of the shoulder muscles, which previous techniques did not, with the exception of one study evaluating the I-tm 12 . This volumetric information is particularly important in atrophic muscle where the relationship between the entire muscle volume and the area within a single slice may be quite different than in uninvolved muscles (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Using the dominant arm as a control provides the best anthropometric match, which is a main methodological issue in pediatric research. In order to avoid the use of anesthesia in this research study and to accurately assess strength, the subjects were older than those in previous studies 5,6,12,10,11,9 . Further, the current segmentation and reconstruction methods are, at present, time-consuming.…”

Section: Discussionmentioning

confidence: 99%

“…Studies evaluating atrophy in OBPP have typically used qualitative assessments 5,6 , substituted cross-sectional areas for volumes 7,6,8,9 , or defined the volume using only a portion of the muscle 10,11 . Additionally, these studies evaluated a limited subset of shoulder muscles, primarily the subscapularis and infraspinatus 6,12,10,11,9 . Therefore, the full extent and pattern of shoulder muscle atrophy in OBPP is not well established.…”

Section: Introductionmentioning

confidence: 99%

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Shoulder muscle atrophy and its relation to strength loss in obstetrical brachial plexus palsy

Pons

Sheehan

et al. 2017

Clinical Biomechanics

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Background Treatment/prevention of shoulder muscle strength imbalances are major therapeutic goals for children with obstetrical brachial plexus palsy. The study aims were to characterize muscle atrophy in children/adolescents with unilateral obstetrical brachial plexus palsy, to quantify the agonist-antagonist muscle volume balance and the association between muscle volume and strength. Methods Eight boys and four girls (age=12.1, standard deviation=3.3) participated in this case-control study. Three-dimensional magnetic resonance images of both shoulders were acquired. The unimpaired shoulder served as a reference. Volumes of deltoid, pectoralis major, supraspinatus, infraspinatus, teres major, subscapularis were calculated based on 3D models, derived through image segmentation. Maximal isometric torques were collected in six directions. Findings All the major muscles studied were significantly atrophied. The teres major demonstrated the biggest difference in atrophy between groups (51 percentage points), the pectoralis major was the least atrophied (23 percentage points). The muscle volume distribution was significantly different between shoulders. Muscle volume could predict maximal voluntary isometric torques, but the regression coefficients were weaker on the impaired side (72% to 91% of the strength could be predicted in the uninvolved side and 24% to 90% in the involved side and external rotation strength could not be predicted). Interpretation This study demonstrates muscle atrophy varied across all the main shoulder muscles of the glenohumeral joint, leading to significant muscle volume imbalances. The weaker coefficients of determination on the impaired side suggest that other variables may contribute to the loss of strength in addition to atrophy.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Shoulder muscle atrophy and its relation to strength loss in obstetrical brachial plexus palsy

Pons

Sheehan

et al. 2017

Clinical Biomechanics

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“…EMG is also useful in evaluating older children with BPP. Infraspinatus muscle recruitment on EMG correlates with active shoulder external rotation as well as muscle volume on MRI [5]. Surface EMG on the long and short heads of the biceps during upper extremity tasks and compared to the contralateral limb showed EMG activity duration was higher in the long head of the biceps during overhead tasks in the affected arm.…”

Section: Discussionmentioning

confidence: 98%