title: Lower-extremity muscle cross-sectional area after incomplete spinal cord injury.
abstract: OBJECTIVE
  (1) To quantify skeletal muscle size in lower-extremity muscles of people after incomplete spinal cord injury (SCI), (2) to assess differences in muscle size between involved lower limbs, (3) to determine the impact of ambulatory status (using wheelchair for community mobility vs not using a wheelchair for community mobility) on muscle size after incomplete SCI, and (4) to determine if differential atrophy occurs among individual muscles after incomplete SCI.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  University research setting.
  
  
  METHODS
  Seventeen people with incomplete SCI and 17 age-, sex-, weight-, and height-matched noninjured controls.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Maximum cross-sectional area (CSA) of individual lower-extremity muscles (soleus, medial gastrocnemius, lateral gastrocnemius, tibialis anterior, quadriceps femoris, hamstrings) as assessed by magnetic resonance imaging.
  
  
  RESULTS
  Overall, subjects with incomplete SCI had significantly smaller (24%-31%) average muscle CSA in affected lower-extremity muscles as compared with control subjects (P<.05). Mean differences were highest in the thigh muscles ( approximately 31%) compared with the lower-leg muscles ( approximately 25%). No differences were noted between the self-reported more- and less-involved limbs within the incomplete SCI group. Dichotomizing the incomplete SCI group showed significantly lower muscle CSA values in both the wheelchair (range, 21%-39%) and nonwheelchair groups (range, 24%-38%). In addition, the wheelchair group exhibited significantly greater plantarflexor muscle atrophy compared with the dorsiflexors, with maximum atrophy in the medial gastrocnemius muscle (39%).
  
  
  CONCLUSIONS
  Our results suggest marked and differential atrophic response of the affected lower-extremity muscles that is seemingly affected by ambulatory status in people with incomplete SCI.
authors.affiliation: Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA.
authors.forename: Prithvi K
authors.initials: PK
authors.lastname: Shah
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Stevens
authors.forename: Chris M
authors.initials: CM
authors.lastname: Gregory
authors.forename: Neeti C
authors.initials: NC
authors.lastname: Pathare
authors.forename: Arun
authors.initials: A
authors.lastname: Jayaraman
authors.forename: Scott C
authors.initials: SC
authors.lastname: Bickel
authors.forename: Mark
authors.initials: M
authors.lastname: Bowden
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Behrman
authors.forename: Glenn A
authors.initials: GA
authors.lastname: Walter
authors.forename: Gary A
authors.initials: GA
authors.lastname: Dudley
authors.forename: Krista
authors.initials: K
authors.lastname: Vandenborne
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology*; D009133:Muscular Atrophy / Q000175:diagnosis*; D013119:Spinal Cord Injuries / Q000473:pathology*; D018709:Statistics, Nonparametric