Jaclyn M Sions1, Emma H Beisheim2, Mark A Hoggarth3, James M Elliott4, Gregory E Hicks5, Ryan T Pohlig6, Mayank Seth2. 1. Department of Physical Therapy, Delaware Limb Loss Studies, University of Delaware, Newark, DE. Electronic address: megsions@udel.edu. 2. Department of Physical Therapy, Delaware Limb Loss Studies, University of Delaware, Newark, DE. 3. Department of Biomedical Engineering, Northwestern University, Evanston, IL. 4. University of Sydney, The Kolling Research Institution, Faculty of Medicine and Health, and The Northern Sydney Local Health District, Sydney, Australia; Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL. 5. Department of Physical Therapy, Delaware Spine Studies, University of Delaware, Newark, DE. 6. University of Delaware, Biostatistics Core Facility, Newark, DE.
Abstract
OBJECTIVE: The primary purpose of this study was to compare trunk muscle characteristics between adults with and without unilateral lower limb amputation (LLA) to determine the presence of modifiable trunk muscle deficits (ie, impaired activity, reduced volume, increased intramuscular fat) evaluated by ultrasonography (US) and magnetic resonance imaging (MRI). We hypothesized that compared with adults without LLA (controls), individuals with transfemoral or transtibial LLA would demonstrate reduced multifidi activity, worse multifidi and erector spinae morphology, and greater side-to-side trunk muscle asymmetries. DESIGN: Cross-sectional imaging study. SETTING: Research laboratory and imaging center. PARTICIPANTS: Sedentary adults (n=38 total) with LLA (n=9 transfemoral level; n=14 transtibial level) and controls without LLA (n=15). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We examined bilateral multifidi activity using US at levels L3/L4-L5/S1. MRI was performed using 3-dimensional quantitative fat-water imaging; bilateral L1-L5 multifidi and erector spinae were manually traced, and muscle volume (normalized to body weight) and percentage intramuscular fat were determined. Between-group and side-to-side differences were evaluated. RESULTS: Compared with adults without LLA, participants with LLA demonstrated reduced sound-side multifidi activity; those with transfemoral LLA had larger amputated-side multifidi volume, whereas those with transtibial LLA had greater sound- and amputated-side erector spinae intramuscular fat (P<.050). With transfemoral LLA, side-to-side differences in erector spinae volume, as well as multifidi and erector spinae intramuscular fat, were found (P<.050). CONCLUSIONS: Impaired trunk muscle activity and increased intramuscular fat may be modifiable targets for intervention after LLA.
OBJECTIVE: The primary purpose of this study was to compare trunk muscle characteristics between adults with and without unilateral lower limb amputation (LLA) to determine the presence of modifiable trunk muscle deficits (ie, impaired activity, reduced volume, increased intramuscular fat) evaluated by ultrasonography (US) and magnetic resonance imaging (MRI). We hypothesized that compared with adults without LLA (controls), individuals with transfemoral or transtibial LLA would demonstrate reduced multifidi activity, worse multifidi and erector spinae morphology, and greater side-to-side trunk muscle asymmetries. DESIGN: Cross-sectional imaging study. SETTING: Research laboratory and imaging center. PARTICIPANTS: Sedentary adults (n=38 total) with LLA (n=9 transfemoral level; n=14 transtibial level) and controls without LLA (n=15). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We examined bilateral multifidi activity using US at levels L3/L4-L5/S1. MRI was performed using 3-dimensional quantitative fat-water imaging; bilateral L1-L5 multifidi and erector spinae were manually traced, and muscle volume (normalized to body weight) and percentage intramuscular fat were determined. Between-group and side-to-side differences were evaluated. RESULTS: Compared with adults without LLA, participants with LLA demonstrated reduced sound-side multifidi activity; those with transfemoral LLA had larger amputated-side multifidi volume, whereas those with transtibial LLA had greater sound- and amputated-side erector spinae intramuscular fat (P<.050). With transfemoral LLA, side-to-side differences in erector spinae volume, as well as multifidi and erector spinae intramuscular fat, were found (P<.050). CONCLUSIONS: Impaired trunk muscle activity and increased intramuscular fat may be modifiable targets for intervention after LLA.
Authors: David C Morgenroth; Michael S Orendurff; Ali Shakir; Ava Segal; Jane Shofer; Joseph M Czerniecki Journal: Am J Phys Med Rehabil Date: 2010-08 Impact factor: 2.159
Authors: Cory L Christiansen; Thomas Fields; Guy Lev; Ryan O Stephenson; Jennifer E Stevens-Lapsley Journal: PM R Date: 2015-05-12 Impact factor: 2.298