The case: a top ranking elite football player was re-injured during the national championship game in one of the top European leagues. Re-injury occurred 2 weeks after the initial injury. The player was immediately pulled from the game and a diagnosis was made: Grade I muscle injury on the myotendinous junction of the long head of the left biceps femoris associated with an interfascial hematoma between the long and short heads of the biceps femoris. The situation was even more critical as the re-injury happened in April, at the end of National and European league and before National Championships.

TMG measurement was utilized three times during the therapy to monitor therapy effectiveness as well as to provide the feedback information to optimize it. For the analysis, the measurements of both left (injured) and right biceps femoris muscles were taken 4, 10 and 16 days after the injury. On day 4 TMG measurements alone confirmed the clinical evaluation and ultrasound diagnostics, while on day 10, when the clinical evaluation and ultrasound diagnostics were negative, they showed a 27% asymmetry which could lead to re-injury. Based on TMG findings the club kept the player off the field and prescribed targeted activation exercises for the injured muscle. The player returned to field on day 16 when TMG measurements showed that the asymmetry was reduced to 12%.
As a result of TMG measurements that demonstrated the need for targeted activation exercises the player was able to participate in a National championship game without re-injury.

You can download full application notes on the following link.

During a very successful TMG workshop the renowned sports medicine specialist Dr. Massimo Manara, presented the benefits of TMG in the field of injury prevention. Formerly with AC Milan and the Aspetar Clinic in Doha-Qatar, Dr. Manara is a moderator and speaker at many conferences and a contributor to several publications.

For TMG the Isokinetic Summit was a resounding success, the four TMG representatives being kept very busy with the many professional enquiries from numerous international delegates.

We were pleased to welcome to our Head Office, Masaki Ishihara, International Operations Director of Inter Reha Co., Ltd. Tokyo and Naoya Tsunoda, Ph.D., Professor of Biodynamics and Human Performance at Kokushan University, Tokyo.

Plans for the introduction of Tensiomyography to the academic and practitioner communities in Japan were agreed upon with focus on a forthcoming major seminar for Physical Medicine Professionals. Hosted by Prof. Tsunoda, the seminar will be held in Tokyo in October 2014 and is expected to attract in excess of 250 attendees.

Following successful meetings in Ljubljana our Japanese partners accompanied us to the Isokinetic Summit in Milan, Italy.

Our latest version of software has been upgraded and In order to ensure your smooth transition to a new version of TMG software, we provide a free of charge software upgrade through our web based upgrade service. Please contact our technical support team on customer-support@tmg.si or +386 838 77530 to secure the upgrade of your software.

Today, there is an innovative muscle diagnostic technique that is simple, fast and non invasive and can add accurate objective muscle measurements to the often difficult diagnostic process.
Musculoskeletal diagnosis is frequently made on the basis of patient history and physical examination sometimes complemented with imaging (US, MRI…).

Tensiomyography (TMG) is method for measuring biomechanical properties of skeletal muscle. It is an objective accurate and non-invasive process used to measure and monitor radial muscle belly displacement under isometric conditions.

Radial muscle belly displacement is of major importance since changes in the radial distance between the actin and myosin filaments, the filament lattice spacing, are responsible for between 20% and 50% of the change in force. Thus, lattice spacing is a significant force regulator, increasing the slope of a muscle’s force–length dependence.

Musculoskeletal disorders (MSD) are one of the biggest contributors to activity “time out” whether the activity be sport, work or leisure. The cost of musculoskeletal disorders can reach 3, 4% of gross domestic product and in the UK alone 11.6 million working days a year are lost to MSD. The key question concerning MSD is, do we have enough relevant information about skeletal muscles, to be able to better diagnose and manage MSD? The aim of these application notes is to highlight Tensiomyography as an eminently suitable diagnostic aid that can be used in order to ascertain individual’s critical data in order to facilitate treatment of or with preventive treatment, avoid MSD.

Changing of activation pattern of the muscle contraction(detected on TMG signal) can be important element for early diagnostic of MSD. since information on muscle fiber type and composition is of great importance in muscle physiology.

A displacement sensor is positioned perpendicularly to the tangential plane on the largest area above the muscle belly. The muscle belly displacement (enlargement) during contraction is measured and recorded. Muscle contraction is elicited by single-twitch electrical stimulus. Two self-adhesive electrodes are placed symmetrically to the TMG sensor. The anode is placed distally and the cathode proximally, 20-50 mm from the measuring point. Bipolar ES consisted of a single DC pulse of 1 ms in duration.

The measured parameters are the maximal amplitude of the signal (Dm), the delay time from the stimulation to 10% of the maximal contraction (td), the time of contraction from 10% to 90% of the maximal contraction (tc), the time of sustained contraction from 50% contraction to 50% of the relaxation (ts) and the relaxation time from 10% relaxation to 50% relaxation (tr).
Tensiomyography has been utilized to monitor pre and post-operative muscle adaptation during the process of ACL reconstruction and rehabilitation. The results demonstrated different patterns of adaptation for each of the skeletal muscles used to ensure knee joint stability. It is very important to have selective information about skeletal muscles when evaluating MSD, since it is necessary to understand the alteration of skeletal muscle contraction pattern due to pain. It is proposed that motor control changes in patients are functional in that they enhance muscle stability.
With Tensiomyography critical information can be obtained through a non-invasive method, without any effort on the part of the subject. It enables optimization of rehabilitation through precise definition of appropriate load and intensity of work, or to detect local muscle fatigue as a changed ability to activate muscle fibers. Moreover, the muscle properties can be controlled to detect any change in the muscle due to a recent injury or an inadequate amount of work, demonstrated as local muscle fatigue. (For example the level of muscle strain can be detected during a very short procedure. )This information can be of great value in managing postoperative recovery or rehabilitation medicine.

To conclude, Tensiomyography is a non-invasive, selective, functional, muscle diagnostic method that has very high repeatability. Tensiomyography can provide accurate objective muscle measurements to the often difficult diagnostic process. Furthermore Tensiomyography can contribute to the optimization of rehabilitation and physical recovery of patients/athletes.

The Technological and Higher Education Institute of Hong Kong and the National Institute of Education of Nanyang Technological University in Singapore, have purchased TMG systems. We have already visited them to provide training and look forward to our future research cooperation.

The Institute for Sports Medicine of Azerbaijan has recently purchased two TMG 100 System to facilitate Diagnostics and Rehabilitation. In 2015, Baku, Azerbaijan will host the First European Games, and TMG technology will play important role in the preparation of their sportsmen and women.

Congratulations to Vesna Fabjan, our Slovenian cross country skier who finished 3rd yesterday in the individual sprint event at the Sochi Winter Olympic Games in Sochi. We have been cooperating with Vesna in the field of muscle diagnostics and training optimization during her preparations for Sochi and are proud to have contributed to her success. She will bring home Slovenia’s 1st Bronze medal and second medal overall for Slovenia of these Games. We’re confident more medals from the Slovenian team will follow. Congratulations also to Peter Prevc for Silver in ski jumping, Teja Gregorin for Bronze in the biathlon and Tina Maze for Gold in downhill.

The Isokinetic Football Medicine Strategies Conference and Football Sciences Summit are specifically designed for the specialists in injury prevention who are daily dealing with training and competitive football. On Saturday 22nd of March, we will hold our workshop entitled “Upgrade clinical evaluation of joint injuries with selective functional muscle diagnostics”. The workshop will be led by Dr. Massimo Manara, specialist in sports medicine, who has been working with many renowned footballers in Parma F.C., Spezia Calcio, Aspetar and with the Qatar National Football Team. You can find more information on the summit website.

On the basis of extensive research work for the last couple of months we are now honored to provide new services in the field of knee assessment, low back evaluation and force transmission through joins. The research work was conducted by renown experts in the field of physiotherapy and data analysis, Stef Harley . His work has been financed by European Social Fund and Slovenian Ministry of Economic Development and Technology

KNEE FUNCTIONAL SYMMETRY ASSESSMENT

THE METHOD
Upper legs consist of two opposing or antagonistic muscle groups – hamstrings and quadriceps. Together they move knee and hip joints and stabilize the knee. The knee is designed to work with everything working in perfect harmony, but when muscle balance is disrupted, undue stress is placed on the joint. In most sports hamstrings tend to be underdeveloped and weaker than quadriceps.

CONSEQUENCES OF BAD FUNCTIONAL KNEE SYMMETRY:

• Increased risk for an injury
• Hamstring tear
• ACL damage
• Cartilage damage
• Lower movement efficiency
• Lower movement economy

ANATOMY AND FUNCTION
The biceps femoris, semitendinosus and semimembranosus muscles make up the hamstrings and are located on the back of the thigh. Front thigh muscles, or quadriceps, are the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Hamstrings extend the hip and flex the knee, whereas the quadricepses flex the hip and extend the knee. Both muscle groups stabilize the knee, especially during dynamic activities.

MEASUREMENT
TMG 100 system is used for assessment of Vastus medialis (VM), Vastus lateralis (VL), Rectus femoris (RF) and Biceps femoris (BF) contractile properties.

 

LOW BACK MUSCLES FUNCTIONALITY EVALUATION

THE METHOD
Muscle functionality is defined as combination of of left and right muscle (erector spinae) symmetry, amplitude of muscle response and muscle fatigue. With this measurement we evaluate symmetry (contraction time, relaxation time), amplitude (displacement) and fatique of erector spinae muscles.

HOW IT WORKS?

1. MEASUREMENT
Measurement accurately measure muscle contraction time, relaxation time and displacement that are indicators for symmetry and fatigue.

2. ANALYSIS
Muscle response is compared to muscle on the other side (left-right) and to reference response. We observe if the measured muscle is within acceptable range of reference values.

3. INTERVENTION
Every measured parameter is indicator for different type of muscle properties. With this measurement we can predict and estimate long and short term low back problems as hernia, spondylolysis, spondylolisthesis, etc.

 

FORCE TRANSMISSION THROUGH KNEE JOINT

THE METHOD
Mechanical properties of the Muscle-tendon complex (MTC) are an important element of human performance study. We measure vastus medialis, vastus lateralis, quadriceps tendon and patellar tendon during squatting.

HOW IT WORKS?

1. MEASUREMENT
We accurately measure force transmitted through knee joint with tension of quadriceps muscles, quadriceps and patellar tendon in squatting.

2. ANALYSIS
Using muscle contraction (MC) method and sensor in our measurement, we focus on force transmission from the quadriceps muscles and tendon to the patellar tendon and ensuing reaction force transmitted to the tibia. We measure knee torque and compare it to MC signals.

3. INTERVENTION
A primary aim in training and rehabilitation is gaining balanced and simultaneous muscle and tendon adaptation.

BENEFITS
•Fast and user-friendly
•Noninvasive
•Highly repeatable
•Objective
•Immediate display of results