Muscle Architecture of Lower Extremity In Multiple Sclerosis

The aim of this study was to determine the muscle architecture of the lower extremity muscles (pennation angle, muscle fiber length and muscle thickness) in patients with multiple sclerosis. Lower extremity muscles of patients with multiple sclerosis and healthy individuals; rectus femoris, biceps femoris, tibialis anterior, gastrosoleus and gastrocnemius muscles will be examined by ultrasound method.

Study Overview

• Status: Completed
• Conditions: Multiple Sclerosis

Detailed Description

Multiple sclerosis (MS) is characterised by complex and heterogeneous symptoms, often leading to reduced quality of life and impaired functional capacity. The latter is related to reduced muscle strength of predominately the lower limbs . The mechanisms underlying the observed strength deficits are of muscular as well as neural origin . At the whole muscle level, a number of studies have examined skeletal muscle characteristics of MS patients, with some studies but not all, reporting loss of muscle mass and decreased or comparable maximal muscle strength.

However, there is no study describing the features of lower extremity muscle architecture in multiple sclerosis. Muscle architecture is defined as the alignment of muscle fibers with respect to the axis of force. Although the diameters of the muscles of different sizes are quite similar to the diameters of the fibers, the sequences of these fibers contain several differences. The alignment of the muscle forming fibers has a significant effect on the force of muscle formation. The parameters that determine muscle architecture characteristics are the muscle fiber length, pennation angle, the physiological cross-sectional area. For each muscle these parameters may differ from each other. Any type of load in the case is the result of an adaptation process that results in muscle development. Muscle architecture allows the macroscopic understanding and interpretation of this adaptation process.

Determining the muscle architecture of multiple sclerosis patients by ultrasound will guide the rehabilitation process.

• Study Type: Observational
• Enrollment (Actual): 35

Contacts and Locations

Study Locations

• Turkey
  • Gaziantep, Turkey
    • SANKO University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Study Population consists of Multiple Sclerosis Patients and Healthy Volunteers.

Description

Inclusion Criteria:

• 18-50 years old
• Individuals who agree to be voluntary,
• With the EDSS 4 and below
• Without pregnancy
• Do not receive corticosteroid treatment in the last month
• Do not take any medicine that will affect walking in the last 1 month

Exclusion Criteria:

• Those who refuse to volunteer,
• EDSS over 4
• Pregnancy
• Corticosteroid therapy within 1 month
• Any medication that will affect walking in the last 1 month

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Architecture Pennation Angle	Pennation Angle will be assesed by ultrasound imaging.	The evaluation will be made on the first 1 day.
Muscle Architecture Muscle Fiber Lengh	Muscle Fiber Lenght will be assesed by ultrasound imaging.	The evaluation will be made on the first 1 day.
Muscle Architecture Muscle Thickness	Muscle Thickness will be assesed by ultrasound imaging.	The evaluation will be made on the first 1 day.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Strength	Ouadriceps, Hamstring, Gastrosoleus and Gastrocnemius muscle Strenght will be asses with digital hand-held dynamometer (Commander PowerTrack II muscle tester).	The evaluation will be made on the first 1 day.
Circumference Measurement of Thigh	Thigh circumference will be measured with a tape measure. Thigh circumference measurement will be measured from the midline of the inguinal line and superior patella.	The evaluation will be made on the first 1 day.
Circumference Measurement of shin	Shin circumference will be measured with a tape measure.Shin circumference measurement will be measured from the poplital line and the middle point of the achilles.	The evaluation will be made on the first 1 day.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Thickness of subcutaneous fat from anterior thigh	Subcutaneous fat will be assesed with skinfold from anterior thigh. At the same time the thickness of subcutaneous fat will also be evaluated by ultrasound imaging.	The evaluation will be made on the first 1 day.
Thickness of subcutaneous fat from posterior leg	Subcutaneous fat will be assesed with skinfold from posterior leg. At the same time the thickness of subcutaneous fat will also be evaluated by ultrasound imaging.	The evaluation will be made on the first 1 day.

Collaborators and Investigators

• Sponsor: Sanko University

Publications and helpful links

General Publications

• Wens I, Dalgas U, Vandenabeele F, Krekels M, Grevendonk L, Eijnde BO. Multiple sclerosis affects skeletal muscle characteristics. PLoS One. 2014 Sep 29;9(9):e108158. doi: 10.1371/journal.pone.0108158. eCollection 2014.
• Kirmaci ZIK, Firat T, Ozkur HA, Neyal AM, Neyal A, Ergun N. Muscle architecture and its relationship with lower extremity muscle strength in multiple sclerosis. Acta Neurol Belg. 2022 Dec;122(6):1521-1528. doi: 10.1007/s13760-021-01768-1. Epub 2021 Aug 20.

Helpful Links

• Multiple Sclerosis and Skeletal Muscle

Study record dates

Study Major Dates

• Study Start (ACTUAL): December 18, 2018
• Primary Completion (ACTUAL): January 18, 2020
• Study Completion (ACTUAL): February 15, 2020

Study Registration Dates

• First Submitted: December 4, 2018
• First Submitted That Met QC Criteria: December 5, 2018
• First Posted (ACTUAL): December 6, 2018

Study Record Updates

• Last Update Posted (ACTUAL): March 18, 2020
• Last Update Submitted That Met QC Criteria: March 17, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: Multiple Sclerosis; Lower extremity; Muscle Architecture
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Immune System Diseases; Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Autoimmune Diseases; Multiple Sclerosis; Sclerosis
• Other Study ID Numbers: SankoUniversity

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Sharing of data information has not yet been decided.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No