Yonsei Med J.  2019 Sep;60(9):876-881. 10.3349/ymj.2019.60.9.876.

Architectural Changes in the Medial Gastrocnemius on Sonography after Nerve Ablation in Healthy Adults

Affiliations
  • 1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. medicus@yuhs.ac
  • 2Hafis Clinic, Seoul, Korea.

Abstract

Architectural changes in healthy muscle after denervation have not yet been reported. This study aimed to investigate architectural changes in the medial head of the gastrocnemius muscle (GCM) after aesthetic tibial nerve ablation in healthy adults using ultrasonography (US). The effects of tibial nerve ablation were verified by visual observation and surface electromyography analysis. US images of medial GCMs were taken by one trained physician using B-mode and real-time US with a linear-array probe before nerve ablation, at 1 week after nerve ablation and at 3 months after nerve ablation in an anatomic standing position with the feet about shoulder-width apart in 19 healthy adults (17 females and 2 males). Muscle thickness was significantly reduced on the left side at 1 week and 3 months after the procedure and on the right side at 3 months after the procedure (p<0.050). Although fascicle length was not significantly changed, pennation angle was significantly reduced on both sides at 3 months after the procedure (p<0.050). Muscle thickness and pennation angle of the muscle fascicle were significantly reduced, although fascicle length was not significantly changed, after tibial nerve ablation in the medial GCM of healthy adults.

Keyword

Pennation angle; fascicle length; muscle thickness; nerve ablation; ultrasonography; muscle architecture

MeSH Terms

Adult*
Denervation
Electromyography
Female
Foot
Gas Chromatography-Mass Spectrometry
Head
Humans
Muscle, Skeletal
Posture
Tibial Nerve
Ultrasonography

Figure

  • Fig. 1 Root mean square (RMS) ratio values of the medial head of the gastrocnemius muscles. X-axis indicates that one gait cycle divided into 16 equally spaced intervals.

  • Fig. 2 Time table. GCM, gastrocnemius muscle.

  • Fig. 3 Gross photos of gastrocnemius muscles (GCMs). Subjects were asked to elevate the heel to contract the GCM. (A) Gross photo taken before tibial nerve block. (B) Gross photo taken three weeks after the tibial nerve block. The size of the GCMs has decreased.

  • Fig. 4 Ultrasound image showing muscle architecture parameters measured.

  • Fig. 5 Changes in muscle architecture parameters after tibial nerve block. Changes of (A) left gastrocnemius muscle (GCM) thickness, (B) left GCM fascicle length, (C) left GCM pennation angle, (D) right GCM thickness, (E) right GCM fascicle length and (F) right GCM pennation angle. Bars indicate one standard deviation. *p<0.050 vs. baseline (post-hoc test).


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