New Approach in the Assessment of the Tone, Elasticity and the Muscular Resistance: Nominal Scales Vs Myoton

Ianieri, Giancarlo; Saggini, R.; Marvulli, Riccardo; Tondi, Giovanna; Aprile, Antonella; Ranieri, Maurizio; Benedetto, Gina; Altini, S.; Lancioni, Giulio E.; Goffredo, L.; Fulle, Stefania; Megna, Marisa; Megna, G.

doi:10.1177/03946320090220s304

Cited by 18 publications

(12 citation statements)

References 6 publications

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“…The muscle responds to the mechanical stimulus in the form of damped oscillations recorded by an acceleration transducer on the testing end, and 3 parameters are calculated from the curve (Figure 2). Three mechanical properties of the muscle tissue are (1) the natural oscillation frequency (Hz), (2) the logarithmic decrement of damping oscillations, and (3) the stiffness (N/m) [15, 27, 34]. …”

Section: Methodsmentioning

confidence: 99%

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Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

Chuang

Lin

et al. 2012

Stroke Research and Treatment

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Objective. Test-retest reliability of the myotonometer was investigated in patients with subacute stroke.Methods. Twelve patients with substroke (3 to 9 months poststroke) were examined in standardized testing position twice, 60 minutes apart, with the Myoton-3 myometer to measure tone, elasticity, and stiffness of relaxed bilateral biceps and triceps brachii muscles. Intrarater reliability of muscle properties was determined using intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the minimal detectable change (MDC).Results. Intrarater reliability of muscle properties of bilateral biceps and triceps brachii muscles were good (ICCs=0.79–0.96) except for unaffected biceps tone (ICC=0.72). The SEM and MDC of bilateral biceps and triceps brachii muscles indicated small measurement error (SEM%<10%, MDC%<25%).Conclusion. The Myoton-3 myometer is a reliable tool for quantifying muscle tone, elasticity, and stiffness of the biceps and triceps brachii in patients with subacute stroke.

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Section: Methodsmentioning

confidence: 99%

“…Therefore, an objective measurement tool with an excellent reliability and small measurement error for assessing the mechanical properties of muscle is necessary. Researchers have reported a new approach, the myotonometric measure, which was more sensitive and precise than the MAS to quantify muscle properties [15]. …”

Section: Introductionmentioning

confidence: 99%

Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

Chuang

Lin

et al. 2012

Stroke Research and Treatment

View full text Add to dashboard Cite

show abstract

“…In this study we used myometric evaluation (Myoton PRO ® ) to objectively assess muscle tone. In an objective, simple, repeatable and non-invasive way, we evaluated even minimum changes in muscle tone; we obtained a broader pathophysiological vision of rheological properties of muscle tissue in different neurological, orthopedic, and sports pathologies [ 19 ]. In fact, during any pharmacological and/or physiokinesis and/or instrumental spasticity treatment, we studied therapeutic efficacy and we monitored the desired clinical effects without any alterations either in the omolateral antagonist muscles or in the contralateral agonists and antagonist muscles [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“Appropriate Treatment” and Therapeutic Window in Spasticity Treatment with IncobotulinumtoxinA: From 100 to 1000 Units

Ianieri

Marvulli

Gallo

et al. 2018

Toxins

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Many neurological diseases (ischemic and hemorrhagic stroke, multiple sclerosis, infant cerebral palsy, spinal cord injuries, traumatic brain injury, and other cerebrovascular disorders) may cause muscle spasticity. Different therapeutic strategies have been proposed for the treatment of spasticity. One of the major treatments for tone modulation is botulinum toxin type A (BTX-A), performed in addition to other rehabilitation strategies based on individualized multidisciplinary programs aimed at achieving certain goals for each patient. Therapeutic plans must be precisely defined as they must balance the reduction of spastic hypertonia and retention of residual motor function. To perform and optimize the treatment, an accurate clinical and instrumental evaluation of spasticity is needed to determine how this symptom is invalidating and to choose the best doses, muscles and times of injection in each patient. We introduce an “appropriate treatment” and no “standard or high dosage treatment” concept based on our retrospective observational study on 120 patients lasting two years, according to the larger Therapeutic Index and Therapeutic Window of Incobotulinumtoxin A doses from 100 to 1000 units. We studied the efficiency and safety of this drug considering the clinical spasticity significance for specialist physicians and patients.

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“…At baseline and during the follow-up visits, patients underwent a physical examination (patients showed independent erect standing possible only with bilateral support and for a few minutes; deambulation was possible with double support for a short time, taking little steps in a precautionary manner; spastic paraparesis resulted in a difficulty in washing and dressing due to AM spasticity) with the use of myometric measurements to evaluate muscle tone [41,42] and the following scales: Modified Ashworth Scale, Barthel Index, Adductor Tone Rating Scale, and Hygiene Score [36].…”

Section: Methodsmentioning

confidence: 99%

Botulinum Toxin Type A and Physiotherapy in Spasticity of the Lower Limbs Due to Amyotrophic Lateral Sclerosis

Marvulli

Megna

Citraro

et al. 2019

Toxins

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Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease (unknown pathogenesis) of the central nervous system that causes death within 1–5 years. Clinically, flabby paralysis, areflexia, muscular atrophy, and muscle fasciculations, signs of II motor neuron damage, appear. Sometimes, clinical manifestations of damage of the I motor neuron come out in lower limbs; spastic paralysis, iperflexia, and clonus emerge, and they impair deambulation and management of activities of daily living, such as personal hygiene or dressing. Thus, the first therapeutic approach in these patients involves antispasmodic drugs orally followed by botulinum toxin type A injection (BTX-A). In this study, we study the efficacy of BTX-A and physiotherapy in lower limb spasticity due to ALS and no response to treatment with oral antispastic drugs. We evaluated 15 patients (10 male and five female), with a mean age of 48.06 ± 5.2 with spasticity of adductor magnus (AM), at baseline (T0, before BTX-A treatment) and in the following three follow-up visits (T1 30 days, T2 60 days, and T3 90 days after infiltration). We evaluated myometric measure of muscle tone, the Modified Ashworth Scale of AM, Barthel Index, Adductor Tone Rating Scale, and Hygiene Score. The study was conducted between November 2018 and April 2019. We treated AM with incobotulinum toxin type A (Xeomin®, Merz). Spasticity (myometric measurement, Adductor Tone Rating Scale, and Modified Ashworth Scale) and clinical (Barthel Index and Hygiene Score) improvements were obtained for 90 days after injection (p < 0.05). Our study shows the possibility of using BTX-A in the treatment of spasticity in patients with ALS and no response to oral antispastic drugs, with no side effects. The limitation of the study is the small number of patients and the limited time of observation; therefore, it is important to increase both the number of patients and the observation time in future studies.

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New Approach in the Assessment of the Tone, Elasticity and the Muscular Resistance: Nominal Scales Vs Myoton

Cited by 18 publications

References 6 publications

Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

“Appropriate Treatment” and Therapeutic Window in Spasticity Treatment with IncobotulinumtoxinA: From 100 to 1000 Units

Botulinum Toxin Type A and Physiotherapy in Spasticity of the Lower Limbs Due to Amyotrophic Lateral Sclerosis

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