Longer Ground Contact Time Is Related to a Superior Running Economy in Highly Trained Distance Runners.

ABSTRACT: Tanji, F, Ohnuma, H, Ando, R, Yamanaka, R, Ikeda, T, and Suzuki, Y. Longer ground contact time is related to a superior running economy in highly trained distance runners. J Strength Cond Res 38(5): 985-990, 2024-Running economy is a key component of distance running performance and is associated with gait parameters. However, there is no consensus of the link between the running economy (RE), ground contact time, and footstrike patterns. Thus, this study aimed to clarify the relationship between RE, ground contact time, and thigh muscle cross-sectional area (CSA) in highly trained distance runners and to compare these parameters between 2 habitual footstrike patterns (midfoot vs. rearfoot). Seventeen male distance runners ran on a treadmill to measure RE and gait parameters. We collected the CSAs of the right thigh muscle using a magnetic resonance imaging scanner. The RE had a significant negative relationship with distance running performance ( r = -0.50) and ground contact time ( r = -0.51). The ground contact time had a significant negative relationship with the normalized CSAs of the vastus lateralis muscle ( r = -0.60) and hamstrings ( r = -0.54). No significant differences were found in RE, ground contact time, or normalized CSAs of muscles between midfoot ( n = 10) and rearfoot ( n = 7) strikers. These results suggest that large CSAs of knee extensor muscles results in short ground contact time and worse RE. The effects of the footstrike pattern on the RE appear insignificant, and the preferred footstrike pattern can be recommended for running in highly trained runners.

The femora of Drepanosauromorpha (Reptilia: Diapsida): Implications for the functional evolution of the thigh of Sauropsida.

The femora of diapsids have undergone morphological changes related to shifts in postural and locomotor modes, such as the transition from plesiomorphic amniote and diapsid taxa to the apomorphic conditions related to a more erect posture within Archosauriformes. One remarkable clade of Triassic diapsids is the chameleon-like Drepanosauromorpha. This group is known from numerous articulated but heavily compressed skeletons that have the potential to further inform early reptile femoral evolution. For the first time, we describe the three-dimensional osteology of the femora of Drepanosauromorpha, based on undistorted fossils from the Upper Triassic Chinle Formation and Dockum Group of North America. We identify apomorphies and a combination of character states that link these femora to those in crushed specimens of drepanosauromorphs and compare our sample with a range of amniote taxa. Several characteristics of drepanosauromorph femora, including a hemispherical proximal articular surface, prominent asymmetry in the proximodistal length of the tibial condyles, and a deep intercondylar sulcus, are plesiomorphies shared with early diapsids. The femora contrast with those of most diapsids in lacking a crest-like, distally tapering internal trochanter. They bear a ventrolaterally positioned tuberosity on the femoral shaft, resembling the fourth trochanter in Archosauriformes. The reduction of an internal trochanter parallels independent reductions in therapsids and archosauriforms. The presence of a ventrolaterally positioned trochanter is also similar to that of chameleonid squamates. Collectively, these features demonstrate a unique femoral morphology for drepanosauromorphs, and suggest an increased capacity for femoral adduction and protraction relative to most other Permo-Triassic diapsids.

Reevaluation of the topographical anatomy of the mid-thigh: A magnetic resonance and ultrasound imaging study.

Adductor canal (AC) and sciatic nerve (SN) blockades are commonly used during total knee arthroplasties for postoperative pain control. Medical professionals have begun to utilize single injection combined regional anesthesia methods due to increased patient comfort. In this study, we examined the topographical anatomy of the mid-thigh, which is recommended as the appropriate intervention level for combined AC and SN blockades, in order to provide a safe approach for clinicians. We examined 184 thigh magnetic resonance images (MRI) from 98 patients. We measured the diameter of the mid-thigh, anterior thigh muscle thickness, subcutaneous adipose tissue thickness, and SN depth on the MRIs. We obtained ultrasound (US) images of the vastoadductor membranes (VAM) of 26 volunteers, and measured the vertical distances between the greater trochanter and the adductor tubercle (A) and the greater trochanter and the upper edge of the VAM (B). We then proportioned B to A in order to determine in which part of the thigh the AC was located. The AC was in the distal third of the thigh, and the SN's depth was located in the third quarter of the thigh's diameter. Only the adductor magnus, and no neurovascular structure, was at risk of injury between the AC and the SN. The upper edge of the VAM was 6.5 cm below the mid-thigh, therefore it is not appropriate to suggest performing an AC blockade at mid-thigh. We think that it is safe to perform a combined AC and SN blockade in a single injection in selected patients.

Anatomical variation of the saphenous nerve path: A case report.

INTRODUCTION: The saphenous nerve has great importance on the sensitivity of the lower limb. In its normal course, it enters the adductor canal and travels under the sartorius muscle, on the medial side of the thigh. METHODS: The anatomical variation was found accidentally during routine cadaveric dissection of the thigh at the Human Anatomy Laboratory of the Department of Morphophysiology of the Faculty of Medical Sciences of Minas Gerais (FCMMG). RESULTS: A different pattern of path of the saphenous nerve was found, which appears to perforate the sartorius muscle. DISCUSSION: Complaints of pain in the lower limbs are highly prevalent in the adult population. Saphenous neuropathy is a pathological entity that is associated with such a clinic and may have compression or trauma as its etiology. In the context of compression, it can be caused due to the unusual nerve path, as described in the present study. In trauma, knowledge of this variation is important to prevent iatrogenic damage to nervous tissue during surgical procedures. CONCLUSION: The anatomic variation presented may be related to the symptom of pain in the lower limbs and is also relevant in the surgical context, in order to prevent complications.

Relationship between physical activity time and intramuscular adipose tissue content of the thigh muscle groups of younger and older men.

We investigated the effect of physical activity on muscle tissue size and intramuscular adipose tissue (IntraMAT) content in the thigh muscle groups of younger and older men. Twenty younger and 20 older men participated in this study. The muscle tissue cross-sectional area (CSA) and the IntraMAT content in the quadriceps femoris (QF), hamstrings (HM), hip adductors (AD), and mid-thigh total were measured using magnetic resonance imaging. The physical activity time was measured using a triaxial accelerometer, and four levels of physical activity were determined depending on the metabolic equivalent of task (METs), including sedentary (≤ 1.5 METs), light intensity (≤ 2.9 METs), moderate intensity (3.0-5.9 METs), and vigorous intensity (≥ 6.0 METs). No significant correlation was observed between the physical activity parameters and muscle tissue CSA in both groups. The IntraMAT content of the three muscle groups (QF, AD, and HM) and the total thigh was inversely correlated with the time of moderate-intensity physical activity (rs = - 0.625 to - 0.489, P < 0.05, for all comparisons) in the young group, but not in the older group. These results indicate that IntraMAT accumulation was associated with the amount of moderate-physical activity in younger men.

Estimating thigh skeletal muscle volume using multi-frequency segmental-bioelectrical impedance analysis.

BACKGROUND: The primary aim of this study was to investigate whether using the extracellular water/intracellular water (ECW/ICW) index and phase angle combined with segmental-bioimpedance analysis (BIA) improved the model fitting of skeletal muscle volume (SMV) estimation. The secondary aim was to compare the accuracy of segmental-BIA with that of ultrasound for estimating the quadriceps SMV measured with MRI. METHODS: Seventeen young men (mean age, 23.8 ± 3.3 years) participated in the study. The T-1 weighted images of thigh muscles were obtained using a 1.5 T magnetic resonance imaging (MRI) scanner. Thigh and quadriceps SMVs were calculated as the sum of the products of anatomical cross-sectional area and slice thickness of 6 mm across all slices. Segmental-BIA was applied to the thigh region, and data on the 50-kHz bioelectrical impedance (BI) index, ICW index, ECW/ICW index, and phase angle were obtained. The muscle thickness index was calculated as the product of the mid-thigh muscle thickness, determined using ultrasound, and thigh length. The standard error of estimate (SEE) of the regression equation was calculated to determine the model fitting of SMV estimation and converted to %SEE by dividing the SEE values by the mean SMV. RESULTS: Multiple regression analysis indicated that the combination of 50-kHz BI and the ECW/ICW index or phase angle was a significant predictor when estimating thigh SMV (SEE = 7.9 and 8.1%, respectively), but were lower than the simple linear regression (SEE = 9.4%). The ICW index alone improved the model fitting for the estimation equation (SEE = 7.6%). The model fitting of the quadriceps SMV with the 50-kHz BI or ICW index was similar to that with the skeletal muscle thickness index measured using ultrasound (SEE = 10.8, 9.6 and 9.7%, respectively). CONCLUSIONS: Combining the traditionally used 50-kHz BI index with the ECW/ICW index and phase angle can improve the model fitting of estimated SMV measured with MRI. We also showed that the model suitability of SMV estimation using segmental-BIA was equivalent to that on using ultrasound. These data indicate that segmental-BIA may be a useful and cost-effective alternative to the gold standard MRI for estimating SMV.

Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity.

PURPOSE: This study aimed to detect the idyllic locations for botulinum neurotoxin injection by analyzing the intramuscular neural distributions of the sartorius muscles. METHODS: An altered Sihler's staining was conducted on sartorius muscles (15 specimens). The nerve entry points and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the anterior superior iliac spine (0%) to the medial femoral epicondyle (100%). RESULTS: Intramuscular neural distribution were densely detected at 20-40% and 60-80% for the sartorius muscles. The result suggests that the treatment of sartorius muscle spasticity requires botulinum neurotoxin injections in particular locations. CONCLUSIONS: These locations, corresponding to the locations of maximum arborization, are suggested as the most suggestive points for botulinum neurotoxin injection.

Rest-pause and drop-set training elicit similar strength and hypertrophy adaptations compared with traditional sets in resistance-trained males.

This paper aimed to compare the effect of drop-set (DS) and rest-pause (RP) systems versus traditional resistance training (TRT) with equalized total training volume on maximum dynamic strength (1RM) and thigh muscle thickness (MT). Twenty-eight resistance-trained males were randomly assigned to either RP (n = 10), DS (n = 9) or TRT (n = 9) protocols performed twice a week for 8 weeks. 1RM and MT of the proximal, middle and distal portions of the lateral thigh were assessed at baseline and post-intervention. A significant time × group interaction was observed for 1RM (P = 0.001) in the barbell back squat after 8-weeks. Post hoc comparisons revealed that RP promoted higher 1RM than TRT (P = 0.001); no statistical differences in strength were observed between the other conditions. A significant main effect of time was revealed for MT at the proximal (P = 0.0001) and middle (P = 0.0001) aspects of the lateral thigh for all training groups; however, the distal portion did not show a time effect (P = 0.190). There were no between-group interactions for MT. Our findings suggest that RP promotes slightly superior strength-related improvements compared with TRT, but hypertrophic adaptations are similar between conditions. Novelty: Rest-pause elicited a slightly superior benefit for strength adaptations compared with traditional resistance training. Resistance training systems do not promote superior hypertrophic adaptations when total training volume is equalized. Muscle thickness in distal portion of thigh is similar to baseline. Although modest, effect sizes tended to favor rest-pause.

Morphologic classification and innervation patterns of the pectineus muscle.

The purpose of this study was to identify the frequency of pectineal hiatus and of pectineus innervations, including femoral, obturator, and/or accessory obturator nerves. Also, this study sought to detailed intramuscular nervous distributions, with a particular focus on the relationship of nerves in multi-innervated pectineus. One hundred (49 right and 51 left) thighs from 52 cadavers (25 men and 27 women) were dissected. The morphology and innervations of the pectineus were investigated. Modified Sihler's whole-mount nerve-staining method was employed for visualization of the intramuscular nerve-distribution patterns of the pectineus. Variation of the pectineus forming a hiatus was identified in 18% of the specimens. The femoral innervations to the pectineus were identified in all specimens. Additional innervation either by the obturator or the accessory obturator branch to the pectineus was identified in 10% or 2% of specimens, respectively. No case of triple innervation to the pectineus was observed. In cases of dually innervated pectineus, two nerves formed a communication system inside the muscle. Among the three nerves supplying the pectineus, the femoral nerve branched more than the other two nerves and covered the greatest area in the muscle. The pectineal hiatus appears to be a common variation. The femoral nerve branch in a dually innervated pectineus is the dominant nerve component that supplies the muscle when considering frequency, branching pattern, and area, even though cooperation between two nerve components is implied. This study serves to advance the existing anatomical knowledge about the pectineus muscle, which is of clinical value.

Kinematic analysis of the human body during sit-to-stand in healthy young adults.

ABSTRACT: Sit-to-stand (STS) motion is one of the most important and energy-consuming basic motions in everyday life. Kinematic analysis provides information regarding what strategy or motion pattern is used by the healthy people, and through which, we can understand and obtain the law of the STS motion. The objective of this article is to study the law of STS motion through the experiment to determine a suitable description of STS motion in healthy adults, so as to provide a starting point and bases for future design and control of STS assistive devices.Thirty healthy adult subjects participated in this study and carried out STS motion experiment of standing up naturally. The STS motions were recorded using a high-definition camera. The experimentally collected kinematic data and a link segment model of the human body were used to obtain the coordinates of joints and to calculate the coordinates, velocity, and momentum of center of gravity; the postures of human body during STS are also obtained. The relationship between human body parameters and motion parameters is analyzed by using Pearson correlation method.The STS motion is divided into 4 phases; the phases are differentiated in terms of STS motion characteristics and postures, and momentum of center of gravity of human body. The main factors determining the differences in STS motion among individuals are horizontal distance between hip joint and ankle joint, lower leg length, thigh length, and the length of the transition period. The horizontal distance between hip joint and ankle joint is positively correlated with the duration from motion begin to trunk stops flexing forward (P = .021 < .05), but not so with the duration from motion begin to the end of phase 2 (P = .15 > .05).The results suggest that when designing the sit-to-stand assistive devices, one should pay attention to the whole-body posture control in STS motion, such as the posture guidance of trunk and lower leg, and should carry out specific training according to different STS phases. Sit-to-stand assistive devices should provide the same horizontal distance between hip joint and ankle joint for different individuals during the STS motion. Transition period should be properly controlled, and the degree of freedom of the lower leg should not be limited.

The Human Muscle Size and Strength Relationship: Effects of Architecture, Muscle Force, and Measurement Location.

PURPOSE: This study aimed to determine the best muscle size index of muscle strength by establishing if incorporating muscle architecture measurements improved the human muscle size-strength relationship. The influence of calculating muscle force and the location of anatomical cross-sectional area (ACSA) measurements on this relationship were also examined. METHODS: Fifty-two recreationally active men completed unilateral isometric knee extension strength assessments and magnetic resonance imaging scans of the dominant thigh and knee to determine quadriceps femoris size variables (ACSA along the length of the femur, maximum ACSA (ACSAMAX), and volume (VOL)) and patellar tendon moment arm. Ultrasound images (two sites per constituent muscle) were analyzed to quantify muscle architecture (fascicle length, pennation angle) and, when combined with VOL (from magnetic resonance imaging), facilitated calculation of quadriceps femoris effective PCSA (EFFPCSA) as potentially the best muscle size determinant of strength. Muscle force was calculated by dividing maximum voluntary torque by the moment arm and addition of antagonist torque (derived from hamstring EMG). RESULTS: The associations of EFFPCSA (r = 0.685), ACSAMAX (r = 0.697), or VOL (r = 0.773) with strength did not differ, although qualitatively VOL explained 59.8% of the variance in strength, ~11%-13% greater than EFFPCSA or ACSAMAX. All muscle size variables had weaker associations with muscle force than maximum voluntary torque. The association of strength-ACSA at 65% of femur length (r = 0.719) was greater than for ACSA measured between 10%-55% and 75%-90% (r = -0.042-0.633) of femur length. CONCLUSIONS: In conclusion, using contemporary methods to assess muscle architecture and calculate EFFPCSA did not enhance the muscle strength-size association. For understanding/monitoring muscle size, the major determinant of strength, these findings support the assessment of muscle volume, which is independent of architecture measurements and was most highly correlated with strength.

Fetal weight estimation by automated three-dimensional limb volume model in late third trimester compared to two-dimensional model: a cross-sectional prospective observational study.

BACKGROUND: Accurate estimation of fetal weight is important for prenatal care and for detection of fetal growth abnormalities. Prediction of fetal weight entails the indirect measurement of fetal biometry by ultrasound that is then introduced into formulae to calculate the estimated fetal weight. The aim of our study was to evaluate the accuracy of fetal weight estimation of Chinese fetuses in the third trimester using an automated three-dimensional (3D) fractional limb volume model, and to compare this model with the traditional two-dimensional (2D) model. METHODS: Prospective 2D and 3D ultrasonography were performed among women with singleton pregnancies 7 days before delivery to obtain 2D data, including fetal biparietal diameter, abdominal circumference and femur length, as well as 3D data, including the fractional arm volume (AVol) and fractional thigh volume (TVol). The fetal weight was estimated using the 2D model and the 3D fractional limb volume model respectively. Percentage error was defined as (estimated fetal weight - actual birth weight) divided by actual birth weight and multiplied by 100. Systematic errors (accuracy) were evaluated as the mean percentage error (MPE). Random errors (precision) were calculated as ±1 SD of percentage error. The intraclass correlation coefficient (ICC) was used to analyze the inter-observer reliability of the 3D ultrasound measurements of fractional limb volume. RESULTS: Ultrasound examination was performed on 56 fetuses at 39.6 ± 1.4 weeks' gestation. The average birth weight of the newborns was 3393 ± 530 g. The average fetal weight estimated by the 2D model was 3478 ± 467 g, and the MPE was 3.2 ± 8.9. The average fetal weights estimated by AVol and TVol of the 3D model were 3268 ± 467 g and 3250 ± 485 g, respectively, and the MPEs were - 3.3 ± 6.6 and - 3.9 ± 6.1, respectively. For the 3D TVol model, the proportion of fetuses with estimated error ≤ 5% was significantly higher than that of the 2D model (55.4% vs. 33.9%, p < 0.05). For fetuses with a birth weight < 3500 g, the accuracy of the AVol and TVol models were better than the 2D model (- 0.8 vs. 7.0 and - 2.8 vs. 7.0, both p < 0.05). Moreover, for these fetuses, the proportions of estimated error ≤ 5% of the AVol and TVol models were 58.1 and 64.5%, respectively, significantly higher than that of the 2D model (19.4%) (both p < 0.05). The inter-observer reliability of measuring fetal AVol and TVol were high, with the ICCs of 0.921 and 0.963, respectively. CONCLUSION: In this cohort, the automated 3D fractional limb volume model improves the accuracy of weight estimation in most third-trimester fetuses. Prediction accuracy of the 3D model for neonatal BW, particularly < 3500 g was higher than that of the traditional 2D model.

Quantitative sonographic assessment of quadriceps muscle thickness for fall injury prediction in patients undergoing maintenance hemodialysis: an observational cohort study.

BACKGROUND: Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be a primary component of fall prevention. This study investigated whether quadriceps muscle thickness measured using ultrasonography can predict fall injury among dialysis patients. METHODS: Using an observational cohort study design, 180 ambulatory hemodialysis patients were recruited from 2015 to 2016 from four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient's self-report during the one-year period. RESULTS: Among the 180 hemodialysis patients, 44 (24.4%) had fall injuries during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertiles, patients in the lowest tertile were more likely to have a higher incidence of fall injury than those in the higher two tertiles (0.52 vs. 0.19 and 0.17 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor of fall injury (hazard ratio [95% confidence interval], 2.33 [1.22-4.52], P < 0.05). Receiver operating characteristic curves were constructed to determine the optimal cutoffs of quadriceps muscle thickness, thigh circumference, and handgrip strength that best predicted fall injury (quadriceps muscle thickness, 3.37 cm and 3.54 cm in men and women; thigh circumference, 44.6 cm and 37.2 cm in men and women; and handgrip strength, 23.3 kg and 16.5 kg in men and women). Using these cutoff values, the areas under the curve were 0.662 (95% CI, 0.576-0.738), 0.625 (95% CI, 0.545-0.699), and 0.701 (95% CI, 0.617-0.774), for quadriceps muscle thickness, thigh circumference, and handgrip strength, respectively. Quadriceps muscle thickness was a more precise predictor of fall injury than thigh circumference and had similar diagnostic performance as handgrip strength tests in dialysis patients. CONCLUSIONS: Quadriceps muscle thickness can be measured easily at the bedside using ultrasonography and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis.

Variation of pectineus muscle forming a hiatus.

Knowledge of the anatomic variations in the pectineus muscle is important for vascular surgeons to minimize complications following surgical approach to the distal part of the deep femoral artery. During routine dissection of the thigh, variations in the bilateral pectineus muscles were identified in an 82-year-old male cadaver. On both sides, the superficial and deep layers of the pectineus were divided at its distal part, forming a triangular-shaped hiatus between them and the femur shaft. Distally, the tendon of the superficial part intermingled with the tendon of the adductor longus. The tendon of the deep part was inserted into the pectineal line. On the right side, the deep femoral artery and its first perforating artery passed through the hiatus. On the left side, the deep femoral artery pierced the hiatus, and then, the first perforating artery was branched from the deep femoral artery. No reported case has described a pectineal hiatus. The variations observed in this study are an ontogenetic vestige of the two different origins of the pectineus. The insertion of the superficial layer into the adductor longus tendon suggests a close relationship between these muscles during prenatal development. Surgeons should be aware of the variation to minimize injury to the pectineus muscle while approaching the deep femoral artery.

Anatomic study of the femur-vastus intermedius muscle-anterolateral thigh osteomyocutaneous free flap.

INTRODUCTION: Resection of head and neck malignancy usually causes facial defects and esthetic deformities. Among the wide range of free flaps available for reconstruction, a novel chimeric free flap-the femur-vastus intermedius muscle-anterolateral thigh osteomyocutaneous free flap (FVATLO flap)-has been demonstrated for clinical use. In this study, we illustrate the anatomy and harvest of the FVATLO flap. METHODS: Eighteen fresh cadavers without damage to either thigh were recruited for dissection. Blood supply to the vastus intermedius muscle and femur were traced and recorded. The diameter, circumference of the middle part of the femur, and thickness of the femoral cortex were measured. RESULTS: The major blood supply to the vastus intermedius muscle showed two patterns of origin. The first arising from the descending branch of the lateral circumflex femoral artery (LCFA-db) accounts for 78% of the cases (28/36), and the second arising from the transverse branch of the lateral circumflex femoral artery (LCFA-tb) accounts for 22% (8/36). Blood supply to the femur consists of two major sources: one from branches penetrating through the nutrient foramen on the posteromedial surface of the femur to the medullary cavity, and the other from the periosteum branches spreading over on the femoral surface. No visible branch from the vastus intermedius muscle to the underlying periosteum was found. The mean diameter, femoral circumference, and mean cortical thickness were 26.30 mm, 85.58 mm, and 6.85 mm, respectively. CONCLUSION: Considering that there is only one injured donor site, the FVALTO flap is an alternative chimeric flap for cases with a large amount of soft tissue loss together with small bony defects.

Limb occlusion pressure for blood flow restricted exercise: Variability and relations with participant characteristics.

OBJECTIVE: Assess lower-extremity blood flow restricted exercise (BFR) limb occlusion pressure (LOP) variability and identify related intrinsic characteristics using a portable Delphi BFR system. DESIGN: Repeated measures. SETTING: Laboratory. PARTICIPANTS: Forty-two healthy males (n = 25) and females (n = 17) (25.8 ± 5.2 y, 1.76 ±0 .09 m, 78.9 ± 14.9 kg) completed two visits. Brachial artery blood pressure, thigh circumferences (TC), and LOP were measured supine. MAIN OUTCOME MEASURES: Linear mixed-effects models (LMM) and generalizability theory were used to evaluate LOP between legs and days, determine intrinsic characteristic relations, and assess random variance components. RESULTS: LOP was not different between legs (p = .730) or days (p = .916; grand mean = 183.7 mmHg [178.4, 189.1]). LOP varied significantly between participants (p = .011, standard error = 47.3 mmHg). 47% of LOP variance was between participants, 18% and 6% was within participants between days and legs, respectively, and 28% was associated with random error. The relative error variance was 14.4 mmHg. Pulse pressure (PP) (p = .005) and TC (p = .040) were positively associated with LOP. A LMM including PP and TC predicted LOP with a mean absolute difference of 11.1 mmHg [9.7, 12.6] compared to measured LOP. CONCLUSIONS: The relative error variance suggests that clinicians should measure LOP consistently for each patient to ensure BFR safety and effectiveness.

An anatomical comparison of the fasciae of the thigh: A macroscopic, microscopic and ultrasound imaging study.

Although the number of Ultrasound (US) imaging studies investigating the fascial layers are becoming more numerous, the majority tend to use different reference points and terminology to describe their findings. The current work set out to compare macroscopic and microscopic data of specimens of the fascial layers of the thigh with US imaging findings. Specimens of the different fascial layers of various regions of the thigh were collected for macroscopic and histological analyses from three fresh cadavers and compared with in vivo US images of the thighs of 20 healthy volunteers. The specimens showed that the subcutaneous tissue of the thigh is made up of three layers: a superficial adipose layer, a membranous layer/superficial fascia, and a deep adipose layer. The deep fascia is composed of an aponeurotic fascia, which envelops all the thigh muscles and is laterally reinforced by the iliotibial tract and an epimysial fascia, which is specific for each muscle. The morphometric measurements of the thickness of the superficial fascia were different (anterior: 153.2 ± 39.3 µm; medial: 128.4 ± 24.7 µm; lateral: 154 ± 28.9 µm; and posterior: 148.8 ± 33.2 µm) as were those of the deep fascia (anterior: 556.8 ± 176.2 µm; medial: 820.4 ± 201 µm; lateral: 1112 ± 237.9 µm; and posterior: 730.4 ± 186.5 µm). The US scans showed a clear picture of the superficial adipose tissue, the superficial fascia, and the deep adipose tissue, as well as the deep fasciae. The epimysial and aponeurotic fasciae of only some topographic areas could be independently identified. The US imaging findings confirmed that the superficial and deep fascia have different thicknesses, and they showed that the US measurements were always larger with respect to those produced by histological analysis (p < 0.001) probably due to shrinkage during the processing. The posterior region (level 1) of the superficial fascia had, for example, a mean thickness of 0.56 ± 0.12 mm at US, while the histological analysis showed that it was 148.8 ± 33.2 µm. Showing a similar pattern, the thickness of the deep fascia was as follows: 1.64 ± 0.85 mm versus 730.4 ± 186.5 µm. Study results have confirmed that US can be considered a valid, non-invasive instrument to evaluate the fascial layers. In any event, there is a clear need for a set of standardised protocols since the thickness of the fascial layers of different parts of the human body varies and the data obtained using inaccurate reference points are not reproducible or comparable. Given the inconsistent terminology used to describe the fascial system, it would also be important to standardise the terminology used to define its parts. The difficulty in distinguishing between the epimysial and aponeurotic/deep fascia can also impede data interpretation.

Interrater reliability of novice examiners using A-mode ultrasound and skinfolds to measure subcutaneous body fat.

Examiners with minimal training and skill are often called upon to make body composition assessments using field methods. This study compared the interrater reliability of novice examiners for the skinfold (SKF) and A-mode ultrasound (US) methods of body composition assessment. Undergraduate Kinesiology majors (48 males, 32 females) with minimal training took both SKF and US measurements at three sites (males: chest, abdomen, thigh; females: triceps, suprailiac, thigh). Interrater reliability was significantly better for US compared to SKF at the thigh (ICCUS = 0.975, ICCSKF = 0.912) and abdomen (ICCUS = 0.984, ICCSKF = 0.693) for men and suprailiac (ICCUS = 0.978, ICCSKF = 0.883) for women. Additionally, interrater reliability of the US method was superior to the SKF method for the estimate of male body fat percentage (ICCUS = 0.990, ICCSKF = 0.862). The 95% CI was generally narrower for the US method than the SKF method at each site. The interrater reliability of the US method was superior to or equal to the SKF method for measuring subcutaneous body fat when novice examiners took the measurements.

Acute Effects of Tissue Flossing Around the Upper Thigh on Neuromuscular Performance: A Study Using Different Degrees of Wrapping Pressure.

CONTEXT: It has been recently demonstrated that tissue flossing around the ankle joint can be effectively used to improve ankle range of motion, jump, and sprint ability. However, there is a lack of studies investigating the acute effects of tissue flossing applied using different wrapping pressures. OBJECTIVE: To investigate the acute effects of tissue flossing and the degree of floss band pressure, around the upper thigh on knee range of motion, strength, and muscle contractile characteristics. DESIGN: Crossover design in 3 distinct sessions. SETTING: University laboratory. PARTICIPANTS: A total of 19 recreationally trained volunteers (age 23.8[4.8] y) participated in this study. INTERVENTION: Active knee extension and flexion performed for 3 sets of 2 minutes (2-min rest between sets with wrapped upper thigh). Individualized wrapping pressures were applied to create conditions of high and moderate vascular occlusion, while a loose band application served as a control condition. MAIN OUTCOME MEASURES: Participants were assessed for active straight leg raise test; tensiomyography displacement and contraction time for rectus femoris, vastus medialis, and biceps femoris muscles; and maximum voluntary contractions for knee extensors and flexors for pre, after, and 30 minutes after applying the floss band. RESULTS: There was a statistically significant increase in maximum voluntary contractions for knee extensors and a significant shortening in rectus femoris contraction time for the moderate condition, which was associated with small to medium effects in favor of the moderate condition. There were no statistically significant changes observed between control and high conditions. The active straight leg raise test was unaffected regardless of intervention. CONCLUSIONS: The results of this study suggest that tissue flossing around the upper thigh might have a localized as well as pressure-sensitive response, thereby improving neuromuscular function of the knee extensors.