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quadriceps muscle weakness

Andrew Kien Han Wee
BACKGROUND: Old age and diabetes mellitus are risk factors for vitamin deficiencies, weakness and falls. Deficiencies of vitamin D, and possibly vitamin B12 and folate (which are associated with hyperhomocysteinaemia), contribute to sarcopenia. Determination of the physical effects of vitamin deficiencies in specific groups of people can help to guide public health policy with regard to vitamin supplementation. METHODS: A pilot cross-sectional study was conducted to determine the association of levels of vitamin D, vitamin B12, folate and homocysteine with muscle strength, gait and fall history in 56 patients >65 years old with diabetes mellitus in primary care in Singapore...
October 18, 2016: Nutrition Journal
Sandeep Kumar, Gerald Pflueger
Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip...
2016: Case Reports in Orthopedics
Sarah Jones, William D-C Man, Wei Gao, Irene J Higginson, Andrew Wilcock, Matthew Maddocks
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews Issue 1, 2013 on Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease.Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole-body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength...
October 17, 2016: Cochrane Database of Systematic Reviews
Mathilde M Bruins Slot-Steenks, Neveen A T Hamdy, Michiel A J van de Sande, Dennis Vriens, Arjen H G Cleven, Natasha M Appelman-Dijkstra
Tumor-induced osteomalacia is a rare acquired metabolic bone disorder characterized by isolated renal phosphate wasting due to abnormal tumor production of fibroblast growth factor 23. We report the case of a 59 year old woman referred to our department with a long history of progressive diffuse muscle weakness and pain, generalized bone pains and multiple insufficiency fractures of heels, ankles and hips due to a hypophosphatemic osteomalacia. A fibroblast growth factor 23-producing phosphaturic mesenchymal tumor localized in the left quadriceps femoris muscle was identified 7 years after onset of symptoms...
October 5, 2016: Endocrine
Monica Lavian, Namita Goyal, Tahseen Mozaffar
We present a case of a 65-year-old woman who was previously diagnosed with idiopathic granulomatous myositis and treated with immunosuppressive therapy for the next 10 years before a clinical diagnosis of inclusion body myositis was made. A review of the previously performed muscle biopsy showed most of the cardinal myopathologic features of sporadic inclusion body myositis, in addition to the granuloma. Her clinical course was strongly suggestive of inclusion body myositis with selective asymmetric weakness of forearm flexor muscles and quadriceps...
September 13, 2016: Neuromuscular Disorders: NMD
Maryne Cozette, Stéphane Delanaud, Pierre-Marie Lepretre, Thierry Weissland
OBJECTIVE: Shoulder internal (IR) and external rotator (ER) muscles play an important role in the stability of glenohumeral joint. The ratio between the peak torque of ER and IR in concentric (ER/IRPT) and mixed (ER-ECC/IR-CONPT) are usually measured to evaluate the effects of muscle weakness, sport activities, injury and treatment (Greenfield et al., 1990; Scoville et al., 1997). However, ER/IRPT and ER-ECC/IR-CONPT failed to provide some indication on the evolution of the ER/IR torque ratio (ER/IRTorque) and mixed torque ratio (ER-EC/IR-COTorque) during the range of motion (ROM)...
September 2016: Annals of Physical and Rehabilitation Medicine
Karima Belhaj, Hicham Elhyaoui, Soumia Meftah, Laila Mahir, Mohamed Rafai, Abdelhak Garch, Fatima Lmidmani, Abdellatif Elfatimi
OBJECTIVE: Meniscal injuries are an extremely common condition that also occurs well in young adults at a sporting injury, than in most elderly where it is often the degenerative changes in the knee illustration. The application of isokinetic knee is widespread, either in assessment or rehabilitation. The objective of the study is to determine the contribution of the isokinetic for meniscal pathology. MATERIAL/PATIENTS AND METHODS: This is a retrospective study of 6 months, including patients followed in physical medicine and rehabilitation for meniscal lesions confirmed by imaging and in whom supported classical rehabilitative and/or isokinetic was indicated...
September 2016: Annals of Physical and Rehabilitation Medicine
Laila Mahir, Karima Belhaj, Siham Zahi, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE/INTRODUCTION: Isokinetic is a reference method for evaluation of muscle strength. It enables a functional diagnosis specifying levels of disability and performance deficits in the subject knee osteoarthritis. OBJECTIVE: To determine the profile isokinetic knee osteoarthritis in the subject compared to a healthy population. MATERIAL/PATIENTS AND METHODS: Prospective study, descriptive and analytical cohort of 6 months of 30 knee OA patients compared with 15 healthy subjects collected in physical medicine and functional rehabilitation of Ibn Rushd University Hospital, Casablanca, Morocco...
September 2016: Annals of Physical and Rehabilitation Medicine
Laila Mahir, Siham Zahi, Karima Belhaj, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE: The isokinetic allows precise and reproducible measurement of muscle strength in the normal state and in various pathological contexts. Its use in neurological diseases is limited, despite its vast scope. To report the profile isokinetic knee during the decisive cauda equina syndrome as a buoyant building program, through 2 comments. OBSERVATIONS: Observation 1: patient aged 58 years, without particular pathological ATCDS, which has a cauda equina syndrome of herniated disc L4/L5 made...
September 2016: Annals of Physical and Rehabilitation Medicine
Joseph M Neal, Francis V Salinas, Daniel S Choi
OBJECTIVE: Local anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB). CASE REPORT: Three patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles...
September 22, 2016: Regional Anesthesia and Pain Medicine
Alice Todeschini, Francesca Gualandi, Cecilia Trabanelli, Annarita Armaroli, Anna Ravani, Marina Fanin, Silvia Rota, Luca Bello, Alessandra Ferlini, Elena Pegoraro, Alessandro Padovani, Massimiliano Filosto
We describe a 29-year-old patient who complained of left thigh muscle weakness since he was 23 and of moderate proximal weakness of both lower limbs with difficulty in climbing stairs and running since he was 27. Mild weakness of iliopsoas and quadriceps muscles and muscle atrophy of both the distal forearm and thigh were observed upon clinical examination. He harboured a novel c.1150-3C>G substitution in the DMD gene, affecting the intron 10 acceptor splice site and causing exon 11 skipping and an out-of-frame transcript...
October 2016: Neuromuscular Disorders: NMD
N Sakai, M Nakatsuka, T Tomita
BACKGROUND: Continuous femoral nerve block (cFNB) induces quadriceps muscle weakness, but patient-controlled femoral nerve block (PCFNB) can provide analgesia with lower consumption of local anesthetics compared to cFNB. We hypothesized that cFNB followed by PCFNB leads to accelerated recovery of quadriceps weakness after total knee arthroplasty compared to cFNB alone. Secondary outcomes were local anesthetic consumption, pain, and mobilization. METHODS: Fifty-six subjects received post-operative cFNB for 24 h and then randomized to receive either cFNB (basal infusion of 6 ml/h using a dummy bolus button; n = 27) or PCFNB (bolus infusion of 3 ml with a lockout time of 30 min and no basal infusion; n = 29) using 0...
November 2016: Acta Anaesthesiologica Scandinavica
Sabrina Eggmann, Martin L Verra, Gere Luder, Jukka Takala, Stephan M Jakob
BACKGROUND: Prolonged need for intensive care is associated with neuromuscular weakness, termed Intensive Care Unit Acquired Weakness. Those affected suffer from severe functional impairment that can persist for years. First studies suggest a positive effect of physiotherapy and early mobilisation. However, the ideal intervention for a preferential functional outcome is not known. So far no randomised controlled trial has been conducted to specifically evaluate an early endurance and resistance training in the mechanically ventilated, critically ill patient...
2016: Trials
Naoki Akazawa, Naomi Okawa, Kimiyuki Tamura, Hideki Moriyama
AIM: The objectives of the present study were to examine the relationships between intramuscular fat, muscle strength and gait independence, as well as to clarify the intramuscular fat characteristics of dependent older women. METHODS: A total of 25 older women who were unable to walk with or without assistance (dependent group), 22 frail older women (frail group) and 22 healthy older women (healthy group) participated in the present study. The frail participants could walk independently, but showed three or more of the following characteristics: slowness, weakness, weight loss, exhaustion and low physical activity...
August 10, 2016: Geriatrics & Gerontology International
Shin Ohta, Ki-Ichi Unoda, Hideto Nakajima, Soichiro Ikeda, Yasuhito Hamaguchi, Fumiharu Kimura
Myositis-specific autoantibodies (MSAs) are associated with myositis. Anti-nuclear matrix protein 2 (NXP-2) antibody was recently identified as a major MSA and was observed mostly in juvenile dermatomyositis. We report the case of a 44-year-old man who presented with myopathy with anti-NXP-2 antibody and large cell carcinoma of the lung. He was hospitalized because of myalgia and edema of limbs. Neurological examination revealed mild proximal-dominant weakness in all four extremities, and laboratory studies showed elevated creatine kinase level (6,432 IU/l)...
August 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
Ans van der Ploeg, Pierre G Carlier, Robert-Yves Carlier, John T Kissel, Benedikt Schoser, Stephan Wenninger, Alan Pestronk, Richard J Barohn, Mazen M Dimachkie, Ozlem Goker-Alpan, Tahseen Mozaffar, Loren D M Pena, Zachary Simmons, Volker Straub, Michela Guglieri, Peter Young, Matthias Boentert, Pierre-Yves Baudin, Stephan Wens, Raheel Shafi, Carl Bjartmar, Beth L Thurberg
BACKGROUND: Late-onset Pompe disease is characterized by progressive skeletal myopathy followed by respiratory muscle weakness, typically leading to loss of ambulation and respiratory failure. In this population, enzyme replacement therapy (ERT) with alglucosidase alfa has been shown to stabilize respiratory function and improve mobility and muscle strength. Muscle pathology and glycogen clearance from skeletal muscle in treatment-naïve adults after ERT have not been extensively examined...
September 2016: Molecular Genetics and Metabolism
A Ferbert, A Zibat, B Rautenstrauß, W Kress, M Hügens-Penzel, J Weis, Y Shah, C Roth
We investigated a four-generation family of German ancestry with distal myopathy. Four individuals in two generations were affected. Foot and toe extensor paresis progressing very slowly over decades was the core neurological sign, reflected by fatty infiltration of the lower leg extensor muscles on muscle MRI. Additionally, finger extensor paresis was present in two patients and quadriceps muscle paresis in one. Distal sensory signs had initially given rise to the diagnosis of axonal Charcot-Marie-Tooth (CMT) disease...
September 2016: Neuromuscular Disorders: NMD
Christopher J Walsh, Jane Batt, Margaret S Herridge, Sunita Mathur, Gary D Bader, Pingzhao Hu, Claudia C Dos Santos
ICU acquired weakness (ICUAW) is a common complication of critical illness characterized by structural and functional impairment of skeletal muscle. The resulting physical impairment may persist for years after ICU discharge, with few patients regaining functional independence. Elucidating molecular mechanisms underscoring sustained ICUAW is crucial to understanding outcomes linked to different morbidity trajectories as well as for the development of novel therapies. Quadriceps muscle biopsies and functional measures of muscle strength and mass were obtained at 7 days and 6 months post-ICU discharge from a cohort of ICUAW patients...
2016: Scientific Reports
C Fiorillo, G Astrea, M Savarese, D Cassandrini, G Brisca, F Trucco, M Pedemonte, R Trovato, L Ruggiero, L Vercelli, A D'Amico, G Tasca, M Pane, M Fanin, L Bello, P Broda, O Musumeci, C Rodolico, S Messina, G L Vita, M Sframeli, S Gibertini, L Morandi, M Mora, L Maggi, A Petrucci, R Massa, M Grandis, A Toscano, E Pegoraro, E Mercuri, E Bertini, T Mongini, L Santoro, V Nigro, C Minetti, F M Santorelli, C Bruno
BACKGROUND: Myosin heavy chain 7 (MYH7)-related myopathies are emerging as an important group of muscle diseases of childhood and adulthood, with variable clinical and histopathological expression depending on the type and location of the mutation. Mutations in the head and neck domains are a well-established cause of hypertrophic cardiomyopathy whereas mutation in the distal regions have been associated with a range of skeletal myopathies with or without cardiac involvement, including Laing distal myopathy and Myosin storage myopathy...
2016: Orphanet Journal of Rare Diseases
Giuseppe Mariniello, Francesca Malacario, Flavia Dones, Rocco Severino, Lorenzo Ugga, Camilla Russo, Andrea Elefante, Francesco Maiuri
Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position...
October 2016: Neuroradiology Journal
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