Muscle, tendons, and bone

Structural changes during denervation and fes treatment

Paolo Gargiulo, Páll Jens Reynisson, Benedikt Helgason, Helmut Kern, Winfried Mayr, Páll Ingvarsson, Thordur Helgason, Ugo Carraro

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: This paper describes a novel approach to determine structural changes in bone, muscle, and tendons using medical imaging, finite element models, and processing techniques to evaluate and quantify: (1) progression of atrophy in permanently lower motor neuron (LMN) denervated human muscles, and tendons; (2) their recovery as induced by functional electrical stimulation (FES); and (3) changes in bone mineral density and bone strength as effect of FES treatment. Methods: Briefly, we used three-dimensional reconstruction of muscle belly, tendons, and bone images to study the structural changes occurring in these tissues in paralysed subjects after complete lumbar- ischiadic spinal cord injury (SCI). These subjects were recruited through the European project RISE, an endeavour designed to establish a novel clinical rehabilitation method for patients who have permanent and non-recoverable muscle LMN denervation in the lower extremities. This paper describes the use of segmentation techniques to study muscles, tendons, and bone in several states: healthy, LMN denervated- degenerated but not stimulated, and LMN denervated-stimulated. Here, we have used medical images to develop three-dimensional models and advanced imaging, including computational tools to display tissue density. Different tissues are visualized associating proper Hounsfield intervals defined experimentally to fat, connective tissue, and muscle. Finite element techniques are used to calculate Young's modulus on the patella bone and to analyse correlation between muscle contraction and bone strength changes. Results: These analyses show restoration of muscular structures, tendons, and bone after FES as well as decline of the same tissues when treatment is not performed. This study suggests also a correlation between muscle growth due to FES treatment and increase in density and strength in patella bone. Conclusion: Segmentation techniques and finite element analysis allow the study of the structural changes of human skeletal muscle, tendons, and bone in SCI patient with LMN injury and to monitor effects and changes in tissue composition due to FES treatment. This work demonstrates improved bone strength in the patella through the FES treatment applied on the quadriceps femur.

Original languageEnglish
Pages (from-to)750-758
Number of pages9
JournalNeurological Research
Volume33
Issue number7
DOIs
Publication statusPublished - Sep 2011

Fingerprint

Denervation
Tendons
Bone and Bones
Muscles
Electric Stimulation
Motor Neurons
Patella
Therapeutics
Spinal Cord Injuries
Finite Element Analysis
Elastic Modulus
Diagnostic Imaging
Muscle Contraction
Connective Tissue
Bone Density
Femur
Atrophy
Lower Extremity
Skeletal Muscle
Rehabilitation

Keywords

  • 3D modelling
  • Finite element model
  • Functional electrical stimulation
  • Lower motor neuron lesion
  • Segmentation
  • Tissue composition

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Gargiulo, P., Reynisson, P. J., Helgason, B., Kern, H., Mayr, W., Ingvarsson, P., ... Carraro, U. (2011). Muscle, tendons, and bone: Structural changes during denervation and fes treatment. Neurological Research, 33(7), 750-758. https://doi.org/10.1179/1743132811Y.0000000007

Muscle, tendons, and bone : Structural changes during denervation and fes treatment. / Gargiulo, Paolo; Reynisson, Páll Jens; Helgason, Benedikt; Kern, Helmut; Mayr, Winfried; Ingvarsson, Páll; Helgason, Thordur; Carraro, Ugo.

In: Neurological Research, Vol. 33, No. 7, 09.2011, p. 750-758.

Research output: Contribution to journalArticle

Gargiulo, P, Reynisson, PJ, Helgason, B, Kern, H, Mayr, W, Ingvarsson, P, Helgason, T & Carraro, U 2011, 'Muscle, tendons, and bone: Structural changes during denervation and fes treatment', Neurological Research, vol. 33, no. 7, pp. 750-758. https://doi.org/10.1179/1743132811Y.0000000007
Gargiulo P, Reynisson PJ, Helgason B, Kern H, Mayr W, Ingvarsson P et al. Muscle, tendons, and bone: Structural changes during denervation and fes treatment. Neurological Research. 2011 Sep;33(7):750-758. https://doi.org/10.1179/1743132811Y.0000000007
Gargiulo, Paolo ; Reynisson, Páll Jens ; Helgason, Benedikt ; Kern, Helmut ; Mayr, Winfried ; Ingvarsson, Páll ; Helgason, Thordur ; Carraro, Ugo. / Muscle, tendons, and bone : Structural changes during denervation and fes treatment. In: Neurological Research. 2011 ; Vol. 33, No. 7. pp. 750-758.
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