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1
المصدر: The Journal of Bone & Joint Surgery. 79:844-9
مصطلحات موضوعية: medicine.medical_specialty, Time Factors, Muscle Relaxation, Rest, Physical Exertion, Ischemia, Physical exercise, Compartment Syndromes, Hemoglobins, Oxygen Consumption, Millimeter of mercury, Pressure, medicine, Humans, Orthopedics and Sports Medicine, Muscle, Skeletal, Compartment (pharmacokinetics), Chronic exertional compartment syndrome, Leg, Spectroscopy, Near-Infrared, Myoglobin, business.industry, Vascular disease, General Medicine, Oxygenation, Tourniquets, medicine.disease, Surgery, Anterior Compartment Syndrome, Case-Control Studies, Anesthesia, Chronic Disease, business, Muscle Contraction
الوصف: Currently, the definitive diagnosis of chronic compartment syndrome is based on invasive measurements of intracompartmental pressure. We measured the intramuscular pressure and the relative oxygenation in the anterior compartment of the leg in eighteen patients who were suspected of having chronic compartment syndrome as well as in ten control subjects before, during, and after exercise. Chronic compartment syndrome was considered to be present if the intramuscular pressure was at least fifteen millimeters of mercury (2.00 kilopascals) before exercise, at least thirty millimeters of mercury (4.00 kilopascals) one minute after exercise, or at least twenty millimeters of mercury (2.67 kilopascals) five minutes after exercise. Changes in relative oxygenation were measured with use of the non-invasive method of near-infrared spectroscopy. In all patients and subjects, there was rapid relative deoxygenation after the initiation of exercise, the level of oxygenation remained relatively stable during continued exercise, and there was reoxygenation to a level that exceeded the pre-exercise resting level after the cessation of exercise. During exercise, maximum relative deoxygenation in the patients who had chronic compartment syndrome (mean relative deoxygenation [and standard error], -290 +/- 39 millivolts) was significantly greater than that in the patients who did not have chronic compartment syndrome (-190 +/- 10 millivolts) and that in the control subjects (-179 +/- 14 millivolts) (p < 0.05 for both comparisons). In addition, the interval between the cessation of exercise and the recovery of the pre-exercise resting level of oxygenation was significantly longer for the patients who had chronic compartment syndrome (184 +/- 54 seconds) than for the patients who did not have chronic compartment syndrome (39 +/- 19 seconds) and the control subjects (33 +/- 10 seconds) (p < 0.05 for both comparisons).
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2
المصدر: The Journal of bone and joint surgery. American volume. 79(6)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Physical Exertion, Pain, Physical exercise, Isometric exercise, Compartment Syndromes, Hemoglobins, Millimeter of mercury, Oxygen Consumption, Tibialis anterior muscle, Ischemia, Isometric Contraction, medicine, Pressure, Humans, Orthopedics and Sports Medicine, Muscle, Skeletal, Oxygen saturation (medicine), Monitoring, Physiologic, Leg, Spectroscopy, Near-Infrared, business.industry, Myoglobin, General Medicine, Oxygenation, Middle Aged, Surgery, Torque, Anesthesia, Cuff, Chronic Disease, Physical Endurance, Female, business, Muscle Contraction
الوصف: Variations in the levels of muscle hemoglobin and of myoglobin oxygen saturation can be detected non-invasively with near-infrared spectroscopy. This technique could be applied to the diagnosis of chronic compartment syndrome, in which invasive testing has shown increased intramuscular pressure associated with ischemia and pain during exercise. We simulated chronic compartment syndrome in ten healthy subjects (seven men and three women) by applying external compression, through a wide inflatable cuff, to increase the intramuscular pressure in the anterior compartment of the leg. The tissue oxygenation of the tibialis anterior muscle was measured with near-infrared spectroscopy during gradual inflation of the cuff to a pressure of forty millimeters of mercury (5.33 kilopascals) during fourteen minutes of cyclic isokinetic dorsiflexion and plantar flexion of the ankle. The subjects exercised with and without external compression. The data on tissue oxygenation for each subject then were normalized to a scale of 100 per cent (the baseline value, or the value at rest) to 0 per cent (the physiological minimum, or the level of oxygenation achieved by exercise to exhaustion during arterial occlusion of the lower extremity). With external compression, tissue oxygenation declined at a rate of 1.4 +/- 0.3 per cent per minute (mean and standard error) during exercise. After an initial decrease at the onset, tissue oxygenation did not decline during exercise without compression. The recovery of tissue oxygenation after exercise was twice as slow with compression (2.5 +/- 0.6 minutes) than it was without the use of compression (1.3 +/- 0.2 minutes).
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3
المصدر: The American journal of sports medicine. 18(1)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Pain, Physical Therapy, Sports Therapy and Rehabilitation, Physical examination, Compartment Syndromes, 03 medical and health sciences, 0302 clinical medicine, Pressure, Medicine, Humans, Orthopedics and Sports Medicine, Compartment (pharmacokinetics), Chronic exertional compartment syndrome, Exercise, Aged, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, Leg, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Muscles, Retrospective cohort study, 030229 sport sciences, Middle Aged, medicine.disease, Surgery, Anterior Compartment Syndrome, Catheter, Chronic Disease, Female, business
الوصف: One hundred fifty-nine patients were referred to the authors for evaluation of chronic exertional leg pain from 1978 to 1987. The records of 131 patients were complete and available for retrospective review. Forty-five patients were diagnosed as having a chronic compartment syndrome (CCS) and seventy-five patients had the syndrome ruled out by intramuscular pressure recordings. The only significant difference found between the two groups on history and physical examination was a 45.9% incidence of muscle herniae in the patients with CCS, compared to a 12.9% incidence in those without the syndrome. One-third of the patients with the syndrome and over one-half of those without it reported persistent, moderate to severe pain at 6 month to 9 year followup. Modified, objective criteria were developed for the diagnosis of CCS. The criteria were based upon the intramuscular pressures recorded with the slit catheter before and after exercise in 210 muscle compartments without CCS. In the presence of appropriate clinical findings, we consider one or more of the following intramuscular pressure criteria to be diagnostic of chronic compartment syndrome of the leg: 1) a preexercise pressure greater than or equal to 15 mm Hg, 2) a 1 minute postexercise pressure of greater than or equal to 30 mm Hg, or 3) a 5 minute postexercise pressure greater than or equal to 20 mm Hg.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ce9ff45cce0b38247dd677b89a69471f
https://pubmed.ncbi.nlm.nih.gov/2301689
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