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- Oskarsson, Eva, 1959-
(författare)
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Lateral epicondylitis : intramuscular blood flow, pressure and metabolism in the ECRB muscle
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lateral epicondylitis is classified as an overuse injury and the main symptom is pain from the lateral side of the elbow. There is general agreement that the extensor carpi radialis brevis (ECRB) muscle and its proximal tendon play a central role in the development of lateral epicondylitis. However, the pathophysiology is to a large extent unclear. The aim of the thesis was to investigate the intramuscular blood flow, the muscle metabolism as well as the vascular reactivity and the intramuscular pressure (IMP). Patients having chronic unilateral epicondylitis were investigated, with the unaffected arm serving as a control. Measurements were performed during rest, before and 3 and 12 months after an injection of botulinum toxin type A to cause relaxation of the muscle as well as after muscle contraction and occlusion of blood flow. Initial intramuscular blood flow in the affected ECRB was lower compared with the unaffected muscle and anaerobic metabolism was recorded. The difference in intramuscular blood flow between the affected and the unaffected arm was reduced after injection of botulinum toxin type A and muscle metabolism was aerobic. Perceived pain (VAS-score) was reduced and functional daily activity was improved, evaluated using the instrument Canadian Occupational Performance Measure (COMP) and the Disability of Arm, Shoulder and Hand instrument (DASH). Vascular reactivity during recovery after muscle contraction tended to be faster on the unaffected side than on the affected side. No difference in the post-occlusive reactive hyperaemia response between the affected and the unaffected ECRB was observed. The intramuscular pressure tended to be elevated in affected muscle. In conclusion, decreased microcirculation and an anaerobic metabolism in ECRB may contribute to the symptoms in chronic lateral epicondylitis, which has not previously been showed. The impaired blood flow in the affected arm does not seem to be caused by impaired vascular reactivity but may partly be due to an elevated IMP probably due to an increased tension in the affected ECRB.
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| 2. |
- Oskarsson, Eva, 1959-, et al.
(författare)
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Reduced daytime intramuscular blood flow in patients with restless legs syndrome/Willis-Ekbom disease
- 2014
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Ingår i: Psychiatry and Clinical Neurosciences. - : Wiley. - 1323-1316 .- 1440-1819. ; 68:8, s. 640-643
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to examine possible signs of impairment of the microcirculation in the lower extremities of female patients suffering from primary restless legs syndrome (RLS)/Willis-Ekbom disease.Methods: This study was performed in eight female patients, mean age 48 years (range 21-65), diagnosed with primary RLS but otherwise healthy. Eight healthy female control subjects, mean age 47 years (range 27-64), were also included in the study. Laser Doppler flowmetry was used to determine intramuscular blood flow by placing an optical single fiber in the tibialis anterior muscle belly. The studies were performed between 08.00 and 10.00 hours and 20.00 and 22.00 hours. Blood flow was expressed in perfusion units.Results: The median intramuscular blood flow in the RLS patients' tibialis anterior muscles, recorded from both legs, was significantly higher in the morning, at 17.9 perfusion units, than in the evening, at 12.1 perfusion units (P = 0.004). Corresponding values for the healthy controls were 13.1 perfusion units and 12.0 perfusion units, a non-significant difference. The relative fold changes of microcirculation in the RLS group compared to healthy age-matched controls were 0.7 +/- 0.3 and 1.1 +/- 0.6, respectively (P = 0.04).Conclusion: Our results suggest that in female patients with primary RLS, the microcirculation in the tibialis anterior muscle is higher in the morning compared with in the evening.
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| 3. |
- Folkesson, Mattias, 1972-, et al.
(författare)
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The expression of heat shock protein in human skeletal muscle : effects of muscle fibre phenotype and training background
- 2013
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Ingår i: Acta Physiologica. - : Wiley-Blackwell. - 1748-1708 .- 1748-1716. ; 209:1, s. 26-33
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Exercise-induced adaptations of skeletal muscle are related to training mode and can be muscle fibre type specific. This study aimed to investigate heat shock protein expression in type I and type II muscle fibres in resting skeletal muscle of subjects with different training backgrounds.Methods: Three groups of subjects were included: healthy active not engaged in any training programme (ACT, n = 12), resistance trained (RES, n = 6) and endurance trained (END, n = 8). Biopsies were obtained from vastus lateralis, and immunohistochemistry was performed using monoclonal antibodies against myosin heavy chain I and IIA, αB-crystallin, HSP27, HSP60 and HSP70.Results: In ACT and RES, but not in END, a fibre type–specific expression with higher staining intensity in type I than type II fibres was seen for αB-crystallin. The opposite (II > I) was found for HSP27 in subjects from ACT (6 of 12 subjects) and RES (3 of 6), whereas all subjects from END displayed uniform staining. HSP60 showed no fibre-specific expression. HSP70 displayed a fibre-specific expression pattern (I > II) in ACT (4 of 12), but not in END or RES.Conclusion: This study shows that the level of expression of the different HSPs in human skeletal muscle is influenced by muscle fibre phenotype. The fibre type–specific expression of HSP70 is influenced by resistance and endurance training, whereas those of αB-crystallin and HSP27 is influenced only by endurance training, suggesting the existence of a training-modality-specific action on the adaptive processes including heat shock proteins in human skeletal muscle.
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| 4. |
- Oskarsson, Eva, 1959-, et al.
(författare)
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Intramuscular pressure in the ECRB muscle of patients with lateral epicondylitis
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Annan publikation (populärvet., debatt m.m.)abstract
- An increased tension and a low intramuscular blood flow in the extensor carpi radialis (ECRB) muscle in patient with lateral epichondylitis has been suggested to contribute to the symptoms. The reason for the lower blood flow may be increased intramuscular pressure. The purpose of this pilot study was to determine intramuscular pressure and blood flow in affected and unaffected ECRB in ten patients with unilateral epicondylitis, with a mean duration of symptoms of 24 (13-48) months. Intramuscular pressure (IMP) was measured using the microcapillary infusion technique and intramuscular blood flow using the laser Doppler flowmetry technique, bilaterally with the non-affected arm serving as a control. The recordings were performed at rest, during isometric dorsal extension of the wrist for 1 min at 40 % and 2 min at 20 % of maximal voluntary contraction (MVC) and during recovery after contractions. At rest the median IMP was 7-8 mm Hg regardless of arm while the median intramuscular blood flow was lower on the affected side compared with the unaffected side (P=0.03). During contraction the IMP and blood flow increased regardless of arm. The IMP fell to pre-contraction level within 2 s after contraction, independent of arm and contraction force. Recovery, regarding the intramuscular blood flow, tended to be faster on the unaffected side than on the affected after contraction at 20 % MVC. After contraction at 40 % MVC the blood flow was equal on both sides. When the IMP value in the unaffected muscle was corrected for the higher force elicited compared to affected muscle the adjusted IMP was significantly lower (P=0.006) at 20 % MVC. In summary, affected ECRB has a lower intramuscular blood flow during rest and a higher intramuscular pressure in relation to the unaffected muscle at contraction for 2 min at 20 % MVC.
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| 5. |
- Oskarsson, Eva, 1959-, et al.
(författare)
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Microvascular response in the ECRB muscle of patients with lateral epicondylitis
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The microvascular response in extensor carpi radialis brevis (ECRB) muscle was studied in thirteen patients with unilateral epicondylitis. At rest the intramuscular blood flow was significantly lower in the affected arm than in the unaffected (P = 0.006). During dorsal extension for 1 min at 40% maximal voluntary contraction (MVC) and 2 min at 20% MVC, blood flow increased significantly in both arms (P = 0.02). Microcirculation remained above resting level both 1 and 2 min after contraction at 40% MVC but was back to the precontraction level 2 min after contraction at 20 % MVC. The reactive hyperaemic response after occlusion of the brachial artery for 5 min, showed no significant difference between the arms. The reason for the hampered microcirculation in ECRB at rest does not seem to be due to a decreased ability of the vessel wall to dilate. Other plausible reasons merits further investigation.
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