PubMed · 144779
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J Jezequel, B Becuwe. 1977. [Proximal pediculate flaps].. https://pubmed.ncbi.nlm.nih.gov/144779/
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1. In order to explain the task-dependent activation of muscles, we have investigated the hypothesis that mono- and bi-articular muscles have a different functional role in the control of multijoint movements. According to this hypothesis, bi-articular muscles are activated in a way to control the direction of external force. The mono-articular muscles are thought to be activated to contribute to joint torque mainly during shortening movements. 2. To investigate this hypothesis, surface electromyographic (EMG) recordings were obtained from several mono- and bi-articular arm muscles during voluntary slow movements of the wrist in a horizontal plane against an external force. The direction of force produced at the wrist and the direction of movement of the wrist were varied independently. 3. The results revealed distinct differences between the activation patterns of mono- and bi-articular muscles. The activation of the bi-articular muscles was not affected by movement direction, but appeared to vary exclusively with the direction of force. 4. The mono-articular muscles showed significantly more EMG activity for movements in a specific direction, which equalled the movement direction corresponding to the largest shortening velocity of the muscle. The EMG activity decreased gradually for movements in other directions. This direction-dependent activation appeared to be independent of the direction of the external force.
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Reflex sympathetic dystrophy, (RSD) is a complex physiologic response of the body to an external stimulus resulting in sympathetically mediated, usually nonanatomic pain, which is out of proportion to the inciting event or expected healing response. This complex entity has been the focus of much investigation, leading however to somewhat confusing and conflicting results and theories about the etiology and pathophysiology. There is even significant conflict about what characteristics define the clinical entity called RSD, and if these characteristics vary with the specific site of involvement. We have examined the current literature regarding these fundamental conflicts, and in addition we have evaluated the current controversies surrounding the role of Three Phase Radionuclide Bone Imaging (TPBI) for diagnosis, prognosis, and patient management. These controversies include the role of scintigraphy, the various criteria for scintigraphic diagnosis, and the reported variations in sensitivity and specificity of TPBI in RSD. We have examined several factors that may have affected these results, and potentially underestimated the value of scintigraphy in the diagnosis of RSD. In addition to the heterogeneous patient populations used to establish the diagnosis by different subspecialty physicians, these factors include duration of patient's symptoms, age of the patient population evaluated, location of the disease, and the varying scintigraphic scan interpretation criteria used.