Understanding lower limb muscle volume adaptations to amputation

Henson, David P.; Edgar, Caitlin; Ding, Ziyun; Sivapuratharasu, Biranavan; Feuvre, Peter Le; Finnegan, Mary E.; Quest, Rebecca A.; McGregor, Alison H.; Bull, Anthony M.J.

doi:10.1016/j.jbiomech.2021.110599

Cited by 11 publications

(14 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The maximum force potential (

) of each muscle was calculated from the multiplication of its PCSA (which is subject specific, as per the anatomical atlas) and an assumed fixed maximum muscle stress (31.39 N

), following the equation ( Yamaguchi, 2005 )

where

, and

represent the maximum force potential, multiplier,

maximum muscle stress, respectively. The multiplier (

) was used to modify

to account for changes in muscle structure that are known to occur due to atrophy and hypertrophy in the residual limb of a transfemoral PWLL post-surgery and rehabilitation ( Henson et al, 2021 ; Toderita et al, 2021 ). There are two contributing factors to the progression of atrophy and hypertrophy observed.…”

Section: Methodsmentioning

confidence: 99%

“…There are two contributing factors to the progression of atrophy and hypertrophy observed. First, changes in muscle recruitment in the monoarticular function are assumed by muscles that have a biarticular function of the knee and hip in their intact state ( Henson et al, 2021 ). Second, the direct effects of the surgery can produce atrophy in muscles that have been re-attached to a non-physiological site ( Fraisse et al, 2008 ; Putz et al, 2017 ).…”

Section: Methodsmentioning

confidence: 99%

“…As per these observations,

was reduced to the following: 0.12 for rectus femoris, 0.33 for bicep femoris and gracilis, 0.50 for the adductor magnus and semimembranosus, and 0.80 for the tensor fascia latae and sartorius. As the adductor brevis, iliacus, pectineus, and gluteus medius have a greater function in the compensatory gait of a PWLL ( Henson et al, 2021 ),

of these muscles was set to 1.20. The adaptations of

account for the physiological/structural changes that occur in an atrophied/hypertrophied muscle which affect force capacity but are not represented by the changes in muscle volume ( Henson et al, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

“…As the adductor brevis, iliacus, pectineus, and gluteus medius have a greater function in the compensatory gait of a PWLL ( Henson et al, 2021 ),

of these muscles was set to 1.20. The adaptations of

Section: Methodsmentioning

confidence: 99%

“…where F i max , M i , and σ represent the maximum force potential, multiplier, and maximum muscle stress, respectively. The multiplier (M i ) was used to modify F i max to account for changes in muscle structure that are known to occur due to atrophy and hypertrophy in the residual limb of a transfemoral PWLL post-surgery and rehabilitation (Henson et al, 2021;Toderita et al, 2021). There are two contributing factors to the progression of atrophy and hypertrophy observed.…”

Section: Subject-specific Msk Modelingmentioning

confidence: 99%

See 4 more Smart Citations

Characterization of muscle recruitment during gait of bilateral transfemoral and through-knee persons with limb loss

Benton

Amiri

Henson

et al. 2023

Front. Bioeng. Biotechnol.

Self Cite

View full text Add to dashboard Cite

Introduction: Due to loss in musculoskeletal capacity, there is an increased burden on the residual limbs of bilateral transfemoral and through-knee persons with limb loss. This reduced capacity is associated with an increased cost of walking that is detrimental to functionality. Compensatory gait strategies are adopted by this population. However, how these strategies relate to specific muscle recruitment is not known. The primary aim of this study is to characterize muscle recruitment during gait of this population. The secondary aim is to assess whether the measured kinematics can be actuated when the endurance of specific muscles is reduced and if this is the case, which alternative muscles facilitate this.Methods: 3D gait data and high-resolution magnetic resonance images were acquired from six bilateral transfemoral and through-knee persons with limb loss. Subject-specific anatomical muscle models were developed for each participant, and a validated musculoskeletal model was used to quantify muscle forces in two conditions: during normal gait (baseline) and when muscles, which were identified as functioning above a “healthy” level at baseline, have a reduced magnitude of maximum force capacity (reduced endurance simulation). To test the hypothesis that there are differences in muscle forces between the baseline trials and the simulations with reduced muscular endurance, a Bonferroni corrected two-way ANOVA with repeated measures was completed between the two states.Results: The baseline analysis showed that the hip flexors experience relatively high muscle activations during gait. The reduced endurance simulation found two scenarios. First, for 5 out of the 12 simulations, the baseline kinematics could not be reproduced with the reduced muscular capacity. Second, for 7 out of 12 cases where the baseline kinematics were achieved, this was possible with compensatory increased activation of some muscles with similar functions (p ≤ 0.003).Discussion: Evidently, due to the loss of the ankle plantar flexors, gait imposes a high demand on the flexor muscle group of the residual limb. This study highlights how the elevated cost of gait in this population manifests in muscle recruitment. To enhance functionality, it is critical to consider the mechanical demand on the hip flexors and to develop rehabilitation interventions accordingly.

show abstract

“…The maximum force potential (

) of each muscle was calculated from the multiplication of its PCSA (which is subject specific, as per the anatomical atlas) and an assumed fixed maximum muscle stress (31.39 N

), following the equation ( Yamaguchi, 2005 )

where

, and

represent the maximum force potential, multiplier,

maximum muscle stress, respectively. The multiplier (

) was used to modify

Section: Methodsmentioning

confidence: 99%