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Sensors (Basel, Switzerland) Aug 2023"Muscle tone" is a clinically important and widely used term and palpation is a crucial skill for its diagnosis. However, the term is defined rather vaguely, and... (Review)
Review
"Muscle tone" is a clinically important and widely used term and palpation is a crucial skill for its diagnosis. However, the term is defined rather vaguely, and palpation is not measurable objectively. Therefore, several methods have been developed to measure muscle tone objectively, in terms of biomechanical properties of the muscle. This article aims to summarize these approaches. Through database searches, we identified those studies related to objective muscle tone measurement in vivo, in situ. Based on them, we described existing methods and devices and compared their reliability. Furthermore, we presented an extensive list of the use of these methods in different fields of research. Although it is believed by some authors that palpation cannot be replaced by a mechanical device, several methods have already proved their utility in muscle biomechanical property diagnosis. There appear to be two issues preventing wider usage of these objective methods in clinical practice. Firstly, a high variability of their reliability, and secondly, a lack of valid mathematical models that would provide the observed mechanical characteristics with a clear physical significance and allow the results to be compared with each other.
Topics: Reproducibility of Results; Muscle Tonus; Databases, Factual; Muscles; Palpation
PubMed: 37631726
DOI: 10.3390/s23167189 -
Multiple Sclerosis and Related Disorders Jul 2023To provide a comprehensive assessment of the treatment effects of nabiximols oromucosal spray on multiple sclerosis spasticity in two clinical trials, GWSP0604 and... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy of nabiximols oromucosal spray on spasticity in people with multiple sclerosis: Treatment effects on Spasticity Numeric Rating Scale, muscle spasm count, and spastic muscle tone in two randomized clinical trials.
BACKGROUND
To provide a comprehensive assessment of the treatment effects of nabiximols oromucosal spray on multiple sclerosis spasticity in two clinical trials, GWSP0604 and SAVANT.
METHODS
Both studies enriched for responders before randomization, defined by a ≥20% improvement in Spasticity 0-10 numeric rating scale (NRS) score. Additionally, SAVANT used randomized re-titration following washout. Spasticity NRS outcomes, spasm count, and modified Ashworth scale (MAS) scores were analyzed.
RESULTS
Mean change from baseline in average daily Spasticity NRS scores was significantly larger for nabiximols than placebo at all postbaseline timepoints, ranging from -0.36 to -0.89 in GWSP0604 and -0.52 to -1.96 in SAVANT. Percent reduction in geometric mean change from baseline in average daily spasm count for nabiximols ranged from 19-35% versus placebo. A treatment difference favoring nabiximols was observed in overall MAS scores during the randomized part of each study. Treatment effect was larger for combinations of lower limb muscle groups (ranging between -0.16 and -0.37).
CONCLUSIONS
Nabiximols leads to improvement in spasticity that was sustained over the 12-week treatment period as measured by average daily Spasticity NRS scores, daily spasm counts, and MAS scores for combinations of muscle groups, especially the combination of the 6 key muscle groups in the lower limbs in NRS responders to nabiximols treatment.
Topics: Humans; Cannabidiol; Dronabinol; Drug Combinations; Multiple Sclerosis; Muscle Spasticity; Muscle Tonus; Randomized Controlled Trials as Topic; Spasm
PubMed: 37209500
DOI: 10.1016/j.msard.2023.104745 -
BMC Anesthesiology Nov 2023The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides... (Observational Study)
Observational Study
OBJECTIVES
The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale.
METHODS
We enrolled 75 adult patients undergoing elective surgery with ASA-PS I - III in the period between December 2018 and March 2021. We measured and calculated the shear wave velocity (SWV) before and after opioid administration (i.e., the baseline at rest and opioid-induced rigidity condition), and after muscle relaxant administration (i.e., zero reference condition). The SWV value was adjusted for the subcutaneous fat thickness by our proposed corrections. The SWVs after the adjustment were compared among the values in baseline, rigidity, and relaxation using one-way repeated-measures ANOVA and post hoc Tukey-Kramer test. A p-value of < 0.05 was considered to be statistically significant. UMIN Clinical Trials Registry identifier UMIN000034692, registered on October 30, 2018.
RESULTS
The SWVs in the baseline, opioid-induced rigidity, and muscle relaxation conditions after the adjustment were 2.08 ± 0.48, 2.41 ± 0.60, and 1.79 ± 0.30 m/s, respectively (p < 0.001 at all comparisons).
CONCLUSION
The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone.
Topics: Adult; Humans; Muscle, Skeletal; Muscle Tonus; Analgesics, Opioid; Elasticity Imaging Techniques; Anesthetics
PubMed: 38031018
DOI: 10.1186/s12871-023-02358-9 -
Biological & Pharmaceutical Bulletin 2024Cl influx and efflux through Cl channels play a role in regulating the homeostasis of biological functions. Therefore, the hyperfunction or dysfunction of Cl channels...
Cl influx and efflux through Cl channels play a role in regulating the homeostasis of biological functions. Therefore, the hyperfunction or dysfunction of Cl channels elicits pathological mechanisms. The Cl channel superfamily includes voltage-gated Cl (ClC) channels, Ca-activated Cl channels (Cl; TMEM16A/TMEM16B), cystic fibrosis transmembrane conductance regulator channels, and ligand-gated Cl channels. These channels are ubiquitously expressed to regulate ion homeostasis, muscle tonus, membrane excitability, cell volume, survival, neurotransmission, and transepithelial transport. The activation or inhibition of Cl channels changes the membrane potential, thereby affecting cytosolic Ca signals. An elevation in cytosolic [Ca] triggers physiological and pathological responses in most cells. However, the roles of Cl channels have not yet been examined as extensively as cation (Na, Ca, and K) channels. We recently reported the functional expression of: (i) TMEM16A/Cl channels in portal vein and pulmonary arterial smooth muscle cells (PASMC), pinealocytes, and brain capillary endothelial cells; (ii) TMEM16B/Cl channels in pinealocytes; (iii) ClC-3 channels in PASMC and chondrocytes; and (iv) ClC-7 channels in chondrocytes. We also showed that the down-regulation of TMEM16A and ClC-7 channel expression was associated with cirrhotic portal hypertension and osteoarthritis, respectively, whereas the enhanced expression of TMEM16A and ClC-3 channels was involved in the pathogenesis of cerebral ischemia and pulmonary arterial hypertension, respectively. Further investigations on the physiological/pathological functions of Cl channels will provide insights into biological functions and contribute to the screening of novel target(s) of drug discovery for associated diseases.
Topics: Endothelial Cells; Chloride Channels; Membrane Potentials; Brain
PubMed: 38171770
DOI: 10.1248/bpb.b23-00820 -
Journal of Voice : Official Journal of... Nov 2023The objectives of this study were to (1) identify optimal clusters of 15 standard acoustic and aerodynamic voice metrics recommended by the American...
OBJECTIVES/HYPOTHESIS
The objectives of this study were to (1) identify optimal clusters of 15 standard acoustic and aerodynamic voice metrics recommended by the American Speech-Language-Hearing Association (ASHA) to improve characterization of patients with primary muscle tension dysphonia (pMTD) and (2) identify combinations of these 15 metrics that could differentiate pMTD from other types of voice disorders.
STUDY DESIGN
Retrospective multiparametric METHODS: Random forest modeling, independent t-tests, logistic regression, and affinity propagation clustering were implemented on a retrospective dataset of 15 acoustic and aerodynamic metrics.
RESULTS
Ten percent of patients seen at the New York University (NYU) Voice Center over two years met the study criteria for pMTD (92 out of 983 patients), with 65 patients with pMTD and 701 of non-pMTD patients with complete data across all 15 acoustic and aerodynamic voice metrics. PCA plots and affinity propagation clustering demonstrated substantial overlap between the two groups on these parameters. The highest ranked parameters by level of importance with random forest models-(1) mean airflow during voicing (L/sec), (2) mean SPL during voicing (dB), (3) mean peak air pressure (cmH2O), (4) highest F0 (Hz), and (5) CPP mean vowel (dB)-accounted for only 65% of variance. T-tests showed three of these parameters-(1) CPP mean vowel (dB), (2) highest F0 (Hz), and (3) mean peak air pressure (cmH2O)-were statistically significant; however, the log2-fold change for each parameter was minimal.
CONCLUSION
Computational models and multivariate statistical testing on 15 acoustic and aerodynamic voice metrics were unable to adequately characterize pMTD and determine differences between the two groups (pMTD and non-pMTD). Further validation of these metrics is needed with voice elicitation tasks that target physiological challenges to the vocal system from baseline vocal acoustic and aerodynamic ouput. Future work should also place greater focus on validating metrics of physiological correlates (eg, neuromuscular processes, laryngeal-respiratory kinematics) across the vocal subsystems over traditional vocal output measures (eg, acoustics, aerodynamics) for patients with pMTD.
LEVEL OF EVIDENCE
II.
Topics: Humans; Dysphonia; Retrospective Studies; Muscle Tonus; Voice Quality; Speech Acoustics; Acoustics
PubMed: 34281751
DOI: 10.1016/j.jvoice.2021.05.019 -
The Laryngoscope Oct 2023The purpose of this study was to determine whether automated estimates of vocal creak would differentiate speakers with adductor laryngeal dystonia (AdLD) from speakers...
OBJECTIVE
The purpose of this study was to determine whether automated estimates of vocal creak would differentiate speakers with adductor laryngeal dystonia (AdLD) from speakers with muscle tension dysphonia (MTD) and speakers without voice disorders.
METHODS
Sixteen speakers with AdLD, sixteen speakers with MTD, and sixteen speakers without voice disorders were recorded in a quiet environment reading aloud a standard paragraph. An open-source creak detector was used to calculate the percentage of creak (% creak) in each of the speaker's six recorded sentences.
RESULTS
A Kruskal-Wallis one-way analysis of variance revealed a statistically significant effect of group on the % creak with a large effect size. Pairwise Wilcoxon tests revealed a statistically significant difference in % creak between speakers with AdLD and controls as well as between speakers with AdLD and MTD. Receiver operating characteristic curve analyses indicated that % creak differentiated AdLD from both controls and speakers with MTD with high sensitivity and specificity (area under the curve statistics of 0.94 and 0.86, respectively).
CONCLUSION
Percentage of creak as calculated by an automated creak detector may be useful as a quantitative indicator of AdLD, demonstrating the potential for use as a screening tool or to aid in a differential diagnosis.
LEVEL OF EVIDENCE
3 Laryngoscope, 133:2687-2694, 2023.
Topics: Humans; Dysphonia; Muscle Tonus; Dystonia; Voice Quality; Voice; Laryngeal Muscles
PubMed: 36715109
DOI: 10.1002/lary.30588 -
PeerJ 2024The mechanical properties of muscles, such as changes in muscle tone and stiffness, are related to sports performance and injuries. Rowers are at increased risk of...
BACKGROUND
The mechanical properties of muscles, such as changes in muscle tone and stiffness, are related to sports performance and injuries. Rowers are at increased risk of muscle fatigue and injury during high-repetition and heavy-load cyclic muscle actions. In view of this, the aim of the present study was to investigate the acute effect on muscle tone and stiffness, as well as bilateral muscle asymmetry, in high school rowers after a 2000-meter rowing ergometer test.
METHODS
Twelve young male rowers (age = 17.1 ± 0.9 years, body weight = 73.5 ± 9.7 kg) were included in the study. The data of muscle tone (frequency) and stiffness of the posterior deltoids (PD), latissimus dorsi (LD), and rectus femoris (RF) (dominant and non-dominant side) before and after a 2000-m rowing ergometer test were collected using a handheld MyotonPRO device.
RESULTS
After the rowing ergometer test, the muscle tone of dominant side PD, LD, and RF were significantly increased ( < 0.05). On the other hand, the muscle stiffness of the non-dominant side LD and RF, as well as the dominant side PD, LD, and RF were significantly increased after the rowing ergometer test ( < 0.05). The muscle tone and stiffness results showed that the dominant side PD, LD, and RF were all significantly higher than the non-dominant side after the rowing ergometer test ( < 0.05), where bilateral PD and RF exhibits moderate asymmetry (5% < symmetry index < 10%).
CONCLUSIONS
After a high-intensity and high-load 2000-m rowing ergometer test, PD, LD, and RF showed increases in muscle tone and stiffness, as well as changes in the symmetry of bilateral muscle mechanical properties.
Topics: Male; Humans; Adolescent; Musculoskeletal Physiological Phenomena; Muscle Tonus; Muscle Fatigue; Quadriceps Muscle; Water Sports
PubMed: 38188161
DOI: 10.7717/peerj.16737 -
Scientific Reports Dec 2023The lumbopelvic muscle mechanical properties (MMPs) are clinically relevant, but their dependence on sex remains unknown. Therefore, this study aimed to identify if...
The lumbopelvic muscle mechanical properties (MMPs) are clinically relevant, but their dependence on sex remains unknown. Therefore, this study aimed to identify if lumbopelvic MMPs depend on the sex in a young adult population. Thirty-five healthy nulliparous women and 35 healthy men were analyzed (age range: 18-50). Lumbopelvic MMPs, that is, tone, stiffness, elasticity, relaxation and creep, assessed with MyotonPRO®, and pelvic floor (PF) health questionnaires were compared between-sexes. Intra-group correlations between sociodemographic and clinical data, and MMPs were also determined. The MMPs of PF were different between healthy non-climacteric adults of both sexes, with women showing higher values of tone and stiffness and lower values of elasticity and viscoelastic properties than men (in all cases, p < 0.03). At lumbar level, tone and stiffness were higher for men at both sides (in all cases, p < 0.04), and relaxation was lower at left side (p = 0.02). The MMPs showed few correlations with sociodemographic data within women. However, within males, there were positive correlations for PF stiffness and viscoelastic parameters with age, BMI and function (0.334 < r < 0.591) and, at lumbar level, negative correlations for tone and stiffness ( - 0.385 < r < -0.590) and positive correlations for viscoelastic properties (0.564 < r < 0.719), with BMI. This indicated that between-sexes differences of lumbopelvic MMPs depend on the specific location of assessment in healthy non-obese young individuals. Women show higher tone and stiffness and lower elasticity and viscoelasticity than men, at PF level.
Topics: Male; Young Adult; Humans; Female; Adolescent; Adult; Middle Aged; Cross-Sectional Studies; Musculoskeletal Physiological Phenomena; Lumbosacral Region; Muscle Tonus; Muscles
PubMed: 38062151
DOI: 10.1038/s41598-023-48984-8 -
BMC Oral Health May 2024The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection...
BACKGROUND
The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection between probable sleep bruxism, electromyographic muscle tone, and respiratory sleep patterns recorded during polysomnography.
METHODS
106 patients with OSA (74 males, 31 females, mean age: 56.1 ± 11.4 years) were divided into two groups (sleep bruxism: SB; no sleep bruxism: NSB). Probable SB were based on the AASM criteria: self-report of clenching/grinding, orofacial symptoms upon awakening, abnormal tooth wear and hypertrophy of the masseter muscle. Both groups underwent clinical examination for painful muscle symptoms aligned with Temporomandibular Disorders Diagnostic Criteria (DC/TMD), such as myalgia, myofascial pain, and headache attributed to temporomandibular disorder. Additionally, non-complaint positive muscle palpation and orofacial-related limitations (Jaw Functional Limited Scale-20: JFLS-20) were assessed. A one-night polysomnography with electromyographic masseter muscle tone (EMG) measurement was performed. Descriptive data, inter-group comparisons and multivariate logistic regression were calculated.
RESULTS
OSA patients had a 37.1% prevalence of SB. EMG muscle tone (N1-N3, REM; P = 0.001) and the number of hypopneas (P = 0.042) were significantly higher in the sleep bruxism group. While measures like apnea-hypopnea-index (AHI), respiratory-disturbance-index (RDI), apnea index (AI), hypopnea-index (HI), number of arousals, and heart rate (1/min) were elevated in sleep bruxers, the differences were not statistically significant. There was no difference in sleep efficiency (SE; P = 0.403). Non-complaint masseter muscle palpation (61.5%; P = 0.015) and myalgia (41%; P = 0.010) were significant higher in SB patients. Multivariate logistic regression showed a significant contribution of EMG muscle tone and JFLS-20 to bruxism risk.
CONCLUSION
Increased EMG muscle tone and orofacial limitations can predict sleep bruxism in OSA patients. Besides, SB patients suffer more from sleep disorder breathing. Thus, sleep bruxism seems to be not only an oral health related problem in obstructive apnea. Consequently, interdisciplinary interventions are crucial for effectively treating these patients.
TRIAL REGISTRATION
The study was approved by the Ethics Committee of Philipps-University Marburg (reg. no. 13/22-2022) and registered at the "German Clinical Trial Register, DRKS" (DRKS0002959).
Topics: Humans; Male; Female; Sleep Apnea, Obstructive; Sleep Bruxism; Middle Aged; Electromyography; Prospective Studies; Polysomnography; Masseter Muscle; Oral Health; Adult; Muscle Tonus
PubMed: 38745301
DOI: 10.1186/s12903-024-04351-1 -
Gait & Posture Feb 2024Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking....
BACKGROUND
Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation.
OBJECTIVE
This study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking.
METHODS
We recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05).
RESULTS
The stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05).
SIGNIFICANCE
Children with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP.
Topics: Child; Humans; Cerebral Palsy; Gait; Walking; Lower Extremity; Muscle, Skeletal; Electromyography
PubMed: 38100956
DOI: 10.1016/j.gaitpost.2023.12.007