To localize the site of motor points within human biceps brachii muscles through surface mapping using electrophysiological method.
We recorded the compound muscle action potentials of each lattice of the biceps brachii in 40 healthy subjects. Standardized reference lines were made as the following: 1) a horizontal reference line (elbow crease) and 2) a vertical reference line connecting coracoid process and mid-point of the horizontal reference line. The Compound muscle action potentials were mapped in reference to the standardized reference lines. The locations of motor points were mapped to the skin surface, in the ratio to the length of the vertical and the half of the horizontal reference lines.
The motor point of the short head of biceps was located at 69.0±4.9% distal and 19.1±9.5% medial to the mid-point of horizontal reference line. The location of the motor point of the long head of the biceps was 67.3±4.3% distal and 21.4±8.7% lateral. The motor point of the short head of the biceps was located more medially and distally in the male subjects compared to that in the female (p<0.05).
This study showed electrophysiological motor points of the biceps brachii muscles through surface mapping. This data might improve the clinical efficacy and the feasibility of motor point targeting, when injecting botulinum neurotoxin in biceps brachii.
Citations
Objective: To evaluate the effects of intra-articular injection of shoulder and subscapularis motor point block on painful hemiplegic shoulder.
Method: Thirty painful hemiplegic shoulder of recent onset stroke were divided randomly into three groups, i.e. group I: range of motion (ROM) exercise only, group II: intra-articular injection with ROM exercise, group III: subscapularis motor point block with ROM exercise. The intra-articular injection of shoulder was done with 20 ml of normal saline, 5 ml of 1% lidocaine, and 40 mg of triamcinolone. The subscapularis motor point block was done with 5 ml of 5% phenol under electromyographic guide. The ROM in external rotation and simple X-ray of shoulder in full abduction were checked in three groups at pre-treatment and post-treatment 3 week, and the glenohumeral abduction and scapulohumeral rhythm were obtained from the shoulder X-ray.
Results: There were significant (p＜0.05) improvements of glenohumeral abduction, external rotation, and scapulohumeral rhythm of shoulder in group II and III, but improvement of only glenohumeral abduction was significant in group I. Angular increment of glenohumeral abduction and external rotation was most significant in group III compared with other two groups.
Conclusion: These results suggest that the intra-articular injection of shoulder and subscapularis motor point block are potentially useful techniques in the prevention and management of the painful hemiplegic shoulder.
Objective: The purposes of this study are to find out the long-term effect of motor point block using phenol on spasticity and gait pattern of spastic cerebral palsy children and to examine contributing factors for success of phenol block in functional implication of cerebral palsy.
Method: We injected 5% phenol into muscles of 35 cases with spastic cerebral palsy under the electromyographic monitoring. Pre, immediate post, and follow-up evaluations for type and severity, grade of spasticity, range of motion, and gait patterns by locomotion rating scale (LRS) were analyzed.
Results: The degree of spasticity was reduced dramatically by block, but this effect returned back to the level of pre-block state on follow-up evaluation. There was much improvement in pes equinus, genu recurvatum and scissoring tendency, while little change was observed in crouch gait and hind foot instability. These effects have been sustained on follow-up evaluation. The gait speed, deviation to normal gait, and instability in walking were significantly improved after block and on follow-up. Maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in phenol block. Initial spasticity, initial and post LRS score were not significant.
Conclusion: After phenol block, spasticity returned back to the level of pre-block state but improvement in locomotion activity was maintained over 8 months on follow-up evaluation. The maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in motor point block for improving locomotion activity.
Purpose: The purpose of this study is to find out the immediate effect of motor point block using phenol on the degree of spasticity and the gait patterns of children with spastic cerebral palsy and then to ascertain the cases to which these findings are most beneficial.
Subjects & Methods: We injected 5% phenol into spastic muscles of 33 cases with spastic cerebral palsy under the electromyographic monitoring. The clinical evaluation for type and severity of cerebral palsy was performed before the block and then, observations on both the degree of spasticity using `modified Ashworth scale' and the range of motion were made before and after the procedures. Finally, the gait patterns before and after block were analyzed by using locomotion rating scale for gait analysis.
Results: The degree of spasticity, which was measured with modified Ashworth scale, was reduced dramatically through our phenol block - i.e. from 2.8 to 1.2 -. The limited range of motion in some cases was not increased significantly after block. The constant pes equinus state resulted in the state that heel contact is occasionally possible. There was also much improvement in genu recurvatum and scissoring tendency, while little change was observed in crouch gait and hind foot instability. The speed of gait, deviation to normal gait and instability in walking were improved significantly after block, but their locomotion state was still moderately incomplete. When comparing the different outcomes of motor point block with one another according to the severity, the cases in moderately disabled state improved most dramatically. The group with both high degree of spasticity and the full range of motion in their joints improved by far the better after motor point block.
Conclusion: The immediate effect of motor point block with phenol solution can be best described as a dramatic relief of spasticity and tip toeing. but other problems such as other abnormal gait patterns and locomotion activity or state improved little, if any. The moderately disabled children with both high degree of spasticity and the full range of motion in their joint could get the best of our findings.
First
Prev
