hi I'm Dr Matt Harkey I'm a researcher at Michigan State University focusing on using ultrasound to monitor structural changes in patients following knee injury and knee surgery with the overall purpose of identifying the patient's at greatest risk for arthritis development within their knees today we're going to be talking about a specific assessment using our clarius ultrasound probe in conjunction with our usono probe fix to be able to dynamically assess how the muscle is responding to a physical activity motion and to start this assessment we are going to measure the participants leg length from the Asis to the lateral joint line and then once we have that leg length assessment marking the 50 percent Mark between those two locations and we're doing that so that we're able to standardize where on the leg that we're assessing the muscle between participants so once we have that Mark I'll put some ultrasound gel down and use our clarius ultrasound probe to identify the rectus femoris muscle and you can see in this image we have the skin the underlying subcutaneous fat as well as our rectus femoris muscle and once we're able to visualize that muscle we'll move the probe for medially to laterally just to see the full extent of that muscle and then find this kind of central cross-sectional piece of this muscle and once we're able to identify this muscle here we'll actually turn the probe longitudinally so that we're able to then gather this longitudinal assessment of the rectus femoris kind of in line with that 50 Mark where we're able to kind of see these individual muscle fascicles going uh through the muscle right here and once we have the longitudinal kind of positioning that we'll want we'll make a mark at the top of the leg above probe there so that we know where we're wanting to to image that muscle and now what we're going to do is take our usono Pro fix and then apply it to that location so centering the circle of the usonal probe fix around that location there put down our lower strap here and then secure the other strap as well so now with the base of our unisonoprofix on to the leg here we'll then secure our clarius scanner into the probe holder of the USANA that's built specifically for our clarius scanner so we just enter it into the hole here and then affix this other piece of the probe holder into here and then now with these two pieces secured onto here and what we're then able to do is secure this onto the skin here we now have the ultrasound probes cured we can have them move on to doing whatever physical activity we want to do so that we can dynamically monitor that muscle during that activity we're having her walking on the treadmill and what you can see in our ultrasound image is again our scan up top our subcutaneous fat and then our rectus femoris muscle line underneath and what we're able to measure in real time is her muscle responding to this walking intervention that we can see in real time how that muscle is Contracting and relaxing with each step she takes so now to kind of Monitor and quantify What's Happening Here we can take a cine Loop video down here in this icon and we can select from a cine length of either one second up to 30 seconds I'm going to take a a 10 second video here and is just now collecting that video uh dynamically of her going through this motion and cyclically being able to see how that muscle is responding to multiple different steps so now we could then take that video out and then Analyze This to look dynamically at how that muscle and how the fascals within that muscle are changing and responding to the loads that are required during this walking this walking trial so now we've transitioned from that lab space into this more real world setting to monitor how someone is walking and how their muscle is responding to that walking with that we're also able to use a a phone with the clarius app to capture and assess the images which will help with that clinical accessibility of using this tool so now let's move into our participant walking and US dynamically assessing our quadriceps you can see on our hilarious iPhone app you can see the skin and the subcutaneous fat up top the rectus femores coming down here similar to where we were inside you can see on the ultrasound machine that the rectus femoris muscle is Contracting and relaxing as she's taking each step which allows us to transfer us using this ultrasound technique from outside the lab to more of a real life setting foreign
