Maladies neuro-musculaires

Le 01/12/2022 de 09:00 à 10:30

Retour Session


Quantification des effets tissulaires et fonctionnels d'un entraînement physique chez les patients atteints de Dystrophie facio scapulo humérale.

Camille Noël (Marseille, France), Constance Michel (Marseille, France), Amira Trabelsi (Marseille, France), Sébastien Vansteenkiste (Marseille, France), Emmanuelle Salort-Campana (Marseille, France), Maëva Cotinat (Marseille, France), Virginie de Milhe (Marseille, France), Laurent Bensoussan (Marseille, France), Shahram Attarian (Marseille, France), David Bendahan (Marseille, France)

Objective : Facio-scapulo-humeral muscular dystrophy (FSHD) is a progressive and asymmetric genetic myopathy. The only interventional option is rehabilitation.
The aim of this study was to quantitatively assess the effects of a personalized rehabilitation strategy using MRI. Fatty infiltration and contractile volume were quantified over time.

Material / Patients and Methods : Quantitative MRI of both thighs and calves was performed in 10 FSDH patients before and after a 8-week rehabilitation program composed of 20 sessions. Each session included aerobic exercice, strength training, balneotherapy and ergotherapy. Intervention effects were analyzed on the basis of clinical and radiological parameters. Clinical parameters were peak oxygen uptake, knee flexors and extensors isokinetic strength, 6-minute ans 10 meters  walk tests, functional, neurological and psychological tests. Fat infiltration and contractile volume of individual muscles were quantified and potential correlations with strength were analyzed.

Results : Fat fraction did not significantly change with a 0.67% decrease in thigh muscles and a 0.14% decrease in leg muscles. Contractile volume did not significantly change over time (-0.74cm3 in thigh and -2.59 cm3 in leg muscles). A significant improvement of clinical parameters such as walk tests, strength, mood was observed. Contractile Volume and Fat Fraction were significantly correlated to knee flexors and extensors strength (R2 from 0.5 to 0.89 and from 0.44 to 0.80).

Discussion - Conclusion : The stability of fat fraction and muscle volumes together with the improved clinical parameters can be considered as positive outcomes of the rehabilitation strategy. Correlations between fat fraction and isokinetic strength indicated that fat fraction could be a useful biomarker of clinical evolution in FSHD.

Keywords :  Muscle MRI, Fat fraction, Contractile Muscle Volume, Rehabilitation