Movement and Mobility
Evaluation of muscle function
The International Classification of Functioning, Disability and Health provides a comprehensive framework to evaluate muscle function and its impact on daily life. Holistic assessment of skeletal muscle in infants and adults include complementary methods:
-
Advanced imaging techniques, including dynamic ultrasound methods, evaluates muscle volume. Advanced ultrasound techniques, such as shear-wave elastography, enable comprehensive assessment of muscle atrophy and dysfunction in Intensive Care Unit patients, offering valuable insights into prognosis and guiding targeted rehabilitation strategies to improve recovery. Muscle length is evaluated during clinical examinations or through personalized musculoskeletal modeling (e.g., OpenSim).
-
Electroneuromyography clinically evaluates muscle control by assessing the integrity of nerve conduction and motor units.
-
Dynamic surface electromyography measures muscle activity during diverse tasks, from spontaneous movements to complex upper and lower motor tasks in children and adults, providing insight into the coordination required for smooth and complex movements.
-
Muscle force is assessed with clinical testing, dynamometry, and isokinetic devices in routine clinical evaluation for lower and upper-limbs, and also for masticatory muscles.
-
The impact of muscle deficits on specific tasks is evaluated with motion capture systems, electromyography and force plates. Kinematics and kinetics are measured to understand how muscle deficits affect walking and other movements. Additionally, the impact of muscle deficits on daily life performance and participation is evaluated using patient-reported outcome measures and objective measurements (wearable devices).
Societal challenges: informing, sensitizing and enhancing mobility
In the last years, strong evidence has emerged regarding the determinant role of physical exercise in maintaining muscle function and health. In particular, the role of physical exercise in delaying sarcopenia, reducing the risk of metabolic disorders, or improving health condition in chronic diseases associated with malnutrition, such as cancers, has been clearly established. In this context, a major societal challenge resides in informing people on the critical importance of performing regular exercise for their health and quality of life. Many people are still unaware of these benefits and do not integrate physical activity in their daily lives. Several barriers, such as a lack of time or motivation, or limited access to infrastructure, contribute to the sedentary lifestyle of a large proportion of the population. People also often lack information on how to exercise effectively and how activity, even moderate, can increase or maintain muscle capacity. In line with this, public campaigns and initiatives to inform people about the importance of activity, to increase accessibility to sport, and to create environments to encourage active lifestyles, are essential.
In parallel, efforts to raise awareness on disabilities have been made in the last years and still need to be reinforced. Stigmatization and insufficient support for people suffering from disability remain a major issue in society. Informing the public on neuromuscular diseases is particularly important to increase awareness and raise funds required to sustain translational research and clinical trials. Creating a more inclusive society is determinant to improve efficient access to medical care for these patients and limit their social isolation. In line with this, increasing coordination between healthcare providers, as well as concerted efforts to improve access to rehabilitation services, in particular in underserved areas or in the case of financial constraints, are paramount to optimize patient outcomes.
Research studies on rehabilitation strategies are required to improve the effectiveness of the interventions and the overall outcomes for the patients. One crucial step is to increase our capacity to tailor rehabilitation programs to individual needs, by adapting and improving existing strategies depending on the pathological condition and the life history of the patients. An efficient evaluation of the short- and long-term effects of these personalized approaches is crucial to systematically shorten recovery times and increase quality of life.