Effect of arterial flow on muscle atrophy_Journal of Biomedical Engineering

Authors：

HE Sili ^1,2 ,  JIANG Wentao ^1,2 , DONG Ruiqi ^1,2 , YAN Fei ^1,2 , XU Zhi ^1,2 , FAN Yubo ^3,4

1. Department of Mechanics & Engineering, College of Architecture and Environment, Sichuan University, Chengdu 610065, P.R.China;
2. Sichuan Province Biomechanical Engineering Laboratory, Sichuan University, Chengdu 610065, P.R.China;
3. National Research Center for Rehabilitation Technical Aids, Beijing 100176, P.R.China;
4. Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P.R.China;

Corresponding author：

JIANG Wentao, Email: scubme@aliyun.com

Keywords：

residual limb; hemodynamics; artery; muscle atrophy; numerical simulation

DOI：

10.7507/1001-5515.201801032

Video：

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This study analyzed the inherent relation between arterial blood mass flow and muscle atrophy of residual limb to provide some necessary information and theoretical support for the clinical rehabilitation of lower limb amputees. Three-dimensional arterial model reconstruction was performed on both intact side and residual limb of a unilateral transfemoral amputee who is the subject. Then hemodynamic calculation was carried out to comparatively analyze the mass flow state at each arterial outlet of both lower extremities. The muscle atrophy ratio of residual limb was calculated by measuring the cross-sectional area of bilateral muscles. Based on the blood supply relationship, the correlation between arterial blood flow reduction ratio and muscle atrophy ratio was discussed. The results showed that the mass flow of superficial femoral arteries and lateral circumflex femoral arteries severely reduced. Meanwhile rectus femoris, vastus lateralis and vastus medialis which were fed by these arteries showed great atrophy too. On the contrary, the mass flow of deep femoral arteries and medial femoral circumflex arteries slightly reduced. Meanwhile gracilis, adductor longus, long head of biceps which were fed by these arteries showed mild atrophy too. These results indicated that there might be a positive and promotion correlation between the muscle atrophy ratio and the blood mass flow reduction ratio of residual limb during rehabilitation.

Citation： HE Sili, JIANG Wentao, DONG Ruiqi, YAN Fei, XU Zhi, FAN Yubo. Effect of arterial flow on muscle atrophy. Journal of Biomedical Engineering, 2019, 36(1): 68-72, 79. doi: 10.7507/1001-5515.201801032 Copy

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2.	Portnoy S, Siev-Ner I, Shabshin N, et al. Patient-specific analyses of deep tissue loads post transtibial amputation in residual limbs of multiple prosthetic users. J Biomech, 2009, 42(16): 2686-2693.
3.	Lyon C C, Kulkarni J, Zimerson E, et al. Skin disorders in amputees. J Am Acad Dermatol, 2000, 42(3): 501-507.
4.	Sanders J E, Garbini J L, Leschen J M, et al. A bidirectional load applicator for the investigation of skin response to mechanical stress. IEEE Trans Biomed Eng, 1997, 44(4): 290-296.
5.	Guzman R J, Brinkley D M, Schumacher P M, et al. Tibial artery calcification as a marker of amputation risk in patients with peripheral arterial disease. J Am Coll Cardiol, 2008, 51(20): 1967-1974.
6.	Bemben D A, Sherk V D, Ertl W J J, et al. Acute bone changes after lower limb amputation resulting from traumatic injury. Osteoporosis International, 2017, 28(7): 2177-2186.
7.	Isakov E, Burger H, Gregorič M, et al. Isokinetic and isometric strength of the thigh muscles in below-knee amputees. Clinical Biomechanics, 1996, 11(4): 232-235.
8.	Dong Ruiqi, Li Xiaolong, Yan Fei, et al. The spatial structure changes of thigh arterial trees after transfemoral amputation: case studies. Journal of Medical Imaging and Health Informatics, 2016, 6(3): 688-692.
9.	Dong Ruiqi, Jiang Wentao, Zhang Ming, et al. Review: hemodynamic studies for lower limb amputation and rehabilitation. Journal of Mechanics in Medicine & Biology, 2015, 15(4): 1530005(1)-1530005(20).
10.	Yan Fei, Jiang Wentao, Dong Ruiqi, et al. Blood flow and oxygen transport in descending branch of lateral femoral circumflex arteries after transfemoral amputation: a numerical study. J Med Biol Eng, 2017, 37(1): 63-73.
11.	董瑞琪. 膝上截肢术后大腿肌肉与动脉形态学及血流动力学研究. 成都: 四川大学, 2017.
12.	李焕珍, 曾士(四干). 断手残肢者康复护理初步体会. 中国康复医学杂志, 1986(4).
13.	谭宏昌, 彭智. 截肢病人残端综合征的康复治疗. 现代康复, 2000, 4(3): 384-385.

1. Fraisse N, Martinet N, Kpadonou T J, et al. Muscles of the below-knee amputees. Annales De Réadaptation Et De Médecine Physique, 2008, 51(3): 218-227.
2. Portnoy S, Siev-Ner I, Shabshin N, et al. Patient-specific analyses of deep tissue loads post transtibial amputation in residual limbs of multiple prosthetic users. J Biomech, 2009, 42(16): 2686-2693.
3. Lyon C C, Kulkarni J, Zimerson E, et al. Skin disorders in amputees. J Am Acad Dermatol, 2000, 42(3): 501-507.
4. Sanders J E, Garbini J L, Leschen J M, et al. A bidirectional load applicator for the investigation of skin response to mechanical stress. IEEE Trans Biomed Eng, 1997, 44(4): 290-296.
5. Guzman R J, Brinkley D M, Schumacher P M, et al. Tibial artery calcification as a marker of amputation risk in patients with peripheral arterial disease. J Am Coll Cardiol, 2008, 51(20): 1967-1974.
6. Bemben D A, Sherk V D, Ertl W J J, et al. Acute bone changes after lower limb amputation resulting from traumatic injury. Osteoporosis International, 2017, 28(7): 2177-2186.
7. Isakov E, Burger H, Gregorič M, et al. Isokinetic and isometric strength of the thigh muscles in below-knee amputees. Clinical Biomechanics, 1996, 11(4): 232-235.
8. Dong Ruiqi, Li Xiaolong, Yan Fei, et al. The spatial structure changes of thigh arterial trees after transfemoral amputation: case studies. Journal of Medical Imaging and Health Informatics, 2016, 6(3): 688-692.
9. Dong Ruiqi, Jiang Wentao, Zhang Ming, et al. Review: hemodynamic studies for lower limb amputation and rehabilitation. Journal of Mechanics in Medicine & Biology, 2015, 15(4): 1530005(1)-1530005(20).
10. Yan Fei, Jiang Wentao, Dong Ruiqi, et al. Blood flow and oxygen transport in descending branch of lateral femoral circumflex arteries after transfemoral amputation: a numerical study. J Med Biol Eng, 2017, 37(1): 63-73.
11. 董瑞琪. 膝上截肢术后大腿肌肉与动脉形态学及血流动力学研究. 成都: 四川大学, 2017.
12. 李焕珍, 曾士(四干). 断手残肢者康复护理初步体会. 中国康复医学杂志, 1986(4).
13. 谭宏昌, 彭智. 截肢病人残端综合征的康复治疗. 现代康复, 2000, 4(3): 384-385.

Journal of Biomedical Engineering

Effect of arterial flow on muscle atrophy

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