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Current Oncology (Toronto, Ont.) Jan 2024The aim of this study was to explore the outcomes of pelvic reconstruction with a rectus abdominis myocutaneous (RAM) or rectus abdominis myoperitoneal (RAMP) flap...
The aim of this study was to explore the outcomes of pelvic reconstruction with a rectus abdominis myocutaneous (RAM) or rectus abdominis myoperitoneal (RAMP) flap following radical surgery for gynecologic malignancy. This is a retrospective case series of all pelvic reconstructions with RAM or RAMP flap performed in a gynecologic oncology service between 1998 and 2023. Reconstructions with other flaps were excluded. A total of 28 patients were included. Most patients had vulvar cancer ( = 15, 53.6%) and the majority had disease recurrence ( = 20, 71.4%). Exenteration was the most common procedure, being carried out in 20 (71.4%) patients. Pelvic reconstruction was carried out with a RAM flap in 24 (85.7%) cases and a RAMP flap in 4 (14.3%) cases. Flap-specific complications included cellulitis (14.3%), partial breakdown (17.9%), and necrosis (17.9%). Donor site complications included surgical site infection and necrosis occurring in seven (25.0%) and three (10.7%) patients, respectively. Neovaginal reconstruction was performed in 14 patients. Out of those, two (14.3%) had neovaginal stenosis and three (21.4%) had rectovaginal fistula. In total, 50% of patients were disease-free at the time of the last follow up. In conclusion, pelvic reconstruction with RAM/RAMP flaps, at the time of radical surgery for gynecologic cancer, is an uncommon procedure. In our case series, we had a significant complication rate with the most common being infection and necrosis. The development of a team approach, with input from services including Gynecologic Oncology and Plastic Surgery should be developed to decrease post-operative complications and improve patient outcomes.
Topics: Humans; Female; Genital Neoplasms, Female; Surgery, Plastic; Retrospective Studies; Cellulitis; Necrosis
PubMed: 38248111
DOI: 10.3390/curroncol31010026 -
Journal of Musculoskeletal & Neuronal... Jun 2024To verify the relationship between the indicators of components of lumbar motor control and determine the factors related to the indicators to each of these components.
OBJECTIVES
To verify the relationship between the indicators of components of lumbar motor control and determine the factors related to the indicators to each of these components.
METHODS
Twenty-five healthy university students were included in the study. The lumbar spine and hip kinematic parameters of posterior/anterior pelvic tilt (mobility and smoothness), ball catching (reactivity), and forward/backward rocking (adaptive stability) were measured as indicators of lumbar motor control. Lumbar proprioception, trunk muscle strength, and lower trunk muscle thickness were also measured. Kinematic parameters of the lumbar spine and hip were measured using a small accelerometer. The data verified the relevance of indicators of lumbar motor control and the relationship with relevant factors.
RESULTS
No significant correlations were found for most lumbar motor control indicators. Lumbar proprioception and rectus abdominis muscle thickness were identified as relevant indicators of lumbar motor control.
CONCLUSIONS
Each component of lumbar motor control is independent and must be evaluated for the component whose function is required. Additionally, some components of lumbar motor control are associated with lumbar proprioception and rectus abdominis muscle thickness; thus, evaluation of these components is necessary when evaluating lumbar motor control.
Topics: Humans; Male; Female; Young Adult; Proprioception; Lumbar Vertebrae; Biomechanical Phenomena; Adult; Muscle Strength; Postural Balance; Lumbosacral Region; Muscle, Skeletal
PubMed: 38825996
DOI: No ID Found -
Clinical Practice and Cases in... May 2024Rectus abdominis muscle strains are common and can be debilitating in both professional and amateur athletes who engage in strenuous activity.
INTRODUCTION
Rectus abdominis muscle strains are common and can be debilitating in both professional and amateur athletes who engage in strenuous activity.
CASE REPORT
We report a rare case of rectus abdominis muscle tear in an amateur bodybuilder diagnosed by point-of-care ultrasound (POCUS) in the emergency department (ED). The patient had presented to the ED three separate times after strenuous exercise, received costly diagnostic workups, and ultimately was diagnosed on the third visit with grade 2 bilateral rectus abdominis tear. The patient was given appropriate education and sports medicine follow-up. He underwent rehabilitation focused on trunk and core stability. At eight-week follow-up, the patient had made a full recovery.
CONCLUSION
To our knowledge, a case of bilateral rectus abdominis tear diagnosed by ultrasound in the emergency setting has not been previously published. Our case report highlights the utility of POCUS in diagnosing musculoskeletal pathology and preventing costly bounce-back visits.
PubMed: 38869342
DOI: 10.5811/cpcem.1670 -
PeerJ 2023The purpose of this study is to examine the impact of trunk kinematic characteristics and trunk muscle electromyography (EMG) activity on propulsion speeds in wheelchair...
BACKGROUND
The purpose of this study is to examine the impact of trunk kinematic characteristics and trunk muscle electromyography (EMG) activity on propulsion speeds in wheelchair racing T54 athletes.
METHOD
The Vicon infrared high-speed 3D motion capture system was utilized to acquire kinematic data of the shoulders, elbows, wrists, and trunk from twelve T54 athletes at four different speeds (5.55 m/s, 6.94 m/s, 8.33 m/s, and personal maximum speed). Additionally, the Trigno Wireless EMG system was employed to collect synchronous surface electromyography (EMG) data from the rectus abdominis and erector spinae muscles. The kinematics and EMG data of the trunk were compared across various wheelchair propulsion speeds while also examining the correlation coefficient between wheelchair propulsion speeds and: (1) the range of motion of upper limb joints as well as the trunk; (2) the maximum angular velocities of the upper limbs joints as well as the trunk; and (3) rectus abdominis and erector spinae EMG activity. Two multiple linear stepwise regression models were utilized to examine the impact of variables that had been identified as significant through correlation coefficient tests (1) and (2) on propulsion speed, respectively.
RESULTS
There were significant differences in the range of motion (<0.01) and angular velocity (<0.01) of the athlete's trunk between different propulsion speeds. The range of motion (<0.01, = 0.725) and angular speed (<0.01, = 0.882) of the trunk showed a stronger correlation with propulsion speed than did upper limb joint movements. The multiple linear stepwise regression model revealed that the standardized values of trunk motion range and angular velocity in athletes were greater than those of other independent variables in both models. In terms of the EMG variables, four of six variables from the rectus abdominis showed differences at different speeds (<0.01), one of six variables from the erector spinae showed differences at different speeds (<0.01). All six variables derived from the rectus abdominis exhibited a significant correlation with propulsion speed (<0.05, >0.3), while one variable derived from the erector spinae was found to be significantly correlated with propulsion speed (<0.01, = 0.551).
CONCLUSION
The movement of the trunk plays a pivotal role in determining the propulsion speed of wheelchair racing T54 athletes. Athletes are advised to utilize trunk movements to enhance their wheelchair's propulsion speed while also being mindful of the potential negative impact on sports performance resulting from excessive trunk elevation. The findings of this study indicate that it would be beneficial for wheelchair racing T54 athletes to incorporate trunk strength training into their overall strength training regimen, with a specific emphasis on enhancing the flexion and extension muscles of the trunk.
Topics: Humans; Electromyography; Biomechanical Phenomena; Muscle, Skeletal; Athletes; Wheelchairs
PubMed: 37581118
DOI: 10.7717/peerj.15792 -
Sports (Basel, Switzerland) Aug 2023Exercises that improve muscle activation are essential for maintaining spinal stability and preventing low back pain. The purpose of this study was to compare the...
Exercises that improve muscle activation are essential for maintaining spinal stability and preventing low back pain. The purpose of this study was to compare the effects of abdominal hollowing and bracing on the activation of the core muscles in CrossFit participants using ultrasound and electromyography (EMG). Twenty-four healthy adults aged 21 to 42 years old with at least two years of CrossFit experience performed three core stability exercises (plank, side plank, bridge) with abdominal hollowing and bracing. We measured the ultrasound relative thickness of the local core muscles (transversus abdominis, internal oblique, and lumbar multifidus), and the EMG percentage of maximal voluntary contraction (MVC) of the global core muscles (rectus abdominis, external oblique, and iliocostalis lumborum). Analysis of variance tests showed that the relative thickness of the local core muscles was greater ( = 0.016) during hollowing (range from 26.8 ± 5.33 to 88.4 ± 11.9% of rest) than bracing (range from 15.9 ± 3.54 to 61.2 ± 15.9% of rest), while the EMG of the global muscles was greater ( = 0.001) in bracing (range from 24.4 ± 7.30 to 72.5 ± 9.17% of MVC) than hollowing (range from 16.4 ± 3.70 to 56.6 ± 7.65% of MVC). These results indicate that the recruitment of spinal muscles during popular exercises is achieved with both hollowing and bracing. Nevertheless, it appears that hollowing tends to recruit more of the local muscles, whilst bracing recruits more of the global muscles. The grading of the exercises varied between muscles and varied between maneuvers, especially for the surface abdominals and lumbar muscles. CrossFit practitioners can choose to use either hollowing or bracing to activate their core muscles more selectively or more appropriately, depending on the goal and purpose of the exercise.
PubMed: 37624139
DOI: 10.3390/sports11080159 -
Physical Therapy Oct 2023Postpartum diastasis recti abdominis (DRA) influences women's appearance and health. Gestational diabetes mellitus (GDM) can affect the structure of the rectus abdominis...
OBJECTIVE
Postpartum diastasis recti abdominis (DRA) influences women's appearance and health. Gestational diabetes mellitus (GDM) can affect the structure of the rectus abdominis muscles. However, the relationship between GDM and postpartum DRA is unknown. The objective of this study was to investigate the relationship between GDM and postpartum DRA.
METHODS
This retrospective cohort study included 241 women in the first year postdelivery. Women with GDM were matched with those without GDM using propensity score matching. They underwent an oral glucose tolerance test during pregnancy and a random blood glucose test before delivery. At follow-up, DRA was diagnosed by palpation, and interrectus distance was measured using ultrasound to evaluate the severity of DRA. The strength of the rectus abdominis was evaluated using the manual muscle testing method.
RESULTS
Among the 241 participants, 174 (72.2%) had postpartum DRA, and 46 women with GDM were matched with 46 women without GDM on the basis of propensity scores. Women with GDM had higher odds of experiencing postpartum DRA (adjusted odds ratio = 4.792; 95% CI = 1.672 to 13.736) and larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. There was a weak and positive correlation between the fasting oral glucose tolerance test level and the interrectus distance values (0.267 ≤ r ≤ 0.367).
CONCLUSION
GDM was associated with postpartum DRA in women in the first year of delivery. Women with GDM had larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. The fasting oral glucose tolerance test level showed a positive and weak correlation with the severity of postpartum DRA.
IMPACT
Women with GDM have higher odds of experiencing postpartum DRA than those without GDM. The upper part of the rectus abdominis deserves increased focus during and after rehabilitation. Controlling the fasting oral glucose tolerance test level may help reduce the severity of postpartum DRA.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Diabetes, Gestational; Retrospective Studies; Postpartum Period; Diastasis, Muscle
PubMed: 37774365
DOI: 10.1093/ptj/pzad102 -
3D Printing in Medicine Sep 2023Deep Inferior Epigastric Perforator Flap (DIEP) surgical procedures have benefited in recent years from the introduction of 3D printed models, yet new technologies are...
BACKGROUND
Deep Inferior Epigastric Perforator Flap (DIEP) surgical procedures have benefited in recent years from the introduction of 3D printed models, yet new technologies are expanding design opportunities which promise to improve patient specific care. Numerous studies, utilizing 3D printed models for DIEP, have shown a reduction of surgical time and complications when used in addition to the review of standard CT imaging. A DIEP free flap procedure requires locating the inferior epigastric perforator vessels traversing and perforating the rectus abdominis muscle, perfusing the abdominal skin and fatty tissue. The goal of dissecting the inferior epigastric perforator vessels is complicated by the opacity of the fatty tissue and muscle. Previous attempts to 3D print patient specific models for DIEP free flap cases from CT imaging has shown a wide range of designs which only show variations of perforator arteries, fatty tissue, and the abdominis rectus muscle.
METHODS
To remedy this limitation, we have leveraged a voxel-based modeling environment to composite complex modeling elements and incorporate a ruled grid upon the muscle providing effortless 'booleaning' and measured guidance.
RESULTS
A limitation of digital surface-based modeling tools has led to existing models lacking the ability to composite critical anatomical features, such as differentiation of vessels through different tissues, coherently into one model, providing information more akin to the surgical challenge.
CONCLUSION
With new technology, highly detailed multi-material 3D printed models are allowing more of the information from medical imaging to be expressed in 3D printed models. This additional data, coupled with advanced digital modeling tools harnessing both voxel- and mesh-based modeling environments, is allowing for an expanded library of modeling techniques which create a wealth of concepts surgeons can use to assemble a presurgical planning model tailored to their setting, equipment, and needs.
TRIAL REGISTRATION
COMIRB 21-3135, ClinicalTrials.gov ID: NCT05144620.
PubMed: 37700101
DOI: 10.1186/s41205-023-00181-z -
Animal Bioscience Aug 2023Pork belly is a cut of meat with high worldwide demand. However, although the belly is comprised of multiple muscles and fat, unlike the loin muscle, research on their...
OBJECTIVE
Pork belly is a cut of meat with high worldwide demand. However, although the belly is comprised of multiple muscles and fat, unlike the loin muscle, research on their genetic parameters has yet to focus on a representative cut. To use swine breeding, it is necessary to estimate heritability against pork belly traits. Moreover, estimating genetic correlations is needed to identify genetic relationship among the traditional carcass and meat quality traits. This study sought to estimate the heritability of the carcass, belly, and their component traits, as well as the genetic correlations among them, to confirm whether these traits can be improved.
METHODS
A total of 543 Yorkshire pigs (406 castrated males and 137 females) from 49 sires and 244 dam were used in this study. To estimate genetic parameters, a total of 12 traits such as lean meat production ability, meat quality and pork belly traits were chosen. The heritabilities were estimated by using genome-wide efficient mixed model association software. The statistical model was selected so that farm, carcass weight, sex, and slaughter season were fixed effects. In addition, its genetic parameters were calculated via MTG2 software.
RESULTS
The heritability estimates for the 7th belly slice along the whole plate and its components were low to moderate (0.07±0.07 to 0.33±0.07). Moreover, the genetic correlations among the carcass and belly traits were moderate to high (0.28±0.20 to 0.99±0.31). Particularly, the rectus abdominis muscle exhibited a high absolute genetic correlation with the belly and meat quality (0.73±52 to 0.93±0.43).
CONCLUSION
A moderate to high correlation coefficient was obtained based on the genetic parameters. The belly could be genetically improved to contain a larger proportion of muscle regardless of lean meat production ability.
PubMed: 36915918
DOI: 10.5713/ab.22.0391 -
Journal of Physiotherapy Apr 2024What is the effect of a 12-week abdominal and pelvic floor muscle exercise program during pregnancy on the inter-recti distance (IRD) in women with diastasis recti... (Randomized Controlled Trial)
Randomized Controlled Trial
QUESTION
What is the effect of a 12-week abdominal and pelvic floor muscle exercise program during pregnancy on the inter-recti distance (IRD) in women with diastasis recti abdominis immediately after the 12-week intervention period and at follow-up 6 weeks postpartum?
DESIGN
An exploratory, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
PARTICIPANTS
Ninety-six pregnant women aged ≥ 18 years, either primigravida or multigravida, in gestation week 24 with an IRD of ≥ 28 mm measured at rest and/or a protrusion on initial assessment.
INTERVENTION
The experimental group participated in a 12-week abdominal and pelvic floor muscle exercise program during pregnancy. The control group received no intervention.
OUTCOME MEASURES
Change (mm) in IRD 2 cm above and below the umbilicus at rest from pre-intervention to immediately post-intervention and to 6 weeks follow-up measured with ultrasonography.
RESULTS
The IRD increased for both groups from baseline to immediately after the intervention and decreased from after the intervention to the follow-up at 6 weeks postpartum. The IRD was smallest for both groups at the follow-up. At 2 cm above the umbilicus, the intervention effect was 2 mm (95% CI -2 to 7) immediately after the intervention and -1 mm (95% CI -4 to 3) at follow-up. At 2 cm below the umbilicus, the intervention effect was -5 mm (95% CI -10 to 0) immediately after the intervention and 0 mm (95% CI -4 to 4) at follow-up.
CONCLUSION
Abdominal and pelvic floor muscle training during pregnancy have a negligible effect on the IRD immediately after 12 weeks of intervention and at 6 weeks post-partum.
REGISTRATION
NCT04960800.
Topics: Female; Humans; Pregnancy; Abdomen; Pelvic Floor; Postpartum Period; Rectus Abdominis; Adult
PubMed: 38472049
DOI: 10.1016/j.jphys.2024.02.002 -
BMC Pulmonary Medicine Jul 2023This study aimed to investigate the effectiveness of neuromuscular electrical stimulation (NMES) blended with early rehabilitation on the diaphragm and skeletal muscle... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study aimed to investigate the effectiveness of neuromuscular electrical stimulation (NMES) blended with early rehabilitation on the diaphragm and skeletal muscle in sufferers on mechanical ventilation (MV).
METHOD
This is a prospective randomized controlled study. Eighty patients on MV for respiratory failure were divided into a study group (40 cases) and a control group (40 cases) randomly. The study group adopted a treatment method of NMES combined with early rehabilitation and the control group adopted the method of early rehabilitation only. The diaphragmatic excursion (DE), diaphragmatic thickening fraction (DTF), variation of thickness of intercostal muscles (TIM), variation of thickness of rectus abdominis (TRA), and variation of the cross-sectional area of rectus femoris (CSA-RF) were measured to evaluate the therapeutic effect by ultrasound before and after intervention at the first day of MV, the 3rd and 7th day of intervention and the day discharged from ICU.
RESULTS
No significant difference was found in the general demographic information and ultrasound indicators between the two groups before treatment (all P > 0.05). After treatment, the variation of DTF (0.15 ± 0.05% vs. 0.12 ± 0.04%, P = 0.034) was significantly higher in the study group than that in the control group on the day discharged from ICU. The variation of TRA (0.05 ± 0.09% vs. 0.10 ± 0.11%, P = 0.029) and variation of CSA-RF (0.13 ± 0.07% vs. 0.19 ± 0.08%, P < 0.001) in the study group were significantly lower than that in the control group. The duration of MV in the study group was significantly shorter than that in the control group [109.5 (88.0, 213.0) hours vs. 189.5 (131.5, 343.5) hours, P = 0.023]. The study group had better muscle strength score than the control group at discharge (52.20 ± 11.70 vs. 44.10 ± 15.70, P = 0.011).
CONCLUSION
NMES combined with early rehabilitation therapy is beneficial in reducing muscle atrophy and improving muscle strength in mechanically ventilated patients. This treatment approach may provide a new option for patients to choose a rehabilitation program; however, more research is needed to fully evaluate the effectiveness of this treatment option.
Topics: Humans; Prospective Studies; Respiration, Artificial; Secondary Prevention; Research Design; Electric Stimulation
PubMed: 37480065
DOI: 10.1186/s12890-023-02481-w