由美国国立卫生研究院授予＃R01HL088045支持。博士。涡流风扇和米歇尔哥是每个从加拿大卫生研究院的奖学金奖的支持。

1。简介在人工肌肉测试（MMT）的双边，每个肌肉群进行测试。出于演示的目的，只有一方是在这6肌肉群中的每一个视频进行测试。一方面考官适用于电阻或palpates收缩肌肉或肌腱，​​而另一方面，稳定保持在测试中的地位，它正在测试的肢体。重复测试，如果病人不理解的说明，或不将尽最大的努力。 2。分级如下医学研究理事会（MRC），系统（表1）1。 图1说明了一个MRC肌力计分制的算法。如果这个问题是缺少一个肢体，有一个演员，或无法将放置在正确的测试位置，肌力评定为“无法评估”。如果病人有一个固定的的挛缩，但可以以其他方式进行测试，肌肉分级。医疗器械，如导管及渠务工程，机械通气通常不妨碍肌肉的测试，除非是固定的联合，以确保设备的正常运作。 <img src="/files/ftp_upload/2632/2632fig1.jpg" alt="图1"/> 图1人工肌肉测试算法。 3。程序<ol><li>每一块肌肉测试，检查站被测试的一侧，病人坐在直立和定位，让反重力联合运动。考官演示所需的反重力运动。然后考官会要求病人重复的议案。 </li><li>如果病人可以通过对抗地心引力的运动所需的范围内移动，考官尝试，同时说明“按住它，不要让我推”或“保持它适用于测试位置的阻力 ，不要让我弯“（图2）。如果病人容忍毫无抵抗能力，肌肉的比分是3级。如果病人容忍一些阻力，比分是4级和充分性，第5级。 </li><li>如果病人不能移动病人重新定位，以对抗地心引力，让重力消除下肢的运动。如果支持的肢体，考官既不提供援助，以病人的自愿运动，也不抵抗。这重力淘汰的定位会有所不同，每一块肌肉测试。如果患者不能完成至少运动的局部范围内消除重力，肌肉或肌腱是观察和/或收缩摸到。 </li><li>对于长期卧床的病人，谁也不能坐在椅子的位置，或放在床沿上一张床，下肢测试的备用位置都包含在这个协议。 </li></ol> 4。肩外展<ol><li>测试位置 - 臂从一侧肩平。考官演示的议案，然后国家“ 抬起你的手臂，一边肩平 。 “给予阻力的手是超过病人的手臂肘关节以上的轮廓。另一方面，稳定肩关节以上的肩膀。考官国家“ 保持它，不要让我推了下去。”要评估3年级，4或5，请参阅第3.2节以上。 </li><li>如果弱于3级，病人仰卧在一旁的武器。考官支持略高于肘部和手腕，以保证肩不对外旋转（转向外）的手臂。病人尝试移动手臂侧面。考官说：“ 尝试将你的手臂侧面 ”。二级分配，如果病人与重力移动淘汰。 </li><li>如果弱于二级考官“ 尝试将你的手臂在一旁 ”，和palpates中间的三角肌，作为证明，收缩，并为先前定义的分数为1或0级。 </li><li>肩宽市场失当行为审裁处可以进行中心静脉导管（如锁骨下和颈）的地方，包括那些使用透析。 （图2） </li></ol>同样以上面使用特定的测试为病人和考官的位置，和病人的运动的具体说明将完成剩余的评估。 5。屈肘<ol><li>测试位置 - 前臂旋后，稍弯曲超过90度。口头指示：“ 稍微弯曲你的胳膊肘超过90度 ”。给予阻力的手是在手腕前臂近端的屈面的轮廓。考官的另一方面适用的反作用力，拔罐前肩的优越方面掌。然后考官指出：“ 保持它不要让我推了下去。”和分数等级3，4或5如前所述。 </li><li>如果超过3级弱，肩被绑架到90度。考官支持ARM UND二肘，如果有必要，手腕以及。前臂变成拇指对着天花板。用肘部延长，病人尝试弯曲肘关节。考官说：“ 尝试弯曲你的胳膊肘。”二级分配，如果病人可以自由弯曲肘关节。 </li><li>如果弱于二级，前臂旋后和肘关节屈曲约45度定位在侧。考官“ 尝试弯曲你的胳膊肘 ”，palpates二头肌肌腱和分数为1级或0。 </li></ol> 6。伸腕<ol><li>试验位置 - 在一侧的手臂，肘关节屈曲90度旋前前臂和手腕完全伸直。口头指示：“ 弯曲你的手腕尽可能。”考官的手给电阻放置在患者的手回远端手腕。考官的另一方面支持患者的前臂。然后考官指出：“ 保持它不要让我推了下去。”和分数3年级，4个或5个。 </li><li>如果弱于3级，肘部弯曲90度，前臂与拇指对着天花板打开。前臂和手腕都支持由考官。考官指出：“ 对我的弯曲你的手 ”。二级分配，如果病人可以延长手腕。 </li><li>如果弱于二级，考官“ 弯对我的手腕 ”和palpates两个伸肌腱，每一侧的手腕上，作为证明，并分数为0或1级。考官是不小心触诊在中间的手腕的肌腱。 </li><li>如果有同侧桡动脉导管到位，不执行此测试。 </li></ol> 7。髋关节屈曲<ol><li>测试位置 - 与臀部坐在充分弯曲，弯曲膝盖。病人可能他们的手放在床上或稳定的表。口头指示：“ 抬起你的膝盖高，因为它会去。”考官的手给电阻是放在大腿近端到膝盖上。另一方面提供一侧髋关节的稳定性。然后考官指出：“ 保持它不要让我推了下去。”和分数3年级，4个或5个。 </li><li>如果超过3级弱，病人奠定了不被测试的一侧。例如，病人的规定进行测试的左髋关节右侧。考官的背后有一个抱着胳膊腿与膝盖下的手支持测试的病人。与此相反的手保持在臀部的主干对齐。考官指出：“把你的膝盖朝向你的胸部。”二级分配，如果病人可以自由弯曲髋关节。 </li><li>如果弱于二级，病人平卧。考官问：“ 这里我摸摸你的腿吗 ？ “ （指向髋关节的内在方面）。与患者的同意，考官“ 弯曲你的髋关节和palpates髂腰肌肌腱，作为证明，分数为0或1级。 </li><li>在长期卧床的病人，5，4，3年级测试床在椅子的位置，或床头抬高尽可能。髋关节弯曲90度，枕头放在膝盖下。考官保证，脚抬离床面时，要求病人离床面，以提高膝关节。如前所述，2级和1拿下。 </li><li>这个测试可以在患者的完整，以及担保的股骨血管内导管执行。 </li></ol> 8。伸膝<ol><li>测试位置 - 坐在直立的膝盖完全伸展到0度。避免膝关节过度伸展。口头指示，“ 你的膝盖拉直 ”。给予阻力的手是腿部踝关节近端上的轮廓。另一方面则是放置在膝盖以上的大腿。考官国家“ 保持它，不要让我弯曲”和分数3年级，4个或5个。 </li><li>病人如果弱于3级，规定对非测试的一面。考官背后病人在膝关节水平。没有测试的腿可弯曲的稳定。一只手臂摇篮的手腿被测试支持各地的大腿膝盖下方。另一方面，持有下肢踝关节以上。考官说：“ 挺起你的膝盖。”二级分配，如果病人可以延长膝盖（图3）。 </li><li>如果弱于二级，病人平卧和考官指出：“按你的膝盖背下来 ”或“ 收紧你的膝盖 ”，palpates股四头肌腱和分数为0或1级。 </li><li>对于长期卧床的病人，在攻入3年级，4，5，患者髋关节屈曲的位置以同样的方式，分级膝关节伸直（图4）以上所述。 </li></ol> 9。踝关节背屈<ol><li>坐在试验位置 - 在地板上，脚踵，充分dorsiflexio删除N，鞋和袜子。口头指示：“ 弯曲你的脚，尽可能 。 “在测试过程中脚趾放松。捧着手给电阻在上方的脚到脚趾近端。另一方面则是轮廓周围的前面的腿踝关节近端。然后考官“ 按住它，不要让我推了下去 ”，分数3级，4个或5个。 </li><li>如果弱于3级，但有部分对抗地心引力的运动范围，分配2级。 </li><li>如果弱于二级，触诊胫前肌腱，得分为1或0级。 </li><li>长期卧床的病人进行测试仰卧，腿的延伸和膝关节下放置一个枕头。 </li><li>此测试通常可以适用于一个完整的安全踏板血管内导管。要小心，不要驱逐导管。 </li></ol> 10。代表性的成果： ARDS的幸存者和模拟专利申请时，MMT的使用此协议具有优良的跨评价者的可靠性。 19学员，检查12个肌肉群的质量保证证明一个组内相关系数为0.99（0.97-1.00）（95％信心区间[CI]）8日的协定（KAPPA，95％CI），检测临床意义的弱点（即复合湄公河。得分&lt;最大的为80％）为1.00（0.55-1.00）。以往的研究表明12-14中风，肌萎缩性脊髓侧索硬化症（ALS），格林-巴利，和其他危重病人评分间的可靠性高。 <img src="/files/ftp_upload/2632/2632fig2.jpg" alt="图2"/> 图2。ICU患者左肩关节外展挛缩。蒙脱土与左桡动脉线，​​心电监护，并通过右颈内静脉导管的连续透析。病人被定位为肩外展蒙脱土等级3，4和5。 <img src="/files/ftp_upload/2632/2632fig3.jpg" alt="图3"/> 图3。ICU长期卧床的病人颈静脉与右连续透析导管。病人是伸膝蒙脱土二级右侧的位置。 <img src="/files/ftp_upload/2632/2632fig4.jpg" alt="图4"/> 图4。ICU长期卧床的病人，用左膝屈曲挛缩。病人是仰卧定位与枕头下膝盖膝盖扩展市场失当行为审裁处3年级，4日和5。 <table border="1"><tbody><tr><td colspan="2">表1。手动肌肉测试3 </th></tr><tr><td>级</td><td>手动肌试验</td></tr><tr><td> 5 </td><td>运动对重力加满阻力</td></tr><tr><td> 4 </td><td>运动对重力加上一些阻力</td></tr><tr><td> 3 </td><td>完成了对抗地心引力的运动测试范围，但不容阻力</td></tr><tr><td> 2 </td><td>病人完成全部或部分范围内的议案，与重力淘汰</td></tr><tr><td> 1 </td><td>没有任何动静轻微收缩</td></tr><tr><td> 0 </td><td>没有证据收缩（全瘫） </td></tr></tbody></table>

<ol>
	<li>De Jonghe, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Paresis+acquired+in+the+intensive+care+unit:+a+prospective+multicenter+study.">Paresis acquired in the intensive care unit: a prospective multicenter study.</a> JAMA. 288, 2859-2867 (2002).</li><li>Ali, N. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acquired+weakness,+handgrip+strength,+and+mortality+in+critically+ill+patients.">Acquired weakness, handgrip strength, and mortality in critically ill patients.</a> Am J Respir Crit Care Med. 178, 261-268 (2008).</li><li>Angel, M. J., Bril, V., Shannon, P., Herridge, M. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuromuscular+function+in+survivors+of+the+acute+respiratory+distress+syndrome.">Neuromuscular function in survivors of the acute respiratory distress syndrome.</a> Can. J. Neurol. Sci. 34, 427-432 (2007).</li><li>Cheung, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Two-year+outcomes,+health+care+use,+and+costs+of+survivors+of+acute+respiratory+distress+syndrome.">Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome.</a> Am. J. Respir. Crit. Care Med. 174, 538-544 (2006).</li><li>Stevens, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuromuscular+dysfunction+acquired+in+critical+illness:+a+systematic+review.+Intensive+Care+Med.">Neuromuscular dysfunction acquired in critical illness: a systematic review. Intensive Care Med.</a> 33, 1876-1891 (2007).</li><li>Herridge, M. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=One-year+outcomes+in+survivors+of+the+acute+respiratory+distress+syndrome.">One-year outcomes in survivors of the acute respiratory distress syndrome.</a> N. Engl. J. Med. 348, 683-693 (2003).</li><li>Medical Research Council. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Aids to the Investigation of the Peripheral Nervous System. , (1976).</li><li>Fan, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inter-rater+reliability+of+manual+muscle+strength+testing+in+ICU+survivors+and+simulated+patients.">Inter-rater reliability of manual muscle strength testing in ICU survivors and simulated patients.</a> Intensive Care Med. 34, 1038-1043 (2010).</li><li>Hislop, H. J., Montgomery, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Daniels and Worthingham's Muscle Testing. , (2007).</li><li>Reese, N. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Muscle and Sensory Testing. , (2005).</li><li>Kendall, F. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Muscles; Testing and Function with Posture and Pain. , (2005).</li><li>Lieu, B. K., Hough, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+Weakness+in+Critically+Ill+Patients+Using+Physical+Examination.">Assessment of Weakness in Critically Ill Patients Using Physical Examination.</a> Am J Respir Crit Care Med. 175, A218-A218 (2007).</li><li>Gregson, J. M. <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+measurements+of+muscle+tone+and+muscle+power+in+stroke+patients.">Reliability of measurements of muscle tone and muscle power in stroke patients.</a> Age Ageing. 29, 223-228 (2000).</li><li>Great Lakes ALS Study Group. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.+A+comparison+of+muscle+strength+testing+techniques+in+amyotrophic+lateral+sclerosis.">. A comparison of muscle strength testing techniques in amyotrophic lateral sclerosis.</a> Neurology. 61, 1503-1507 (2003).</li><li>Kleyweg, R. P., van der Meche, F. G., Schmitz, P. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interobserver+agreement+in+the+assessment+of+muscle+strength+and+functional+abilities+in+Guillain-Barre+syndrome.">Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barre syndrome.</a> Muscle Nerve. 14, 1103-1109 (1991).</li><li>Zink, W., Kollmar, R., Schwab, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Critical+illness+polyneuropathy+and+myopathy+in+the+intensive+care+unit.">Critical illness polyneuropathy and myopathy in the intensive care unit.</a> Nat. Rev. Neurol. 5, 372-379 (2009).</li><li>Sharshar, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Presence+and+severity+of+intensive+care+unit-acquired+paresis+at+time+of+awakening+are+associated+with+increased+intensive+care+unit+and+hospital+mortality.">Presence and severity of intensive care unit-acquired paresis at time of awakening are associated with increased intensive care unit and hospital mortality.</a> Crit. Care Med. 37, 3047-3053 (2009).</li><li>Griffiths, R. D., Hall, J. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+care+unit-acquired+weakness.">Intensive care unit-acquired weakness.</a> Crit. Care Med. 38, 779-787 (2010).</li><li>Bohannon, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+knee+extensor+muscle+strength.">Measuring knee extensor muscle strength.</a> Am J Phys Med Rehabil. 80, 13-18 (2001).</li><li>Needham, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mobilizing+patients+in+the+intensive+care+unit:+improving+neuromuscular+weakness+and+physical+function.">Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function.</a> JAMA. 300, 1685-1690 (2008).</li></ol>

根据诊断标准，9 - ICU患者的87％，发展神经肌肉并发症，这是长时间机械通气相关，增加了住院和康复时间，并有可能与死亡率增加相关肌肉1,2,16-18定期评估。强度，使用可靠的方法，最大限度地减少评分间变异检测随着时间的推移变化是有益的。使用MRC评分系统的市场失当行为的重要限制是6点序规模。举行测功机手的肌肉力量测试是不太常用，但使用的比例尺度测量的优势。19...

manual muscle testing:  a method of measuring extremity muscle strength applied to critically ill patients

急性呼吸窘迫综合征（ARDS）和其他原因造成的重大疾病的幸存者往往有全身乏力，运动耐受力降低，以及出院后的持久性神经和肌肉损伤 。1-6使用一个明确的协议与结构化方法，培训和质量保证人工肌肉测试（MMT）的研究人员，是一个高度可靠的方法评估实力，采用标准化的临床检查，以下ARDS患者，，就可以完成与机械通气的病人，他可以容忍坐在直立在床上，并能够按照两个步骤的命令7， 8 本视频演示了一个审裁处，已教≥43，&gt; 280 ARDS的幸存者进行&gt; 800评估的研究人员的协议。修改为长期卧床的病人。定位，稳定，电阻，触诊为每6点序号医学研究理事会的规模分，每一块肌肉测试的具体技术是在本议定书分级 7,9-11三上，三下肢肌肉：肩外展屈肘，伸腕，髋关节屈曲，膝关节伸直，踝关节背屈。这些肌肉ICU获得前出版物中使用的弱点评估病人的标准方法的基础上选择1,2。

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

急性呼吸窘迫综合征（ARDS）和危重病的幸存者经常制定长期的肌肉无力。人工肌肉测试（MMT）的是一个标准化的临床检查，常用来衡量周围骨骼肌肉群的力量。本视频演示了市场失当行为审裁处使用了6点的医学研究理事会的规模。

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, ...

manual-muscle-testing-method-measuring-extremity-muscle-strength

Research

JoVE Journal

Medicine

80.4K 次观看.  Johns Hopkins University. 急性呼吸窘迫综合征（ARDS）和危重病的幸存者经常制定长期的肌肉无力。人工肌肉测试（MMT）的是一个标准化的临床检查，常用来衡量周围骨骼肌肉群的力量。本视频演示了市场失当行为审裁处使用了6点的医学研究理事会的规模。

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

Measuring the Strength of Mice

Kondziela7 devised the inverted screen test and published it in 1964. It is a test of muscle strength using all four limbs. Most normal mice easily score maximum on this task; it is a quick but insensitive gross screen, and the weights test described in this article will provide a finer measure of muscular strength.
There are also several strain gauge-based pieces of apparatus available commercially that will provide more graded data than the inverted screen test, but their cost may put them beyond the reach of many laboratories which do not specialize in strength testing. Hence in 2000 a cheap and simple apparatus was devised by the author. It consists of a series of chain links of increasing length, attached to a "fur collector" a ball of fine wire mesh sold for preventing limescale build up in hard water areas. An accidental observation revealed that mice could grip these very tightly, so they proved ideal as a grip point for a weight-lifting apparatus. A common fault with commercial strength meters is that the bar or other grip feature is not thin enough for mice to exert a maximum grip. As a general rule, the thinner the wire or bar, the better a mouse can grip with its small claws.
This is a pure test of strength, although as for any test motivational factors could potentially play a role. The use of scale collectors, however, seems to minimize motivational problems as the motivation appears to be very high for most normal young adult mice.

Deficits in muscular strength occur in many clinical conditions such as motor neuron disease. The inverted screen and weight lifting tests described here measure strength in mice almost exclusively, with minimal influence of factors such as coordination.

强度测量小鼠

Kondziela7 devised the inverted screen test and published it in 1964. It is a test of muscle strength using all four limbs. Most normal mice easily score ...

科研

医学

Method to Measure Tone of Axial and Proximal Muscle

The control of tonic muscular activity remains poorly understood. While abnormal tone is commonly assessed clinically by measuring the passive resistance of relaxed limbs1, no systems are available to study tonic muscle control in a natural, active state of antigravity support. We have developed a device (Twister) to study tonic regulation of axial and proximal muscles during active postural maintenance (i.e. postural tone). Twister rotates axial body regions relative to each other about the vertical axis during stance, so as to twist the neck, trunk or hip regions. This twisting imposes length changes on axial muscles without changing the body's relationship to gravity. Because Twister does not provide postural support, tone must be regulated to counteract gravitational torques. We quantify this tonic regulation by the restive torque to twisting, which reflects the state of all muscles undergoing length changes, as well as by electromyography of relevant muscles. Because tone is characterized by long-lasting low-level muscle activity, tonic control is studied with slow movements that produce "tonic" changes in muscle length, without evoking fast "phasic" responses. Twister can be reconfigured to study various aspects of muscle tone, such as co-contraction, tonic modulation to postural changes, tonic interactions across body segments, as well as perceptual thresholds to slow axial rotation. Twister can also be used to provide a quantitative measurement of the effects of disease on axial and proximal postural tone and assess the efficacy of intervention.

We have developed a device (Twister) to study the regulation of tonic muscle activity during active postural maintenance. Twister measures torsional resistance and muscular responses in standing subjects during twisting of the body axis. The device can be flexibly configured to study various aspects of tonic control across the neck, trunk, and/or hips.

测量方法轴向和近端肌肉音

The control of tonic muscular activity remains poorly understood.  While abnormal tone is commonly assessed clinically by measuring the passive resistance ...

High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum

Over the recent years, antibodies against surface and conformational proteins involved in neurotransmission have been detected in autoimmune CNS diseases in children and adults. These antibodies have been used to guide diagnosis and treatment. Cell-based assays have improved the detection of antibodies in patient serum. They are based on the surface expression of brain antigens on eukaryotic cells, which are then incubated with diluted patient sera followed by fluorochrome-conjugated secondary antibodies. After washing, secondary antibody binding is then analyzed by flow cytometry. Our group has developed a high-throughput flow cytometry live cell-based assay to reliably detect antibodies against specific neurotransmitter receptors. This flow cytometry method is straight forward, quantitative, efficient, and the use of a high-throughput sampler system allows for large patient cohorts to be easily assayed in a short space of time. Additionally, this cell-based assay can be easily adapted to detect antibodies to many different antigenic targets, both from the central nervous system and periphery. Discovering additional novel antibody biomarkers will enable prompt and accurate diagnosis and improve treatment of immune-mediated disorders.

Over the recent years, live cell-based assays have been used successfully to detect antibodies against surface and conformational antigens. Here, we describe a method using high-throughput flow cytometry enabling the analysis of large cohorts of patients. Detection of novel antibodies will improve diagnosis and treatment of immune-mediated disorders.

高通量流式细胞仪检测细胞为基础的试验检测抗体，以N-甲基-D-天冬氨酸受体或多巴胺2受体在人血清

Over the recent years, antibodies against surface and conformational proteins involved in neurotransmission have been detected in autoimmune CNS diseases ...

Bladder Smooth Muscle Strip Contractility as a Method to Evaluate Lower Urinary Tract Pharmacology

We describe an in vitro method to measure bladder smooth muscle contractility, and its use for investigating physiological and pharmacological properties of the smooth muscle as well as changes induced by pathology. This method provides critical information for understanding bladder function while overcoming major methodological difficulties encountered in in vivo experiments, such as surgical and pharmacological manipulations that affect stability and survival of the preparations, the use of human tissue, and/or the use of expensive chemicals. It also provides a way to investigate the properties of each bladder component (i.e. smooth muscle, mucosa, nerves) in healthy and pathological conditions.
The urinary bladder is removed from an anesthetized animal, placed in Krebs solution and cut into strips. Strips are placed into a chamber filled with warm Krebs solution. One end is attached to an isometric tension transducer to measure contraction force, the other end is attached to a fixed rod. Tissue is stimulated by directly adding compounds to the bath or by electric field stimulation electrodes that activate nerves, similar to triggering bladder contractions in vivo. We demonstrate the use of this method to evaluate spontaneous smooth muscle contractility during development and after an experimental spinal cord injury, the nature of neurotransmission (transmitters and receptors involved), factors involved in modulation of smooth muscle activity, the role of individual bladder components, and species and organ differences in response to pharmacological agents. Additionally, it could be used for investigating intracellular pathways involved in contraction and/or relaxation of the smooth muscle, drug structure-activity relationships and evaluation of transmitter release.
The in vitro smooth muscle contractility method has been used extensively for over 50 years, and has provided data that significantly contributed to our understanding of bladder function as well as to pharmaceutical development of compounds currently used clinically for bladder management.

This manuscript presents a simple, yet powerful, in vitro method for evaluating smooth muscle contractility in response to pharmacological agents or nerve stimulation. Main applications are drug screening and understanding tissue physiology, pharmacology,&#160;and pathology.

膀胱平滑肌收缩带作为一种方法来评估下尿路药理学

We describe an in vitro method to measure bladder smooth muscle contractility, and its use for investigating physiological and pharmacological properties ...

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

The kidney normally functions to maintain hemodynamic homeostasis and is a major site of damage caused by drug toxicity. Drug-induced nephrotoxicity is estimated to contribute to 19- 25% of all clinical cases of acute kidney injury (AKI) in critically ill patients. AKI detection has historically relied on metrics such as serum creatinine (sCr) or blood urea nitrogen (BUN) which are demonstrably inadequate in full assessment of nephrotoxicity in the early phase of renal dysfunction. Currently, there is no robust diagnostic method to accurately detect hemodynamic alteration in the early phase of AKI while such alterations might actually precede the rise in serum biomarker levels. Such early detection can help clinicians make an accurate diagnosis and help in in decision making for therapeutic strategy. Rats were treated with Cisplatin to induce AKI. Nephrotoxicity was assessed for six days using high-frequency sonography, sCr measurement and upon histopathology of kidney. Hemodynamic evaluation using 2D and Color-Doppler images were used to serially study nephrotoxicity in rats, using the sonography. Our data showed successful drug-induced kidney injury in adult rats by histological examination. Color-Doppler based sonographic assessment of AKI indicated that resistive-index (RI) and pulsatile-index (PI) were increased in the treatment group; and peak-systolic velocity (mm/s), end-diastolic velocity (mm/s) and velocity-time integral (VTI, mm) were decreased in renal arteries in the same group. Importantly, these hemodynamic changes evaluated by sonography preceded the rise of sCr levels. Sonography-based indices such as RI or PI can thus be useful predictive markers of declining renal function in rodents. From our sonography-based observations in the kidneys of rats that underwent AKI, we showed that these noninvasive hemodynamic measurements may consider as an accurate, sensitive and robust method in detecting early stage kidney dysfunction. This study also underscores the importance of ethical issues associated with animal use in research.

Early stage hemodynamic dysfunction is critical to the development of kidney disease. Yet, detection methodologies are limited. Recent advances in sonography provide a noninvasive, accurate option for early detection of kidney injury. This study outlines a step-by-step, sonographic methodology for detecting kidney dysfunction using a drug-induced nephrotoxicity rat model.

大鼠使用超声技术药物引起的肾血流动力学障碍的早期检测

The kidney normally functions to maintain hemodynamic homeostasis and is a major site of damage caused by drug toxicity. Drug-induced nephrotoxicity is ...

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

冠脉流量和冠状动脉血流储备用小鼠压力超负荷基于模型的超声评估

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients. Manual exchange transfusions combine one or more manual phlebotomies with a PRBC transfusion.
At the Reference Center of Sickle Cell Disease, we set up a continuous method of manual exchange transfusion that is feasible for all hospital settings, demands no specific equipment, and is widely applicable. In terms of HbS decrease, stroke prevention, and iron overload prevention, this method showed comparable efficiency to erythrapheresis. In cases where erythrapheresis is not available, this method can be a good alternative for patients and care centers.

We have outlined a method of continuous manual exchange transfusion for the treatment of sickle cell disease in patients. This safe protocol was designed to effectively limit iron overload in patients in need of chronic transfusions and can be used extensively without any special equipment.

与镰状细胞疾病患者连续手动换血：的有效方法避免铁超负荷

Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. ...

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in elderly people performing short-term resistance training (RET). Supervised progressive resistance training for 1 h three times a week over 8 weeks was performed by RET participants (71&#177;1 years, range 65-80). Compared to a control group without training, the RET showed improvements on the measures used to indicate strength, power, glucose tolerance, and several parameters of muscle aerobic capacity. Strength training was performed in a gym with only robust fitness equipment. An isokinetic dynamometer for knee extensor strength permitted the measurement of concentric, eccentric, and static strength, which increased for the RET group (8-12% post- versus pre-test). The power (rate of force development, RFD) at the initial 0-30 ms also showed an increase for the RET group (52%). A glucose tolerance test with frequent blood glucose measurements showed improvements only for the RET group in terms of blood glucose values after 2 h (14%) and the area under the curve (21%). The blood lipid profile also improved (8%). From muscle biopsy samples prepared using histochemistry, the amount of fiber type IIa increased, and a trend towards a decrease in IIx in the RET group reflected a change to a more oxidative profile in terms of fiber composition. Western blot (to determine the protein content related to the signaling for muscle protein synthesis) showed a rise of 69% in both Akt and mTOR in the RET group; this also showed an increase in mitochondrial proteins for OXPHOS complex II and citrate synthase (both ~30%) and for complex IV (90%), in only the RET group. We demonstrate that this type of progressive resistance training offers various improvements (e.g., strength, power, aerobic capacity, glucose tolerance, and plasma lipid profile).

The effect of short-term resistance training on elderly people was investigated through the simultaneous use of several methods. Compared to a control group, many improvements were seen, including on muscle aerobic capacity, glucose tolerance, strength, power, and muscle quality (i.e., protein involved in cell signaling and muscle fiber type composition).

通过长期进步力量训练提高力量，力量，肌肉有氧能力和葡萄糖耐量

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in ...

In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue

The tongue is a highly innervated and vascularized muscle hydrostat on the floor of the mouth of most vertebrates. Its primary functions include supporting mastication and deglutition, as well as taste-sensing and phonetics. Accordingly, the strength and volume of the tongue can impact the ability of vertebrates to accomplish basic activities such as feeding, communicating, and breathing. Human patients with sleep apnea have enlarged tongues, characterized by reduced muscle tone and increased intramuscular fat that can be visualized and quantified by magnetic resonance imaging (MRI). The abilities to measure force generation and viscoelastic properties of the tongue constitute important tools for obtaining functional information to correlate with imaging data. Here, we present techniques for measuring tongue force production in anesthetized Zucker rats via electrical stimulation of the hypoglossal nerves and for determining the viscoelastic properties of the tongue by applying passive Lissajous force/deformation curves.

In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue

We describe a surgical procedure in an anesthetized rat model for determining the muscle tone and viscoelastic properties of the tongue. The procedure involves specific stimulation of the hypoglossal nerves and application of passive Lissajous force/deformation curves to the muscle.

大鼠舌的机械和粘弹性的体内评估

The tongue is a highly innervated and vascularized muscle hydrostat on the floor of the mouth of most vertebrates. Its primary functions include ...

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 ...