Alterations in Muscle Architecture: A Review of the Relevance to Individuals After Limb Salvage Surgery for Bone Sarcoma

Frontiers in Pediatrics

article

Christa M. Nelson¹  Victoria Marchese¹  Kelly Rock¹  Robert M. Henshaw²  Odessa Addison¹ 

[1] Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, United States;Department of Orthopedic Oncology, MedStar Georgetown Orthopedic Institute, United States;Department of Orthopedic Oncology, Children's National Medical Center, United States

关键词: bone sarcoma;    limb salvage surgery;    muscle architecture;    lower extremity;    muscle adaptation;    ultrasound;    physical therapy;   

DOI  :  10.3389/fped.2020.00292

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Osteosarcoma and Ewing's sarcoma are the most common primary bone malignancies affecting children and adolescents. Optimal treatment requires a combination of chemotherapy and/or radiation along with surgical removal when feasible. Advances in multiple aspects of surgical management have allowed limb salvage surgery (LSS) to supplant amputation as the most common procedure for these tumors. However, individuals may experience significant impairment after LSS, including deficits in range of motion and strength that limit function and impact participation in work, school, and the community, ultimately affecting quality of life. Muscle force and speed of contraction are important contributors to normal function during activities such as gait, stairs, and other functional tasks. Muscle architecture is the primary contributor to muscle function and adapts to various stimuli, including periods of immobilization-protected weightbearing after surgery. The impacts of LSS on muscle architecture and how adaptations may impact deficits within the rehabilitation period and into long-term survivorship is not well-studied. The purpose of this paper is to [1] provide relevant background on bone sarcomas and LSS, [2] highlight the importance of muscle architecture, its measurement, and alterations as seen in other relevant populations and [3] discuss the clinical relevance of muscle architectural changes and the impact on muscle dysfunction in this population. Understanding the changes that occur in muscle architecture and its impact on long-term impairments in bone sarcoma survivors is important in developing new rehabilitation treatments that optimize functional outcomes.

【 授权许可】

CC BY