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Blocks of Nerves of the Lumbar Plexus Supplying the Lower Extremities
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The posterior division branches of the femoral nerve consist of: Articular branches, supplying the hip joint (they issue from branches supplying the rectus femoris muscle) and the knee joint (they arise from the saphenous nerve and from nerves innervating the vastus muscles)The saphenous nerve, which is the largest terminal branch of the femoral nerve; it runs within the adductor canal, crosses the femoral vessels obliquely at the distal end of the adductor magnus muscle, passes behind the sartorius muscle, then descends along the tibia and ends at the medial side of the ankle by dividing into two terminal branches; in the adductor canal, it gives off twigs which unite with the medial cutaneous nerve of the thigh and the obturator nerve, thus constituting the subsartorial plexus;it also gives off infrapatellar branches, which contribute to the patellar plexus and medial cutaneous branches; the saphenous nerve supplies sensory innervation to the medial part of the leg and the foot (Figure 2.4C)
Clinical Management of Spasticity and Contractures in Stroke
Published in Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway, Neurological Rehabilitation, 2018
Judith F. M. Fleuren, Jaap H. Buurke, Alexander C. H. Geurts
Adequate foot clearance can also be at risk due to “stiff knee gait,” the phenomenon of reduced knee flexion in early swing. Normal peak knee flexion in this phase is 60–65 degrees and is induced by ankle plantar flexion force during push-off in pre-swing, in combination with hip flexion. Knee extensor muscles are normally relaxed in early swing, although rectus femoris has a short period of action during stance to swing transition (Nene et al., 2004). An exact definition of stiff knee gait for stroke patients is not available. For children with cerebral palsy a cut-off value below 45 degrees of peak knee flexion or a delayed knee peak flexion is generally used (Sutherland and Davids, 1993). Whether overactivity of rectus femoris or pathological activity of vastus muscles is the underlying cause should be assessed with surface electromyography (Figure 5.6). In almost all cases decreased plantar flexion power is an important contributing factor.
Molecular Mechanisms of Training Effects
Published in Atko Viru, Adaptation in Sports Training, 2017
The differences in training effects related to the intensity and duration of exercises can be expected by the results of a study in the uptake of3 H-leucine into different fractions of the rat skeletal muscle following acute endurance and sprint exercises. The changes appeared to be different after prolonged moderate running vs. short-term intensive dashes. Endurance exercises caused a post-exercise increase of labeled amino acid incorporation into the protein of the mitochondrial fraction both in the red and white vastus muscle. Sprint exercise caused the same only in the white muscle. During post-exercise recovery, episodes of increased label incorporation into the soluble fractions of proteins were found only in the red vastus after endurance exercise, but in both types of muscles after sprint exercise.48
Acute effects of repetitive peripheral magnetic stimulation following low-intensity isometric exercise on muscle swelling for selective muscle in healthy young men
Published in Electromagnetic Biology and Medicine, 2021
Tetsuya Hirono, Tome Ikezoe, Masashi Taniguchi, Shusuke Nojiri, Hiroki Tanaka, Noriaki Ichihashi
The characteristic of stimulating selective vastus muscles of the quadriceps femoris muscles may be expected to be applied in various clinical situations. Patients with knee osteoarthritis have been reported to have less muscle mass of the vastus muscles compared with healthy individuals (Aily et al. 2019; Taniguchi et al. 2015). In knee extension exercises, it is generally not possible to contract only one of the synergist muscles to enable contraction of only the VL; rather all synergist muscles contract. Considering that individual differences in force distribution among synergist muscles occur while exerting muscle force (Crouzier et al. 2020; Hug et al. 2015, 2019), general strength training may not improve the muscle mass of the vastus muscles in patients with less force exertion. Applying rPMS selectively to atrophied muscle may improve imbalance among synergist muscles. In addition, because imbalance of muscle forces among hip muscles could increase joint stress (Lewis et al. 2007), it is expected that there will be clinical applications in the prevention of muscle atrophy and promotion of muscle hypertrophy for selective muscles in various joints. The effects of selective stimulation of various muscles on kinesiology or motor functions should be investigated in future studies.
Sports activity after soft tissue sarcoma of the lower extremity
Published in Disability and Rehabilitation, 2020
Gerhard M. Hobusch, Miroslava Cernakova, Stephan E. Puchner, Alexander Kolb, Joannis Panotopoulos, Reinhard Windhager
Gerrand et al. described an influence of the anatomical location of tumors of lower-extremity sarcomas on functional outcome measured by MSTS and TESS. Although there was a strong correlation between UCLA Activity Score in this current study, with these mentioned functional scores, the results did not exactly correspond with functional scores for the analog anatomical areas descripted by Gerrand et al. There is partial agreement on less favorable results after resection of the lateral vastus muscle and gastrocnemius muscle, but hardly any agreement after biceps femoris resection. According to this rough classification, long-term UCLA Activity level was lowest after resection of parts of the gastrocnemius muscle (7.2 ± 2.7) and lateral quadriceps femoris (7.3 ± 1.7), also low scoring in Gerrand et al. Highest rating was obtained after resection of biceps femoris muscle (9.7 ± 0.6), which was also low scoring in Gerrand et al. Reasons for outcome discrepancies on the five afflicted muscle groups may be found in the low number of patients and presumably differences regarding individual adaptation skills of these patients, and finally the described regions including different muscles in the cited work.
Long-term effects on body functions, activity and participation of hemiplegic patients in equino varus foot deformity surgical correction followed by immediate rehabilitation. A prospective observational study
Published in Topics in Stroke Rehabilitation, 2019
Davide Mazzoli, Erika Giannotti, Chiara Rambelli, Paolo Zerbinati, Martina Galletti, Francesca Mascioli, Paolo Prati, Andrea Merlo
The long-term safety, durability, and effectiveness of FS in improving walking ability and reducing the need for orthosis after EVFD correction were demonstrated in a review by Renzenbrink and colleagues.2 Considering the outcome measures, only 4 of the 15 trials included analyzed walking ability with the 6 Minute Walking Test (6MWT) and Functional Ambulation Categories (FAC). However, GA was used in three studies only, when pre- and post-operative ankle kinematics were compared. Namndari published a paper evaluating the transfer of the rectus femoris and fractional lengthening of vastus muscles, which in turn determined an increase (from 8 to 33 degrees) of maximum peak of flexion in a swing. These results were only obtained from observational GA and were not supported by instrumental data.10