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The anterior approach to the hip for a minimally invasive prosthesis
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Alessandro Geraci, Alberto Ricciardi
Digital mobilization is easy, so the tensor fascia lata can be pushed laterally. It is important that the split in the aponeurosis of this muscle be carried well proximally and distally beneath the skin, so that the retractors will not damage the muscle. A Beckmann retractor is inserted to hold the tensor, and the aponeurosis covering the rectus femoris is visualized. The rectus femoris muscle can be seen below its aponeurosis. It is possible to see three colors that identify different areas: white, red, and yellow areas representing the aponeurosis, muscle, and fat above the joint capsule, respectively. The thin aponeurosis covering the red area is incised. Here again, some hemostasis is often required. It is now possible to retract the muscle medially using the Beckmann retractor. Furthermore, placing this retractor between the lateral side of the rectus femoris and the medial side of the tensor fascia lata, an unnamed pearly aponeurosis is seen, which represents the only structure standing in the way of the capsule (Figure 28.12f).
Sports medicine and sports injuries
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Quadriceps tears : these most commonly occur in the rectus femoris muscle. They may be due to a direct blow, but more commonly they are due to twisting injury and occur along the aponeurosis of the rectus femoris, which is a weak point where the two muscle bellies join.
Examination of Knee Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Begin by comparing the quadriceps muscle in both limbs. The musculature should be symmetrical bilaterally. Variations may be obvious in affections, e.g., chronic post-traumatic affection of the extremity, chronic osteomyelitis femur, etc. The muscle girth can be recorded by measuring it in reference to a fixed bony landmark such as the upper pole of the patella or above the knee joint line. Look at and palpate any gaps or defects in the rectus femoris muscle and patellar tendon that feel as soft yields in these otherwise firm structures. Examine the tone of the quadriceps muscle by palpating it after asking the patient to actively contract it. The patient can be helped in this maneuver by placing a hand or rolled towel in the posterior knee region and instructing the patient to press against it. The vastus medialis component can be selectively examined by asking the patient to dorsiflex the inverted foot while attempting a knee extension. Surface electromyography (EMG) studies have shown that the muscle is facilitated by knee extension in an inverted dorsiflexed ankle. Much of the patella’s articular surface is accessible to palpation if the patella is first pushed medially and then laterally in a relaxed knee. The undersurface of the patella may be tender in chondromalacia patellae or retropatellar arthritis. Point tenderness should also be sought over the quadriceps tendon (e.g., quadriceps tendinitis), anterior surface of the patella (e.g., fractures), and lower pole (e.g., Sinding–Larsen–Johansson disease), patellar tendon (e.g., strains), and tibial tubercle (e.g., Osgood–Schlatter disease in children and adolescents).
Association of gross motor function and activities of daily living with muscle mass of the trunk and lower extremity muscles, range of motion, and spasticity in children and adults with cerebral palsy
Published in Developmental Neurorehabilitation, 2023
Mitsuhiro Masaki, Honoka Isobe, Yuki Uchikawa, Mami Okamoto, Yoshie Chiyoda, Yuki Katsuhara, Kunio Mino, Kaori Aoyama, Tatsuya Nishi, Yasushi Ando
Our results showed that gross motor function and ADL were not associated with the thickness of the hip and ankle joint muscles. This finding suggested that the actions of trunk muscles such as the thoracic erector spinae and rectus abdominis muscles and knee joint muscles such as the vastus lateralis muscle are more important than those of the hip and ankle joint muscles for gross motor function and ADL in children and adults with CP. Moreover, previous studies have demonstrated the effects of strength training interventions in children and adults with CP. Strength training of the trunk muscles improved the thicknesses of the rectus abdominis, obliquus externus, internus abdominis, and transversus abdominis muscles in children with CP.37 Additionally, strength training of the lower extremity muscles led to improved cross-sectional area of the rectus femoris muscle in children and adults with CP.38 Thus, strength training in addition to increased amount of exercise in daily living may be necessary to improve or maintain the thickness of the trunk and lower extremity muscles such as the thoracic erector spinae, rectus abdominis, and vastus lateralis muscles in children and adults with CP. Considering the clinical usefulness of the present study, the thickness of the trunk and lower extremity muscles should be measured regularly using an ultrasound imaging device (e.g., once yearly), if possible, in children and adults with CP.
Comparison of the Upper and Lower Extremity and Trunk Muscle Masses between Children with Down Syndrome and Children with Typical Development
Published in Developmental Neurorehabilitation, 2022
Mitsuhiro Masaki, Seina Maruyama, Yukika Inagaki, Yukine Ogawa, Yoshino Sato, Minori Yokota, Moeka Takeuchi, Maki Kasahara, Kota Minakawa, Kana Kato, Kenji Sakaino
The rectus femoris muscle thickness was significantly lower in the DS group than in the TD group. The rectus femoris muscle performs hip joint flexion and knee joint extension and is activated not only in the stance phase of gait requiring knee extension movement but also in the initial swing, which requires a swing of the lower extremities during the walking motion.28 Delayed acquisition of independent walking29 and decreased activities in daily living30 in children with DS compared to those in children with TD leads to decreased opportunities to perform the walking motion. Furthermore, decreased activity of the rectus femoris muscle due to decreased opportunities to perform the walking motion may lead to decreased muscle thickness in children with DS. Decreased knee extensor muscle strength in children with DS compared to that in children with TD has been reported,15 a finding consistent with that of the present study showing reduced knee extensor muscle in the DS group than in the TD group, although the measurement methods in the present study (muscle thickness) differed from those in the previous study (muscle strength).
The effect of exercise training interventions in adult kidney transplant recipients: a systematic review and meta-analysis of randomised control trials
Published in Physical Therapy Reviews, 2022
Thomas J. Wilkinson, Nicolette C. Bishop, Roseanne E. Billany, Courtney J. Lightfoot, Ellen M. Castle, Alice C. Smith, Sharlene A. Greenwood
Three studies [32,33,44] measured body composition changes by DXA. However, heterogeneity in the variables presented meant no meta-analysis could be performed. Painter et al. [33] found an increased fat mass, lean mass, and body fat % in both the exercise and control group with no difference in the changes during the 12-months. Karelis et al. [32] reported increases in fat mass % in both the exercise and control group (4.8 and 6.4%, respectively). Lean mass % was reduced by 1.5 and 2.3% in both groups, although this was non-significant. Tzvetanov et al. [44] assessed body composition in the intervention group only. They reported that mean lean mass increased from 60.8 ± 6.3 kg at baseline to 63.1 ± 14.1 kg at 12-months, an increase of 2.3 kg (p = 0.39). The mean fat mass % decreased slightly throughout 12-months (no data provided in the study). No change in rectus femoris muscle thickness was see following 10-weeks of resistance training by Herndandez-Sanchez et al. [40].