Differences between motor point and innervation zone locations in the biceps brachii. An exploratory consideration for the treatment of spasticity with botulinum toxin |
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| Affiliation: | 1. Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo (LIBFE), Kinesiology School, Faculty of Medicine, Universidad de los Andes, Santiago, Chile;2. Centro de Estudios del Movimiento Humano, Kinesiology School, Faculty of Medicine, Universidad Mayor, Santiago, Chile;1. Department of Rehabilitation, Sagamihara Chuo Hospital, 6-4-20, Fujimi, Chuo-ku, Sagamihara, Kanagawa, Japan;2. Department of Rehabilitation, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, Japan;3. Department of Exercise Physiology and Biomechanics, Faculty of Medicine, School of Medicine, Toho University, 5-21-16, Omori-Nishi, Ota-ku, Tokyo, Japan;4. Department of Physical Therapy, Tokyo University of Technology, 5-23-22, Nishi-Kamata, Ota-ku, Tokyo, Japan;5. Department of Exercise Physiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, Japan;6. Department of Rehabilitation, School of Allied Health Science, Kitasato University, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan;1. School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia;2. Human Performance Laboratory, University of Calgary, Calgary, Alberta, Canada;1. Industrial and Management Systems Engineering, West Virginia University, PO Box 6070, Morgantown, WV 26506-6107, United States;2. Safety Sciences Department, Indiana University of Pennsylvania, 1011 South Drive, Indiana, PA 15705, United States;1. Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil;2. Faculty of Electrical Engineering, Biomedical Engineering Lab, Federal University of Uberlândia, Uberlândia, MG, Brazil |
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| Abstract: | BackgroundBotulinum toxin (BTX) acts on the neuromuscular junction which can be located by the innervation zone (IZ). Clinically, the motor point (MP) is homologous to the IZ and it is used as the injection site of BTX. Differences in the effectiveness of the application of BTX between MP and IZ locations have been determined.ObjectiveCompare the location of the MP obtained using electrical stimulation and the location of the IZ using a linear surface electrodes array on the biceps brachii muscle.MethodsThe biceps brachii muscle of twenty men was assessed. The MP was located using the torque measurement generated by electrical stimulation. The IZ was detected using a linear surface electrodes array.ResultsA difference between the MP and the IZ positions (75.8 vs. 86.5 mm, delta 10.7 mm; p = 0.003, post-hoc power 0.89) was observed.DiscussionThe magnitude of the difference between the MP and the IZ may be clinically relevant. The IZ location using surface electromyography as a guide to optimize BTX injection is proposed. |
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| Keywords: | Motor point Innervation zone Botulinum toxin Electrical stimulation Motor endplate |
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