Reliability of Processing 3-D Freehand Ultrasound Data to Define Muscle Volume and Echo-intensity in Pediatric Lower Limb Muscles with Typical Development or with Spasticity

Hanssen, Britta; Beukelaer, Nathalie De; Schless, Simon‐Henri; Cenni, Francesco; Bar‐On, Lynn; Peeters, Nicky; Molenaers, Guy; Campenhout, Anja Van; Broeck, Christine Van den; Desloovere, Kaat

doi:10.1016/j.ultrasmedbio.2021.04.028

Cited by 18 publications

(49 citation statements)

References 46 publications

(91 reference statements)

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“…Third, images were obtained close to the tendinous inscription and not at different locations within each compartment; however, as the anatomical cross-sectional area of ST varies greatly along its length ( 47 ), confining data acquisition to a small region of the whole muscle reduced the effects anatomical cross-sectional area may have on the slope of the increase in the shear modulus-force relationship ( 22 ). In addition, image quality can be poor in more proximal portions of ST prox ( 18 , 20 ). Fourth, although we ensured electromyography silence of semimembranosus during data acquisition, we cannot definitively confirm ST was inactive as it was not possible to simultaneously acquire electromyograms and elastograms given 1 ) the large gluteals covering ST prox proximal to the transducer, and 2 ) the available ST dist electrode position being in the distal portion of the muscle, where ST is small compared with the adjacent synergists ( 47 ) and thus exposing the recordings to high amounts of cross talk.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the maximum single fiber and fiber bundle tangent moduli are ∼20–25 times greater in the frog compared with human ST muscle ( 13 , 14 ). Furthermore, it has been established that neuromuscular properties and behavior observed in cats do not always extend to humans ( 15 , 16 ) and thus observations made from cat ST must be empirically confirmed in human ST. Studies clearly distinguishing human ST prox and ST dist have been limited to measuring intramuscular electromyographic amplitudes during isometric contractions ( 17 ) and architectural and morphological measures from cadavers ( 1 , 8 , 18 ) or children with and without spasticity ( 19 , 20 ). As none of these previous studies directly quantified forces or stiffness within each compartment, further information is required to adequately assess the mechanical properties of human ST compartments.…”

Section: Introductionmentioning

confidence: 99%

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In vivo assessment of the passive stretching response of the bicompartmental human semitendinosus muscle using shear-wave elastography

Kositsky

Saxby

Lesch

et al. 2022

Journal of Applied Physiology

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The semitendinosus muscle contains distinct proximal and distal compartments arranged anatomically in-series but separated by a tendinous inscription, with each compartment innervated by separate nerve branches. Although extensively investigated in other mammals, compartment-specific mechanical properties within the human semitendinosus have scarcely been assessed in vivo. Experimental data obtained during muscle-tendon unit stretching (e.g., slack angle) can also be used to validate and/or improve musculoskeletal model estimates of semitendinosus muscle force. The purpose of this study was to investigate the passive stretching response of proximal and distal humans semitendinosus compartments to distal joint extension. Using two-dimensional shear wave elastography, we bilaterally obtained shear moduli of both semitendinosus compartments from 14 prone-positioned individuals at ten knee flexion angles (from 90° to 0° [full extension] at 10° intervals). Passive muscle mechanical characteristics (slack angle, slack shear modulus, and the slope of the increase in shear modulus) were determined for each semitendinosus compartment by fitting a piecewise exponential model to the shear modulus-joint angle curves. We found no differences between compartments or legs for slack angle, slack shear modulus, or the slope of the increase in shear modulus. We also found the experimentally determined slack angle occurred at ~15-80° higher knee flexion angles compared to estimates from two commonly used musculoskeletal models, depending on participant and model used. Overall, these findings demonstrate that passive shear modulus-joint angle curves do not differ between proximal and distal human semitendinosus compartments, and provide experimental data to improve semitendinosus force estimates derived from musculoskeletal models.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In vivo assessment of the passive stretching response of the bicompartmental human semitendinosus muscle using shear-wave elastography

Kositsky

Saxby

Lesch

et al. 2022

Journal of Applied Physiology

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“…Both data collection and processing were performed using STRADWIN software (version 6.0; Mechanical Engineering, Cambridge University, Cambridge, UK) for four lower limb muscles: m. rectus femoris (RF), m. semitendinosus (ST), m. tibialis anterior (TA), and m. gastrocnemius medialis (MG). The reliability of 3DfUS has been confirmed for the plantar flexor muscles (50-52), as well as for the processing of the TA, RF, and ST (53). MV (in milliliters) was estimated by drawing equally spaced transverse plane segmentations along the inside of the muscle border for ∼5% of all acquired images, followed by an automatic linear interpolation.…”

Section: Three-dimensional Freehand Ultrasonographymentioning

confidence: 92%

The Contribution of Decreased Muscle Size to Muscle Weakness in Children With Spastic Cerebral Palsy

et al. 2021

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Muscle weakness is a common clinical symptom in children with spastic cerebral palsy (SCP). It is caused by impaired neural ability and altered intrinsic capacity of the muscles. To define the contribution of decreased muscle size to muscle weakness, two cohorts were recruited in this cross-sectional investigation: 53 children with SCP [median age, 8.2 (IQR, 4.1) years, 19/34 uni/bilateral] and 31 children with a typical development (TD) [median age, 9.7 (IQR, 2.9) years]. Muscle volume (MV) and muscle belly length for m. rectus femoris, semitendinosus, gastrocnemius medialis, and tibialis anterior were defined from three-dimensional freehand ultrasound acquisitions. A fixed dynamometer was used to assess maximal voluntary isometric contractions for knee extension, knee flexion, plantar flexion, and dorsiflexion from which maximal joint torque (MJT) was calculated. Selective motor control (SMC) was assessed on a 5-point scale for the children with SCP. First, the anthropometrics, strength, and muscle size parameters were compared between the cohorts. Significant differences for all muscle size and strength parameters were found (p ≤ 0.003), except for joint torque per MV for the plantar flexors. Secondly, the associations of anthropometrics, muscle size, gross motor function classification system (GMFCS) level, and SMC with MJT were investigated using univariate and stepwise multiple linear regressions. The associations of MJT with growth-related parameters like age, weight, and height appeared strongest in the TD cohort, whereas for the SCP cohort, these associations were accompanied by associations with SMC and GMFCS. The stepwise regression models resulted in ranges of explained variance in MJT from 29.3 to 66.3% in the TD cohort and from 16.8 to 60.1% in the SCP cohort. Finally, the MJT deficit observed in the SCP cohort was further investigated using the TD regression equations to estimate norm MJT based on height and potential MJT based on MV. From the total MJT deficit, 22.6–57.3% could be explained by deficits in MV. This investigation confirmed the disproportional decrease in muscle size and muscle strength around the knee and ankle joint in children with SCP, but also highlighted the large variability in the contribution of muscle size to muscle weakness.

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“…Large amounts of acoustic transmission gel were used and combined with the Portico (i.e., custom-shaped plastic mount combined with gel pad) which minimizes muscle deformation during ultrasound acquisitions [56]. The acquired images of the automatically generated 3D muscle reconstruction were manually analyzed by a single experienced researcher [57]. Prior to the statistical analysis, this processor was blinded for the patient sensitive data, the timing of assessment and the group allocation.…”

Section: Assessmentmentioning

confidence: 99%

Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

De Beukelaer,

Weide,

Huyghe

et al. 2022

Toxins

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Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (n = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (n = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (n = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, p < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.

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Reliability of Processing 3-D Freehand Ultrasound Data to Define Muscle Volume and Echo-intensity in Pediatric Lower Limb Muscles with Typical Development or with Spasticity

Cited by 18 publications

References 46 publications

In vivo assessment of the passive stretching response of the bicompartmental human semitendinosus muscle using shear-wave elastography

In vivo assessment of the passive stretching response of the bicompartmental human semitendinosus muscle using shear-wave elastography

The Contribution of Decreased Muscle Size to Muscle Weakness in Children With Spastic Cerebral Palsy

Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

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