Name: diagnosis of musculus gastrocnemius tightness - key factors for the clinical examination
Uploaded: 2016-07-07T10:00:00.000+00:00
Duration: 8 min 43 s
Description: Watch this Scientific Journal Video about Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination at JoVE.com

We would like to thank Jakob Binder for his help in subject acquisition and organization of the examinations, Mrs. Hella Thun for designing Figure 1 and 2 and finally Mr. Dipl.-Ing. (FH), M.Sc. M. Saller for his statistical support.

伦理学声明:这项研究是由德国慕尼黑大学（＃007-14）的当地伦理委员会的批准。 注意:检查床上双方可以自由进出，对于一些非承重测试脚端。在垂直的墙壁上的接地的线路（磁带，约2米），是需要负重测试。与2°增量和20厘米长的标准测角仪使用。我们建议使用含有ADF测量膝关节延长，弯曲分开每条腿一个标准化的四格表记录结果。 1.参与者准备<ol><li>让主体脱下自己的裤子脱掉鞋袜。 </li><li>通过绘制连接远侧腓骨5厘米，15厘米腓骨的前端上面的中心的线标记腓骨的轴线。 </li></ol> 2.非承重测量（图2A） <ol><li>有两名调查员进行measuremen吨，一进行测试，其它测量踝关节背屈程度。 </li><li>在广场上检查床上取仰卧位的主题。检查榻必须在两侧和脚端都可以自由进出。 </li><li>有研究者第一次发生，一方面在距下关节的水平，以确保后脚的中性旋前，旋后位，并将另一方面周围的足弓。从而一方面稳定距舟关节，而另一只手上的前掌跖方面施加力以达到最大的踝关节背屈。 </li><li>有研究者首先确保膝关节完全伸直。 </li><li>有研究者第二次执行使用测角仪的踝关节背屈的测量。放置连接腓骨的先前标记轴的起点和终点的测角器的一个臂。对准另一个臂与脚的足底方面。 </li><li>注意在documentati结果上表。 </li><li>有研究者首先保证90度屈膝通过将一只手放在大腿远端背侧，而另一只手放在前脚掌的足底方面施加力，以实现最大踝关节背屈。 </li><li>有研究者第一次发生，一方面在距下关节的水平，以确保后脚的中性旋前，旋后位，并将另一方面周围的足弓。从而一方面稳定距舟关节和另一方面在前脚的足底方面施加力以达到最大的踝关节背屈。 </li><li>有研究者第二次执行使用测角仪的踝关节背屈的测量。放置连接腓骨的先前标记轴的起点和终点的测角器的一个臂。对准另一个臂与脚的足底方面。 </li><li>注意在文件表的结果。 </li><li>为对照重复步骤2.1至2.10alateral一面。 </li></ol> 3.负重测量（图2B） <ol><li>有一个调查员进行测试。 </li><li>将标的站在墙对面。 </li><li>让主体进入与腿弓步姿势来衡量是后排腿部。 </li><li>有研究者帮助主题把他/她后脚集中在先前标记线。确保脚后跟和后腿的第二个脚趾上线居中。 </li><li>让主体守住墙，以稳定他们的立场。 </li><li>有主题充分扩大其后排腿部。有研究者保证膝盖完全伸展。要知道，即使是轻微的膝关节屈曲显著影响踝关节背屈。 </li><li>让主体朝墙将他们的臀部，直到刚刚才脚跟抬离后腿。根据需要前腿可弯曲/舒适。 </li><li>有研究者将一只手放在背距下关节的方面，以确保后脚的中性旋前，旋后位。 </li><li>有研究者用另一只手进行踝关节背屈的测量。对准连接腓骨的先前标记轴的起点和终点的测角器的一个臂。放置在地板上的另一只手臂。 </li><li>注意在文件表的结果。 </li><li>让主体进入与腿弓步姿势来衡量是后排腿部。因此有朝墙患者移动，直到一个舒适的位置已经到达。 </li><li>有研究者帮助主题把他/她后脚集中在先前标记线。确保脚后跟和后腿的第二个脚趾上线居中。 </li><li>让主体守住墙，以稳定他们的立场。 </li><li>有弯曲的小腿后部的主题舒适和朝墙将他们的臀部，直到刚刚才脚跟取下后腿。根据需要前腿可弯曲/舒适。 </li><li>已经研究者保证后膝关节弯曲至少20度。在有疑问的情况下，使用测角仪，确保膝关节屈曲超过19度。 </li><li>对距下关节的背侧研究者地方一方面要保证后脚的中性旋前，旋后位。 </li><li>用另一只手进行踝关节背屈的测量。对准连接腓骨的先前标记轴的起点和终点的测角器的一个臂。放置在地板上的另一只手臂。 </li><li>注意在文件表的结果。 </li><li>为对侧重复步骤3.1至3.18。 </li></ol> 4.数据分析与解读<ol><li>向受试者识别对症侧。 </li><li>查看的文档表中ADF数据。 <ol><li>首先确定是否ADF与KNee值扩展是在症状侧小于10°。如果是这样，考虑MGT是一个可能的原因。然后，比较的ADF用膝盖延伸并弯曲。如果在ADF的显著增加膝关节屈曲的结果，MGT存在。 </li><li>如果ADF大于10°，用膝盖延长双腿之间比较ADF。如果ADF上的症状相比减少非对症侧考虑MGT是一个可能的原因。如果在ADF的显著增加对症侧面结果膝关节屈曲，MGT存在。 </li></ol></li></ol>

<ol>
	<li>Wilder, R. P., Sethi, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Overuse+injuries:+tendinopathies,+stress+fractures,+compartment+syndrome,+and+shin+splints.">Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints.</a> Clin Sorts Med. 23, 55-81 (2004).</li><li>Irving, D. B., Cook, J. L., Menz, H. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+associated+with+chronic+plantar+heel+pain:+a+systematic+review.">Factors associated with chronic plantar heel pain: a systematic review.</a> J Sci Med Sport. 9, 11-22 (2006).</li><li>Patel, A., DiGiovanni, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Association+between+plantar+fasciitis+and+isolated+contracture+of+the+gastrocnemius.">Association between plantar fasciitis and isolated contracture of the gastrocnemius.</a> Foot Ankle Int. 32, 5-8 (2011).</li><li>DiGiovanni, C. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolated+gastrocnemius+tightness.">Isolated gastrocnemius tightness.</a> JBJS Am. 84-A, 962-970 (2002).</li><li>Bol&#236;var, Y. A., Munuera, P. V., Padillo, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Relationship+between+tightness+of+the+posterior+muscles+of+the+lower+limb+and+plantar+fasciitis.">Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis.</a> Foot Ankle Int. 34, 42-48 (2013).</li><li>Hill, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ankle+equinus.+Prevalence+and+linkage+to+common+foot+pathology.">Ankle equinus. Prevalence and linkage to common foot pathology.</a> J Am Podiatr Med Assoc. 85, 295-300 (1995).</li><li>Silfverskiold, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reduction+of+the+uncrossed+two-joints+muscles+of+the+leg+to+one-joint+muscles+in+spastic+conditions.">Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions.</a> Acta Chir Scand. 56, 315-330 (1923).</li><li>Krause, D. A., Cloud, B. A., Forster, L. A., Schrank, J. A., Hollman, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurement+of+ankle+dorsiflexion:+a+comparison+of+active+and+passive+techniques+in+multiple+positions.">Measurement of ankle dorsiflexion: a comparison of active and passive techniques in multiple positions.</a> J Sport Rehabil. 20, 333-344 (2011).</li><li>Bennell, K. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intra-rater+and+inter-rater+reliability+of+a+weight-bearing+lunge+measure+of+ankle+dorsiflexion.">Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion.</a> Aust J Physiother. 44, 175-180 (1998).</li><li>Munteanu, S. E., Strawhorn, A. B., Landorf, K. B., Bird, A. R., Murley, G. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+weightbearing+technique+for+the+measurement+of+ankle+joint+dorsiflexion+with+the+knee+extended+is+reliable.">A weightbearing technique for the measurement of ankle joint dorsiflexion with the knee extended is reliable.</a> J Sci Med Sport. 12, 54-59 (2009).</li><li>Wilken, J., Rao, S., Estin, M., Saltzman, C. L., Yack, H. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+device+for+assessing+ankle+dorsiflexion+motion:+reliability+and+validity.">A new device for assessing ankle dorsiflexion motion: reliability and validity.</a> J Orthop Sports Phys Ther. 41, 274-280 (2011).</li><li>Gatt, A., Chockalingam, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validity+and+reliability+of+a+new+ankle+dorsiflexion+measurement+device.">Validity and reliability of a new ankle dorsiflexion measurement device.</a> Prosthet Orthot Int. 37, 289-297 (2013).</li><li>Baggett, B. D., Young, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ankle+joint+dorsiflexion.+Establishment+of+a+normal+range.">Ankle joint dorsiflexion. Establishment of a normal range.</a> J Am Podiatr Med Assoc. 83, 251-254 (1993).</li><li>Menz, H. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+clinical+tests+of+foot+and+ankle+characteristics+in+older+people.">Reliability of clinical tests of foot and ankle characteristics in older people.</a> J Am Podiatr Med Assoc. 93, 380-387 (2003).</li><li>Rabin, A., Kozol, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Weightbearing+and+Nonweightbearing+Ankle+Dorsiflexion+Range+of+Motion:+Are+We+Measuring+the+Same+Thing?.">Weightbearing and Nonweightbearing Ankle Dorsiflexion Range of Motion: Are We Measuring the Same Thing?.</a> J Am Podiatr Med Assoc. 12, 406-411 (2012).</li><li>You, J. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gastrocnemius+tightness+on+joint+angle+and+work+of+lower+extremity+during+gait.">Gastrocnemius tightness on joint angle and work of lower extremity during gait.</a> Clin Biomech (Bristol, Avon). 24, 744-750 (2009).</li><li>Baumbach, S. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+knee+position+on+ankle+dorsiflexion+-+a+biometric+study.">The influence of knee position on ankle dorsiflexion - a biometric study.</a> BMC Musculoskelet Disord. 15, 246 (2014).</li><li>Martin, R. L., McPoil, T. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+ankle+goniometric+measurements:+a+literature+review.">Reliability of ankle goniometric measurements: a literature review.</a> J Am Podiatr Med Assoc. 95, 564-572 (2005).</li><li>Tiberio, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+functional+ankle+dorsiflexion+using+subtalar+neutral+position.+A+clinical+report.">Evaluation of functional ankle dorsiflexion using subtalar neutral position. A clinical report.</a> Phys Ther. 67, 955-957 (1987).</li><li>Tiberio, D., Bohannon, R. W., Zito, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+subtalar+joint+position+on+the+measurement+of+maximum+ankle+dorsiflexic.">Effect of subtalar joint position on the measurement of maximum ankle dorsiflexic.</a> Clin Biomech (Bristol, Avon). 4, 189-191 (1989).</li><li>Bohannon, R. W., Tiberio, D., Waters, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Motion+measured+from+forefoot+and+hindfoot+landmarks+during+passive+ankle+dorsiflexion+range+of+motion.">Motion measured from forefoot and hindfoot landmarks during passive ankle dorsiflexion range of motion.</a> J Orthop Sports Phys Ther. 13, 20-22 (1991).</li><li>Johanson, M., Baer, J., Hovermale, H., Phouthavong, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subtalar+joint+position+during+gastrocnemius+stretching+and+ankle+dorsiflexion+range+of+motion.">Subtalar joint position during gastrocnemius stretching and ankle dorsiflexion range of motion.</a> J Athl Train. 43, 172-178 (2008).</li><li>Kim, P. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interrater+and+intrarater+reliability+in+the+measurement+of+ankle+joint+dorsiflexion+is+independent+of+examiner+experience+and+technique+used.">Interrater and intrarater reliability in the measurement of ankle joint dorsiflexion is independent of examiner experience and technique used.</a> J Am Podiatr Med Assoc. 101, 407-414 (2011).</li><li>Youdas, J. W., Krause, D. A., Egan, K. S., Therneau, T. M., Laskowski, E. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+static+stretching+of+the+calf+muscle-tendon+unit+on+active+ankle+dorsiflexion+range+of+motion.">The effect of static stretching of the calf muscle-tendon unit on active ankle dorsiflexion range of motion.</a> J Orthop Sports Phys Ther. 33, 408-417 (2003).</li><li>Worrell, T. W., McCullough, M., Pfeiffer, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+foot+position+on+gastrocnemius/soleus+stretching+in+subjects+with+normal+flexibility.">Effect of foot position on gastrocnemius/soleus stretching in subjects with normal flexibility.</a> TJ Orthop Sports Phys Ther. 19, 352-356 (1994).</li><li>Norkin, C. C., White, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Measurement of Joint Motion: A Guide to Goniometry. , (2003).</li><li>Williams, C. M., Caserta, A. J., Haines, T. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+TiltMeter+app+is+a+novel+and+accurate+measurement+tool+for+the+weight+bearing+lunge+test.">The TiltMeter app is a novel and accurate measurement tool for the weight bearing lunge test.</a> J Sci Med Sport. 16, 392-395 (2013).</li><li>Burns, J., Crosbie, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Weight+bearing+ankle+dorsiflexion+range+of+motion+in+idiopathic+pes+cavus+compared+to+normal+and+pes+planus+feet.">Weight bearing ankle dorsiflexion range of motion in idiopathic pes cavus compared to normal and pes planus feet.</a> Foot (Edinb). 15, 91-94 (2005).</li><li>Konor, M. M., Morton, S., Eckerson, J. M., Grindstaff, T. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+three+measures+of+ankle+dorsiflexion+range+of+motion.">Reliability of three measures of ankle dorsiflexion range of motion.</a> Int J Sports Phys Ther. 7, 279-287 (2012).</li><li>Basnett, C. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ankle+dorsiflexion+range+of+motion+influences+dynamic+balance+in+individuals+with+chronic+ankle+instability.">Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability.</a> Int J Sports Phys Ther. 8, 121-128 (2013).</li><li>Kang, M. H., Lee, D. K., Park, K. H., Oh, J. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Association+of+ankle+kinematics+and+performance+on+the+y-balance+test+with+inclinometer+measurements+on+the+weight-bearing-lunge+test.">Association of ankle kinematics and performance on the y-balance test with inclinometer measurements on the weight-bearing-lunge test.</a> J Sport Rehabil. 24, 62-67 (2015).</li><li>Purcell, S. B., Schuckman, B. E., Docherty, C. L., Schrader, J., Poppy, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differences+in+ankle+range+of+motion+before+and+after+exercise+in+2+tape+conditions.">Differences in ankle range of motion before and after exercise in 2 tape conditions.</a> Am J Sports Med. 37, 383-389 (2009).</li><li>Simondson, D., Brock, K., Cotton, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+and+smallest+real+difference+of+the+ankle+lunge+test+post+ankle+fracture.">Reliability and smallest real difference of the ankle lunge test post ankle fracture.</a> Man Ther. 17, 34-38 (2012).</li><li>Hoch, M. C., Staton, G. S., Medina McKeon, J. M., Mattacola, C. G., Mckeon, P. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dorsiflexion+and+dynamic+postural+control+deficits+are+present+in+those+with+chronic+ankle+instability.">Dorsiflexion and dynamic postural control deficits are present in those with chronic ankle instability.</a> J Sci Med Sport. 15, 574-579 (2012).</li><li>Hoch, M. C., Staton, G. S., Mckeon, P. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dorsiflexion+range+of+motion+significantly+influences+dynamic+balance.">Dorsiflexion range of motion significantly influences dynamic balance.</a> J Sci Med Sport. 14, 90-92 (2011).</li><li>Charles, J., Scutter, S. D., Buckley, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Static+ankle+joint+equinus:+toward+a+standard+definition+and+diagnosis.">Static ankle joint equinus: toward a standard definition and diagnosis.</a> J Am Podiatr Med Assoc. 100, 195-203 (2010).</li></ol>

The authors have nothing to disclose. 
A biometric version of this study has been published 17. The herein presented paper focuses on the actual conduct of the clinical examinations for isolated MGT. The findings of the biometric paper 17 on the influence of the degree of knee flexion are implanted in this paper.

20健康人检查发现，这20度屈膝已经消除了M的影响腓肠肌上ADF。另外膝关节屈曲造成了不显著ADF增加。对于MGT标准化非负重和负重检查的此呈现视频说明构建未来研究建立生理正常值的前提。 这项研究有局限性。第一，没有定制测量装置被用来评估ADF，这可能有助于测量误差。这是为研究者依靠在非负重检测，使用测角仪和相邻关节运动的施加力。此外，本文所使用的测角仪有2°的增量，这也可能导致测量结果不准确。不过，本文所使用的测量设备是提供给每个医生18。接下来，相邻的关节运动， 即在距下关节midtarsa​​l，改变特别是负重ADF测量。为了减少这种影响，我们在测试过程中密切监控脚距下中立位置，如在文献19-22建议。整体，作者旨在呈现标准化检查例程，这是适用于日常和不依赖于特殊的设备。本文中所观察到的高值ICC主张所提出的审查程序的有效性。最后，屈膝（20°）的最小程度被使用的orthesis预定义。因此，我们无法调查甚至更少膝关节屈曲是否已经消除了M的ADF制约作用腓肠肌 。尽管如此，确定最小膝关节屈曲20°是负重测试实用。 的本文中所呈现的技术的各种修改已经出版。首先，不同的解剖学界标已采用。对于非承重测试，已经使用腓骨（y轴）和任一脚13,23,24或第五跖骨8,25,26的轴线的足底表面的轴。对于负重测量，地板（x轴）和腓骨10,14的轴线，跟腱27,28，或胫骨29-31进行了评估。第二，用于测量ADF上的设备而异。在以往的研究应用测量设备包括数字测斜27,31，移动应用27，亚克力板10，定制设备11,12,32，皮尺33,34，和一个标准的测角仪5,15,29。第三，负重检查最初被描述为"膝到墙"冲刺测试测量到壁33-35越大脚趾的距离。总体来说，已发表的变化是相当大的，以不同的方式被合并。这不仅阻碍在学习间的比较，但采用的技术往往不是每天用实际。我们旨在确定可进行非负重和负重很少有精力和资源的标准化和可重复的过程。因此腓骨的轴线并且其中作为测定的地标所选择的脚/地板的足底方面。采用标准的测角仪作为作者认为这提供给每一位医生的工具。最后负重试验用后支腿被称为"膝到墙"的原则测量所述一个不能与膝盖延伸进行进行。 在进行上述检查中，作者经历了几个陷阱。首先，负重测试过程中腓骨的识别是困难的，由于腓骨肌腱突出。为了产生可重复的结果，我们建议标记测试前腓骨的轴。第二，对于负重测试用膝盖伸展，必须小心膝盖完全伸展。我们发现最小的膝关节屈曲，以对ADF产生深远的影响。第三，研究者必须确保距下中间位置相邻关节运动改变了测量。最后，如​​上所述，作者建议非负重检查由两名调查进行。一名调查员对前掌的跖方面施加力，并确保后脚的中性旋前，旋后位。其他研究者进行的实际测量。 我们目前面临的主要缺点是缺少生理和病理值4,36。首先，对于具有非负重和负重检测完全扩展所得到的膝的ADF值显著变化。在文献负重测试已被证明是更可再现9,10,13-15。此外，它更紧密地resembLES的生理负荷条件下，部分消除了力评判间的差异应用获得最大的ADF。此外，非负重测试需要两个考官，而只有一个考官可以进行负重测试。在总结负重测试似乎更胜一筹。到现在为止还不清楚需要什么膝关节屈曲度，以消除M的ADF制约作用腓肠肌在负重测试。本研究首次能够证明膝关节屈曲20°就足够了。因此，标准化的负重考试MGT的此呈现视频说明确保有效的测试，并且在未来的研究中进行。 未来的研究应该应用此处所呈现负重检查，以便确定ADF的范数值与膝盖延伸并弯曲。在与我们的结果行以往的研究表明在ADF高的品种。如果这种变化确实不允许规范的定义值一个有前途的方法是比较两个脚踝的ADF。

有限公司踝关节背屈（ADF）改变步态运动学，并负责常见的足部病变，包括跟腱炎，应力性骨折，跖骨和足底足跟痛1-5。有限ADF的最常见的原因是孤立的家鼠腓肠肌密封性（MGT）3,6。 脚踝的关节运动由屈膝作为分枝的影响腓肠肌桥梁双侧颞下颌关节。肌肉是在张力下时膝盖完全伸展，作为肌肉的起源然后最远近端。这M.腓肠肌然后抑制ADF。屈膝近似于肌肉的原点，从而降低了分枝腓肠肌的张力，并因此增加了ADF中。踝关节背屈然后通过踝关节的其他解剖结构的限制， 图1示出了这一原理。在MGT的情况下，ADF是有限的膝盖完全离倾向于而是由膝关节4的屈曲大大增加。 对于MGT临床检查取上述原则的优势，首先是由Silfverskiöld，瑞典骨科医生7于1923年发表。从那时起，许多检查技术已被描述的，所有这些比较在ADF用膝盖延伸并弯曲。发表的临床试验可分为非负重5,8，负重9,10和仪表11,12。如今，非负重检查是最常见的进行13。病人被置于仰卧在检查床上和ADF进行评估与膝盖完全伸展并一般为90°弯曲（ 图2A）。与此相反，负重ADF测量与弓步姿态直立受试者进行。后排膝盖伸展或弯曲，询问受试者只是脚跟发射前向前倾（ 图2B）。对于这两种测试MGT诊断，如果用膝盖延长了ADF自动进稿器中的一个显著上升受损和膝关节屈曲结果。 虽然非负重测试频繁地进行，负重测试有几个优点。首先，需要一种用于负重检查只有一个调查，而两位考官需要实现可靠的非负重测量。二，负重检查更加紧密地反映步态期间的负荷。第三，施加到踝的力独立于检查者。四，负重检查具有更高的内部和跨信度9,10,13-15。 为MGT所有测试的主要限制是，膝屈曲的最小程度需要消除分枝的抑制作用在ADF 腓肠肌不明8,15。而90°膝关节屈曲通常应用在非负重检测5,8,16撒谎，这是不适合的负重检查可行的。广大人民不能没有抬起脚跟离地执行与膝关节屈曲90°弓步。因此，大多数的研究进行负重考试没有控制膝关节屈曲8,15。为了进行可靠的负重检查它必须查明最小程度所需的膝盖屈曲消除M的抑制作用腓肠肌上ADF。 总体而言，文学主张负重测试MGT的诊断。为了提供有效的负重检查过程，膝屈曲，以消除M的ADF抑制效果所需的最低限度腓肠肌必须已知。本研究的目的是调查屈膝ADF的非负重的影响和负重检测，并提供一个步骤bŸ一步的指导，进行​​非负重和负重考试MGT。

<table><tbody><tr><td>Examination couch</td><td></td><td></td><td></td></tr><tr><td>Standard goniometer&amp;nbsp;</td><td>MDF Instruments USA, Inc. Malibu, CA, USA</td><td></td><td>2&amp;deg; increments</td></tr></tbody></table>

diagnosis of musculus gastrocnemius tightness - key factors for the clinical examination

常见的脚和踝关节病症已与孤立家鼠腓肠肌密封性（MGT）。各种检查技术已经描述评估MGT。尽管如此，标准化的审批程序缺失。文学主张负重检查，但需要膝关节屈曲度，以消除M的制约作用对踝关节背屈（ADF） 腓肠肌是未知的。该原稿调查屈膝上踝关节背屈的影响，并提供了标准化检查协议的详细描述。关于20名健康个体检查发现，即20°屈膝足以充分消除M的影响腓肠肌上ADF。这建立了一个标准化考试MGT的前提。 ADF的非负重和负重检查具有进行与膝盖完全伸展和至少20°弯曲。两名调查员应在仰卧位进行主题非负重测试。为了获得可靠的结果，腓骨的轴线应标明。一个考官可以在弓步立场主题进行负重检查。如果ADF与膝盖在显著上升ADF完全伸展和屈膝结果受损的隔离MGT存在。本文中所提出的统一考试是为今后的研究旨在建立正常值的前提。

20名健康个体的两个脚踝（平均27.1±3.9岁），50％为女性，进行了检查。在六个不同程度的膝盖屈曲非负重和负重试验（完全伸展，20°，30°，45°，60°，75°）和伦哥测试（不受控制的膝关节屈曲）进行的。一个功能括号是用来控制膝关节屈曲。测量被蒙蔽对方的结果两名调查员进行。每个个体之间，调查的顺序和膝关节屈曲的顺序改变。该达戈斯蒂诺和Pearson检验显示没有正态分布。多个测试由一个Bonferroni校正（P &lt;0.004）占。标准描述性统计，一个曼 - 惠特尼U型试验的两侧，性别和测量技术（非负重与负重），以及用于度的ADF之间的差异的重复测量ANOVA之间差异校准culated。一个组内相关系数（ICC; 1,1）来评估评判间的可靠性。 呈现的数据都是审查员的平均值。 0.961之间的评判间可靠性范围为0.992。没有性别或侧面差异被发现了。 图3显示了双方的合并数据为ADF膝关节屈曲的每个步骤。所有负重测量导致显著更高的ADF值相比，非负重测量（曼 - 惠特尼-U检验，p &lt;0.001）。 在膝关节屈曲的各个步骤之间图4显示汇集ADF差异（增量）提出的盒状图。显著差异只有完全伸膝和膝关节屈曲（P &lt;0.001）的20℃之间变化。另外膝关节屈曲并没有因此而增加ADF的。被发现的ADF没有显著差异之间的隆Ë试验和任何负重检查膝关节弯曲（20°〜75°）。 <img alt="图1" src="/files/ftp_upload/53446/53446fig1.jpg" /> 图1. 测试的功能性解剖的示意图隔离M.腓肠肌密封性。 （A）随着膝盖的绷紧M的全面推广腓肠肌抑制ADF;（B）屈膝降低M.的张力因此腓肠肌和增加ADF;图从17调整。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/53446/53446fig1large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图2" src="/files/ftp_upload/53446/53446fig2.jpg" /> 图2. 测试过程的示意图。 <strong&gt;的（A）非负重检查:研究者施力于脚采用完全伸展（A1）膝关节和90°弯曲（A2）足底方面。第二次调查的措施ADF（B）负重检查:主题进入与中心一行后脚弓步姿势。 ADF与膝盖完全伸展（B1）和至少20℃测得的挠曲（B2）。对于这两种测量照顾所测量的脚是中性旋前，旋后位。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/53446/53446fig2large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图3" src="/files/ftp_upload/53446/53446fig3.jpg" /> 图3.箱图（95％CI）汇集踝关节背屈对膝关节屈曲每度。 （A）非承重测试:平均ADF用于膝关节屈曲的每一步;（B）负重测试:平均ADF用于膝关节屈曲的每个步骤。图从17调整。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/53446/53446fig3large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图4" src="/files/ftp_upload/53446/53446fig4.jpg" /> 图4.箱图踝关节背屈的膝关节屈曲（汇集值）的每个步骤之间的分歧。 （一）非承重测量:屈膝的每个步骤之间ADF的差异;（B）负重测量:屈膝的每个步骤之间ADF差异; ***:P &lt;0.001;图改编自17。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/53446/53446fig4large.jpg" target="_blank">请点击此处查看LARG</a>呃版本这个数字。

Watch this Scientific Journal Video about Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination at JoVE.com

Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination

隔离家鼠腓肠肌密封性是足踝部病变的常见原因。目前国内还没有规范的检测程序存在。这份手稿表明，20度屈膝消除了M的制约作用对踝关节背屈和腓肠肌提出了统一考试协议的视频描述。

诊断<em&gt;家鼠腓肠肌</em&gt;密封性 - 关键因素临床考试

Common foot and ankle pathologies have been linked to isolated Musculus gastrocnemius tightness (MGT). Various examination techniques have been described ...

diagnosis-musculus-gastrocnemius-tightness-key-factors-for-clinical

Nanyang Technological University

Research

JoVE Journal

Medicine

Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination

14.1K 次观看.  Munich University Hospital. 隔离家鼠腓肠肌密封性是足踝部病变的常见原因。目前国内还没有规范的检测程序存在。这份手稿表明，20度屈膝消除了M的制约作用对踝关节背屈和腓肠肌提出了统一考试协议的视频描述。 

视频: Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination

In Vivo Canine Muscle Function Assay

We describe a minimally-invasive and reproducible method to measure canine pelvic limb muscle strength and muscle response to repeated eccentric 
contractions. The pelvic limb of an anesthetized dog is immobilized in a stereotactic frame to align the tibia at a right angle to the femur. Adhesive wrap affixes the 
paw to a pedal mounted on the shaft of a servomotor to measure torque. Percutaneous nerve stimulation activates pelvic limb muscles of the paw to either push (extend) or 
pull (flex) against the pedal to generate isometric torque. Percutaneous tibial nerve stimulation activates tibiotarsal extensor muscles. Repeated eccentric (lengthening) 
contractions are induced in the tibiotarsal flexor muscles by percutaneous peroneal nerve stimulation. The eccentric protocol consists of an initial isometric contraction 
followed by a forced stretch imposed by the servomotor. The rotation effectively lengthens the muscle while it contracts, e.g., an eccentric contraction. During 
stimulation flexor muscles are subjected to an 800 msec isometric and 200 msec eccentric contraction. This procedure is repeated every 5 sec. To avoid fatigue, 4 min rest 
follows every 10 contractions with a total of 30 contractions performed.

In Vivo Canine Muscle Function Assay

We describe a minimally-invasive and painless method to measure canine hindlimb muscle strength and muscle response to repeated eccentric contractions.

在犬体内的肌肉功能测定

We describe a minimally-invasive and reproducible method to measure canine pelvic limb muscle strength and muscle response to repeated eccentric 
...

科研

医学

Manual Muscle Testing:  A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients 

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge.1-6 Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. 7, 8 
This video demonstrates a protocol for MMT, which has been taught to &ge;43 research staff who have performed &gt;800 assessments on &gt;280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale.7,9-11 Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. 1,2.

Manual Muscle Testing:  A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Survivors of acute respiratory distress syndrome (ARDS) and critical illness frequently develop long-lasting muscle weakness. Manual muscle testing (MMT) is a standardized clinical examination commonly used to measure strength of peripheral skeletal muscle groups. This video demonstrates MMT using the 6-point Medical Research Council scale.

危重病人中的应用手册肌力测试：下肢肌力测量方法

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, ...

Tibial Nerve Transection - A Standardized Model for Denervation-induced Skeletal Muscle Atrophy in Mice

The tibial nerve transection model is a well-tolerated, validated, and reproducible model of denervation-induced skeletal muscle atrophy in rodents. Although originally developed and used extensively in the rat due to its larger size, the tibial nerve in mice is big enough that it can be easily manipulated with either crush or transection, leaving the peroneal and sural nerve branches of the sciatic nerve intact and thereby preserving their target muscles. Thus, this model offers the advantages of inducing less morbidity and impediment of ambulation than the sciatic nerve transection model and also allows investigators to study the physiologic, cellular and molecular biologic mechanisms regulating the process of muscle atrophy in genetically engineered mice. The tibial nerve supplies the gastrocnemius, soleus and plantaris muscles, so its transection permits the study of denervated skeletal muscle composed of fast twitch type II fibers and/or slow twitch type I fibers. Here we demonstrate the tibial nerve transection model in the C57Black6 mouse. We assess the atrophy of the gastrocnemius muscle, as a representative muscle, at 1, 2, and 4 weeks post-denervation by measuring muscle weights and fiber type specific cross-sectional area on paraffin-embedded histologic sections immunostained for fast twitch myosin.

The tibial nerve transection model is a well-tolerated, validated, and reproducible model of skeletal muscle atrophy. The model surgical protocol is described and demonstrated in C57Black6 mice. &#160;

胫骨神经切断术 - 一个标准化的模型失神经诱导小鼠骨骼肌

The tibial nerve transection model is a well-tolerated, validated, and reproducible model of denervation-induced skeletal muscle atrophy in rodents. ...

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels). The present protocol describes how this method can be used to stimulate the posterior tibial nerve that activates plantar flexor muscles. Percutaneous electrical nerve stimulation consists of inducing an electrical stimulus to a motor nerve to evoke a muscular response. Direct (M-wave) and/or indirect (H-reflex) electrophysiological responses can be recorded at rest using surface electromyography. Mechanical (twitch torque) responses can be quantified with a force/torque ergometer. M-wave and twitch torque reflect neuromuscular transmission and excitation-contraction coupling, whereas H-reflex provides an index of spinal excitability. EMG activity and mechanical (superimposed twitch) responses can also be recorded during maximal voluntary contractions to evaluate voluntary activation level. Percutaneous nerve stimulation provides an assessment of neuromuscular function in humans, and is highly beneficial especially for studies evaluating neuromuscular plasticity following acute (fatigue) or chronic (training/detraining) exercise.

We present a protocol to assess changes in neuromuscular function. Percutaneous electrical nerve stimulation is a non-invasive method that evokes muscular responses. Electrophysiological and mechanical properties of these responses permit the evaluation of neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels).

神经肌肉功能的应用经皮神经电刺激评估

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, ...

神经科学

Procedures for Rat in situ Skeletal Muscle Contractile Properties

There are many circumstances where it is desirable to obtain the contractile response of skeletal muscle under physiological circumstances: normal circulation, intact whole muscle, at body temperature. This includes the study of contractile responses like posttetanic potentiation, staircase and fatigue. Furthermore, the consequences of disease, disuse, injury, training and drug treatment can be of interest. This video demonstrates appropriate procedures to set up and use this valuable muscle preparation.
To set up this preparation, the animal must be anesthetized, and the medial gastrocnemius muscle is surgically isolated, with the origin intact. Care must be taken to maintain the blood and nerve supplies. A long section of the sciatic nerve is cleared of connective tissue, and severed proximally. All branches of the distal stump that do not innervate the medial gastrocnemius muscle are severed. The distal nerve stump is inserted into a cuff lined with stainless steel stimulating wires. The calcaneus is severed, leaving a small piece of bone still attached to the Achilles tendon. Sonometric crystals and/or electrodes for electromyography can be inserted. Immobilization by metal probes in the femur and tibia prevents movement of the muscle origin. The Achilles tendon is attached to the force transducer and the loosened skin is pulled up at the sides to form a container that is filled with warmed paraffin oil. The oil distributes heat evenly and minimizes evaporative heat loss. A heat lamp is directed on the muscle, and the muscle and rat are allowed to warm up to 37&deg;C. While it is warming, maximal voltage and optimal length can be determined. These are important initial conditions for any experiment on intact whole muscle. The experiment may include determination of standard contractile properties, like the force-frequency relationship, force-length relationship, and force-velocity relationship.
With care in surgical isolation, immobilization of the origin of the muscle and alignment of the muscle-tendon unit with the force transducer, and proper data analysis, high quality measurements can be obtained with this muscle preparation.

Procedures for Rat in situ Skeletal Muscle Contractile Properties

This video demonstrates the surgical preparation and procedures needed to study the contractile responses of the rat medial gastrocnemius muscle preparation in situ. This preparation allows measurement of skeletal muscle contractile properties under physiological conditions. The animal is anesthetized and the muscle is separated from surrounding tissue at its distal end. The Achilles tendon is attached to a force transducer, allowing measurement of the muscle&#x2019;s contractile response at 37 degrees C with an intact circulation.

对大鼠的过程<em在原位</em骨骼肌收缩性能

There are many circumstances where it is desirable to obtain the contractile response of skeletal muscle under physiological circumstances: normal ...

生物学

Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations

Many hamstring injuries that occur during physical activity occur while the muscles are lengthening, during eccentric hamstring muscle actions. Opposite of these eccentric hamstring actions are concentric quadriceps actions, where the larger and likely stronger quadriceps straighten the knee. Therefore, to stabilize the lower limbs during movement, the hamstrings must eccentrically combat against the strong knee-straightening torque of the quadriceps. As such, eccentric hamstring strength expressed relative to concentric quadricep strength is commonly referred to as the &#34;functional ratio&#34; as most movements in sports require simultaneous concentric knee extension and eccentric knee flexion. To increase the strength, resiliency, and functional performance of the hamstrings, it is necessary to test and train the hamstrings at different eccentric speeds. The main purpose of this work is to provide instructions for measuring and interpreting eccentric hamstring strength. Techniques for measuring the functional ratio using isokinetic dynamometry are provided and sample data will be compared. Additionally, we briefly describe how to address hamstring strength deficiencies or unilateral strength differences using exercises that specifically focus on increasing eccentric hamstring strength.

The hamstrings are a group of muscles that are sometimes problematic for athletes, resulting in soft tissue injury in the lower limbs. To prevent such injuries, functional training of the hamstrings requires intensive eccentric contractions. Additionally, hamstring function should be tested in relation to quadricep function at different contraction speeds.

肌肉失衡: 运动人群功能性偏心肌筋强度的检测与训练

Many hamstring injuries that occur during physical activity occur while the muscles are lengthening, during eccentric hamstring muscle actions. Opposite ...

跟腱形态的超声评估

Measurement of Healthy and Injured Triceps Surae Morphology

Achilles tendon injuries occur throughout the lifespan and can negatively affect quality of life and overall health. Achilles tendinopathy is generally classified as an overuse injury associated with fusiform tendon thickening, neovascularization, and interstitial tendon degeneration. Current literature suggests these structural changes are associated with&#160;symptoms and lower physical activity levels, as well as&#160;symptoms and lower extremity function in the long term. Surgically and non-surgically managed Achilles tendon ruptures result in increased tendon cross-sectional area (CSA) and a lengthened Achilles tendon. Both structural outcomes have clinical implications, as larger CSA positively predicts function, whereas increased tendon lengthening predicts reduced function after Achilles tendon rupture. Given the relationship between structural changes associated with Achilles tendon injuries for both injury severity and injury recovery, it is critical to be able to quantify Achilles tendon structure reliably and accurately. Silbernagel&#39;s group has established a valid and reliable method for efficiently evaluating triceps surae muscle and tendon structure. In this protocol, B-mode musculoskeletal ultrasound imaging is used to measure triceps surae structure, including Achilles tendon thickness and CSA, soleus thickness, and the presence of additional findings (calcifications and bursitis). B-mode extended field-of-view is used to measure Achilles tendon length and gastrocnemius anatomical CSA. Finally, power Doppler is used to identify intratendinous neovascularization. Quantification of triceps surae structure allows for comparison between limbs as well as longitudinal changes in response to exercise and treatment for healthy individuals and those with Achilles tendon injuries. This protocol has been used in many research studies to date and proves valuable in understanding the relationship between tendon structure and injury development, severity, and recovery. As ultrasound devices are becoming more affordable and portable, this protocol proves promising as a clinical tool, given its quick and efficient methods.

作者聚焦:探索跟腱损伤的复杂性 — 研究和未来方向

Ultrasound imaging is becoming more accessible in clinical and research settings, and a consistent protocol will be beneficial for comparison between studies and for clinical interpretations. This protocol for ultrasound evaluation is a valid and reliable method to evaluate Achilles tendon morphology in healthy, tendinopathic, and ruptured tendons.

健康和受伤的肱三头肌形态的测量

Achilles tendon injuries occur throughout the lifespan and can negatively affect quality of life and overall health. Achilles tendinopathy is generally ...

Motor Exam I

Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women&#39;s/Massachusetts General Hospital, Boston, Massachusetts, USA
Abnormalities in the motor function are associated with a wide range of diseases, from movement disorders and myopathies to strokes. The motor assessment starts with observation of the patient. When the patient enters the examination area, the clinician observes the patient&#39;s ability to walk unassisted and the speed and coordination while moving. Taking the patient&#39;s history provides an additional opportunity to observe for evidence of tremors or other abnormal movements, such as chorea or tardive dyskinesia. Such simple but important observations can yield valuable clues to the diagnosis and help to focus the rest of the examination. The motor assessment continues in a systematic fashion, including inspection for muscle atrophy and abnormal movements, assessment of muscle tone, muscle strength testing, and finally the examination of the muscle reflexes and coordination. The careful systematic testing of the motor system and the integration of all the findings provide insight to the level at which the motor pathway is affected, and also help the clinician to formulate the differential diagnosis and determine the course of the subsequent evaluation and treatment.

诊断

摘要

探索更多视频

此视频中的章节

在犬体内的肌肉功能测定

危重病人中的应用手册肌力测试：下肢肌力测量方法

胫骨神经切断术 - 一个标准化的模型失神经诱导小鼠骨骼肌

神经肌肉功能的应用经皮神经电刺激评估

对大鼠的过程

肌肉失衡: 运动人群功能性偏心肌筋强度的检测与训练

健康和受伤的肱三头肌形态的测量

健康和受伤的肱三头肌形态的测量

健康和受伤的肱三头肌形态的测量

摩托车考试我