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Leong SS, Wong JHD, Rozalli FI, Yahya F, Tee YC, Yamin LSM, Razalli MM, Baharuddin H. 2D shear wave elastography for the assessment of quadriceps entheses-a methodological study. Skeletal Radiol 2024; 53:455-463. [PMID: 37594519 DOI: 10.1007/s00256-023-04425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To establish the scanning protocol for 2-dimensional shear wave elastography (SWE) on normal entheses by investigating the possible confounding factors that may increase the variability of measured elasticity. MATERIAL AND METHODS 30 normal quadriceps entheses were scanned using SWE to compare the stiffness and coefficient variation by changing the ultrasonic coupling gel thickness, knee position, region of interest size, and scanning plane. RESULTS No significant difference in median shear wave velocity (SWV) was observed in different coupling gel thicknesses. The median SWV was higher in the knee flexion position than in the extended position (p < 0.001). Increased knee flexion led to stiffer quadriceps enthesis and higher SWV (ρ = 0.8, p < 0.001). The median SWV was higher when the diameter region of interest was 4.0 mm than 2.0 mm (p = 0.001). The median SWV was higher in the transverse plane than in the longitudinal plane (p < 0.001). Strong correlation was found between SWV and the degree of the shear wave to muscle fiber direction (ρ = 0.8, p < 0.001). The coefficient variation was lower in a gel thickness of 2.5 cm, with an extended knee, a region of interest of 2.0 mm, and a longitudinal plane (p > 0.05). For interobserver reliability for the proposed protocol, the intraclass correlation coefficients was 0.763. CONCLUSION In this study, we determined supine position with the knee extended; using 2.0 mm diameter region of interest and image acquisition at the longitudinal plane with thicker layer coupling gel seems most appropriate to reliably image healthy quadriceps entheses with SWE.
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Affiliation(s)
- Sook Sam Leong
- Centre for Medical Imaging Studies, Faculty of Health Sciences, Universiti Teknologi MARA, 42300, Selangor, Malaysia.
| | - Jeannie Hsiu Ding Wong
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Faizatul Izza Rozalli
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Fariz Yahya
- Department of Medicine, Faculty of Medicine, Rheumatology Unit, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Ying Chew Tee
- Department of Medicine, Faculty of Medicine, Rheumatology Unit, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Lyana Shahirah Mohamad Yamin
- Centre for Medical Imaging Studies, Faculty of Health Sciences, Universiti Teknologi MARA, 42300, Selangor, Malaysia
| | - Mazuin Mohd Razalli
- Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, 47000, Sungai Buloh, Malaysia
| | - Hazlyna Baharuddin
- Department of Internal Medicine, Faculty of Medicine, Rheumatology Unit, UniversitiTeknologi MARA, 47000, Sungai Buloh, Malaysia
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Pasurka M, Falck T, Kubach J, Simon M, Söllner S, Strobel D, Perl M, Betsch M. Comparison of In Vivo Stiffness of Tendons Commonly Used for Anterior Cruciate Ligament Reconstruction - A Shear Wave Elastography Study. Acad Radiol 2024:S1076-6332(24)00060-6. [PMID: 38378326 DOI: 10.1016/j.acra.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/22/2024]
Abstract
RATIONALE AND OBJECTIVES There are currently no studies investigating the in vivo stiffness of the most commonly used autografts for anterior cruciate ligament reconstruction (ACLR) using Shear wave elastography (SWE). We hypothesize that there are differences regarding the elastic properties between the three tendons commonly used for ACLR and that they are influenced by patient-related factors. MATERIALS AND METHODS 80 healthy subjects (25 females, 55 males, age: 25.33 ± 4.76 years, BMI: 23.76 ± 3.14 kg/m2, 40 semiprofessional athletes, athlete group [AG], age: 25.51 [19-29]; 40 healthy controls, control group [CG], age: 25.50 [20-29]) were recruited as participants. In addition to patient reported outcome scores, every participant underwent a standardized multimodal ultrasound protocol consisting of B-mode-ultrasound (B-US), Color Doppler-ultrasound (CD-US) and a SWE examination of the bilateral quadriceps tendon (QT), patellar tendon (PT) and semitendinosus tendon (ST). RESULTS The highest shear wave velocity (SWV) were observed in ST (4.88 (4.35-5.52) m/s, ST vs QT, p = 0.005; ST vs PT, p < 0.001) followed by QT (4.61 (4.13-5.26) m/s, QT vs PT, p < 0.001) and PT (3.73 (3.30-4.68) m/s). Median QT, PT and ST stiffness was significantly higher in AG compared to CG. Male subjects tend to have stiffer QT and PT than female subjects. Positive correlation with SWV was obtained for age and activity level. CONCLUSION There are significant differences regarding in vivo tendon stiffness between the most frequently used autograft tendon options for ACLR. The quantitative information obtained by SWE could be of particular interest for graft choice for ACLR.
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Affiliation(s)
- Mario Pasurka
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany.
| | - Theo Falck
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
| | - Joshua Kubach
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
| | - Michael Simon
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
| | - Stefan Söllner
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
| | - Deike Strobel
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany
| | - Mario Perl
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
| | - Marcel Betsch
- Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
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Morin T, Souron R, Boulaouche I, Jubeau M, Nordez A, Lacourpaille L. Mild to moderate damage in knee extensor muscles accumulates after two bouts of maximal eccentric contractions. Eur J Appl Physiol 2023; 123:2723-2732. [PMID: 37351697 DOI: 10.1007/s00421-023-05257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE This study aimed to determine whether mild to moderate muscle damage accumulates on the knee extensors after two bouts of maximal eccentric contractions performed over two consecutive days. METHODS Thirty participants performed an initial bout of maximal eccentric contractions of knee extensors during the first day of the protocol (ECC1). Then, they were separated in two groups. The Experimental (EXP) group repeated the eccentric bout 24 h later (ECC2) while the Control (CON) group did not. Indirect markers of muscle damage (i.e., strength loss, muscle soreness, and shear modulus) were measured to quantify the amount of muscle damage and its time course. RESULTS Two days after the initial eccentric session, participants from EXP had a higher strength deficit (- 14.5 ± 10.6%) than CON (- 6.6 ± 8.7%) (P = 0.017, d = 0.9). Although both groups exhibited an increase in knee extensors shear modulus after ECC1, we found a significant increase in muscle shear modulus (+ 13.3 ± 22.7%; P < 0.01; d = 0.5) after ECC2 for the EXP group, despite the presence of mild to moderate muscle damage (i.e., strength deficit about 16%). CONCLUSION Although the markers of muscle damage used in the current study were indirect, they suggest that the repetition of two bouts of maximal eccentric contractions with 24 h apart induces additional muscle damage in the knee extensors in presence of mild to moderate muscle damage.
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Affiliation(s)
- Titouan Morin
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France
| | - Robin Souron
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France
| | - Ines Boulaouche
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France
| | - Marc Jubeau
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France
| | - Antoine Nordez
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France
- Institut Universitaire de France (IUF), Paris, France
| | - Lilian Lacourpaille
- Laboratory Movement, Interactions, Performance, MIP (UR 4334), Nantes Université, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France.
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Pimenta R, Lopes T, Correia JP, Veloso AP. Effects of repeated sprinting on hamstring shear modulus pattern and knee flexor neuromuscular parameters. Sci Rep 2023; 13:12624. [PMID: 37537276 PMCID: PMC10400546 DOI: 10.1038/s41598-023-38861-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023] Open
Abstract
The purpose of the present study was to examine the acute effects of a maximum repeated sprint protocol on (1) hamstring shear modulus and (2) knee flexor neuromuscular parameters such as peak torque (PT) and rate of torque development (RTD). Muscle shear modulus was assessed in 18 healthy males using shear wave elastography at rest and during 30° isometric knee flexion at 20% of maximal voluntary isometric contraction, before and after a 10 × 30 m repeated sprint protocol. There was a 9% decrease in average speed between the fastest and slowest sprint (p < 0.001; d = 2.27). A pre-post decrease was observed in PT (p = 0.004; η2p = 0.399) and in the 0-50 ms (p = 0.042; η2p = 0.222), and 50-100 ms (p = 0.028; η2p = 0.254) RTD periods. For the active shear modulus, the only significant change after the sprint task was in the biceps femoris long head (BFlh) with an increase of 10% (Pre: 26.29 ± 8.89 kPa; Post: 28.93 ± 8.31 kPa; p = 0.015; d = 0.31). The present study provides evidence that repeated sprinting leads to significant decreases in average speed, PT, early RTD (0-50 ms; 50-100 ms), and to an increase in BFlh active shear modulus without changing the shear modulus of the other hamstrings muscles.
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Affiliation(s)
- Ricardo Pimenta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada - Dafundo, Lisboa, Portugal.
- Research Center of the Polytechnic Institute of Maia (N2i), Maia Polytechnic Institute (IPMAIA), Castêlo da Maia, 4475-690, Maia, Portugal.
| | - Tomás Lopes
- Department of Biochemistry, King's College London, Strand, London, UK
| | - José Pedro Correia
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada - Dafundo, Lisboa, Portugal
| | - António Prieto Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada - Dafundo, Lisboa, Portugal
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Chalchat E, Siracusa J, Bourrilhon C, Charlot K, Gennisson JL, Garcia-Vicencio S, Martin V. Contractile properties are less affected at long than short muscle length after eccentric exercise. Eur J Appl Physiol 2023; 123:1101-1114. [PMID: 36645479 DOI: 10.1007/s00421-023-05134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/15/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE The aim of the present study was to investigate whether the electrically evoked muscle responses are differently affected over time by the knee joint angle after an exercise-induced muscle damage (EIMD). We hypothesized that low-frequency-evoked responses would be less affected at long than short muscle length, and that mechanisms located within the muscle and tendinous tissues would be involved. METHODS Fifteen males performed 45 min loaded downhill walking (DW) exercise. Maximal voluntary contraction torque (MVC), optimal angle for torque production, voluntary activation level (VAL), twitch, doublet at 10 and 100 Hz (Db10 and Db100, respectively), rate of torque development (RTD), post-activation potentiation (PAP), muscle shear elastic modulus (µ) and aponeurosis stiffness were assessed before, after, and 4, 24, 48, 72 and 168 h after the exercise at a knee angle of 40°, 90° and 120° (0°: full extension). RESULTS MVC, VAL and Db100 were similarly decreased across joint angles after the DW and optimal angle was not affected. Twitch, Db10, Db10/Db100, PAP and RTD were less affected and muscle µ more increased at long than short muscle lengths (p < 0.05), especially during the first 24 h after the DW exercise. CONCLUSION Low-frequency-evoked responses were more preserved at long than short muscle length the first 24 h after the DW exercise, suggesting that joint angle should be taken into account to assess muscular alterations after EIMD. This length-dependence could be associated to the higher sensitivity to Ca2+ and the higher increase in muscle stiffness at long than short muscle length.
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Affiliation(s)
- Emeric Chalchat
- Unité de Physiologie de l'Exercice et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 91223, Bretigny-Sur-Orge, France.
- AME2P, Université Clermont Auvergne, Clermont-Ferrand, France.
| | - Julien Siracusa
- Unité de Physiologie de l'Exercice et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 91223, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
| | - Cyprien Bourrilhon
- Unité de Physiologie de l'Exercice et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 91223, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
| | - Keyne Charlot
- Unité de Physiologie de l'Exercice et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 91223, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
| | - Jean-Luc Gennisson
- BIOMAPS, Laboratoire d'Imagerie Biomédicale Multimodale, Université Paris-Saclay, CEA, CNRS, Inserm, Orsay, France
| | - Sebastian Garcia-Vicencio
- Unité de Physiologie de l'Exercice et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 91223, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
- Human Motion Analysis, Humanfab, Aix-en-Provence, France
| | - Vincent Martin
- AME2P, Université Clermont Auvergne, Clermont-Ferrand, France
- Institut Universitaire de France (IUF), Paris, France
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Vatovec R, Kozinc Ž, Voglar M. The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements. SENSORS (BASEL, SWITZERLAND) 2022; 22:9476. [PMID: 36502176 PMCID: PMC9735660 DOI: 10.3390/s22239476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (-8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006-0.022; Cohen's d = 0.40-46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697-0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29-0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain.
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Affiliation(s)
- Rok Vatovec
- Department of Physiotherapy, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
| | - Žiga Kozinc
- Department of Kinesiology, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, SI-6000 Koper, Slovenia
| | - Matej Voglar
- Department of Physiotherapy, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
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Kalinowski R, Pisz A, Kolinger D, Wilk M, Stastny P, Krzysztofik M. Acute effects of combined isometric and plyometric conditioning activities on sports performance and tendon stiffness in female volleyball players. Front Physiol 2022; 13:1025839. [PMID: 36304585 PMCID: PMC9593028 DOI: 10.3389/fphys.2022.1025839] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/30/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to compare the effects of bilateral and unilateral conditioning activities (CA; combined isometric and plyometric) on countermovement jump performance, modified t-agility test, Achilles tendon stiffness and skin surface temperature. Thirteen female semi-professional volleyball players performed two CAs in random order: 1) bilateral isometric half back squats followed by bilateral drop jumps (BI-CA); and 2) unilateral isometric half back squats followed by unilateral drop jumps (UNI-CA). To assess the effects of CAs, countermovement jump, modified t-agility test, Achilles tendon stiffness and skin surface temperature measurements were performed 5 min before and 6 min after the CA. Both CAs significantly increased thigh skin surface temperature from pre- to post-CA (BI-CA, p < 0.001; effect size [ES] = 1.41 and UNI-CA, p = 0.001; ES = 1.39) but none of them influenced modified t-agility test time (interaction: p = 0.338, main effect of time: p = 0.121 and condition: p = 0.819). The countermovement jump height and modified reactive strength index significantly increased from pre-to post-CA during the BI-CA condition (p = 0.003, ES = 0.45, and p = 0.008, ES = 0.48) but not for UNI-CA (p = 0.061, ES = 0.18 and p = 0.065, ES = 0.26). No significant impact has been found for countermovement depth (interaction: p = 0.054, main effect of time: 0.097, and condition: p = 0.41) as well as for contraction time (interaction: p = 0.536, main effect of time: p = 0.224, and condition: p = 0.807). Moreover, stronger and weaker limb CMJ relative peak force significantly decreased from pre-to post-CA (p = 0.014, ES = −0.31, and p = 0.027, ES = −0.26; respectively) during UNI-CA condition but not for BI-CA (p = 0.096, ES = 0.23, and p = 1.41, ES = 0.18). The stronger and weaker limb Achilles tendon stiffness significantly increased from pre-to post-CA during the UNI-CA condition (p = 0.013, ES = 0.60 and p < 0.001, ES = 0.79; respectively) but not for BI-CA (p = 0.66; ES = 0.15 and p = 0.265; ES = 0.42). Furthermore, the post-CA stronger limb Achilles tendon stiffness during the UNI-CA was significantly higher than that noted during the BI-CA (p = 0.006, ES = 0.7). The present study showed that combined isometric and plyometric bilateral CA effectively improved the countermovement jump but did not enhance the t-agility test performance. These findings indicate that exercise combinations could effectively produce a post-activation performance enhancement effect but should replicate the following explosive task as much as possible.
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Affiliation(s)
- Rafał Kalinowski
- Department of Exercise and Sport Performance, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Anna Pisz
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Dominik Kolinger
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Michał Wilk
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Petr Stastny
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Michał Krzysztofik
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
- *Correspondence: Michał Krzysztofik,
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Ličen U, Kozinc Ž. Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:7574. [PMID: 36236672 PMCID: PMC9571996 DOI: 10.3390/s22197574] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/21/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Shear-wave elastography is a method that is increasingly used to assess muscle stiffness in clinical practice and human health research. Recently, shear-wave elastography has been suggested and used to assess exercise-induced muscle damage. This review aimed to summarize the current knowledge of the utility of shear-wave elastography for assessment of muscle damage. In general, the literature supports the shear-wave elastography as a promising method for assessment of muscle damage. Increases in shear modulus are reported immediately and up to several days after eccentric exercise, while studies using shear-wave elastography during and after endurance events are showing mixed results. Moreover, it seems that shear modulus increases are related to the decline in voluntary strength loss. We recommend that shear modulus is measured at multiple muscles within a muscle group and preferably at longer muscle lengths. While further studies are needed to confirm this, the disruption of calcium homeostasis seems to be the primary candidate for the underlying mechanism explaining the increases in shear modulus observed after eccentric exercise. It remains to be investigated how well the changes in shear modulus correlate with directly assessed amount of muscle damage (biopsy).
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Affiliation(s)
- Urška Ličen
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, 6000 Koper, Slovenia
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Effects of Two Botulinum Toxin Type a Evaluated by Shear Wave Elastography and Electromyographic Measurements of Masseter Reduction. J Craniofac Surg 2022; 33:1450-1453. [PMID: 35758504 DOI: 10.1097/scs.0000000000008368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/07/2021] [Indexed: 10/17/2022] Open
Abstract
ABSTRACT The purpose of this study was to evaluate the efficacy and safety of onabotulinumtoxin A and Chinese botulinum toxin type A (CBA) for masseter reduction using elastography and electromyographic measurement. Female subjects aged 21 to 38 years with benign masseter hypertrophy received 1 treatment of either 50 units onabotulinumtoxin A or 50 units CBA in a double-blind clinical trial. The study enrolled 102 subjects (204 sides of masseters); 51 subjects per group. The thickness and stiffness of the masseter muscle and the electromyographic changes were evaluated before and 1, 4, 12, and 24 weeks after injection. One week after injection, the thickness of the masseter muscle did not change significantly, but the stiffness was reduced by 5% to 9%. After 4 weeks of injection, masseter muscle thickness, stiffness and strength decreased significantly compared with before injection. The changes were significantly at 12 weeks. Muscle stiffness measured by Shear-wave elastography was significantly reduced by 20% to 32% in the relaxed state and 25% to 47% in the contractile state. The electromyography showed that masseter muscle strength changed consistently with Shear-wave elastography value before and after injection. Six months after injection, ultrasound and electromyography showed that the masseter muscle thickness and stiffness began to recover. Between the 2 groups, there are no significant difference in thickness, stiffness and muscle strength reduction of masseters after treatment (P > 0.05), as well as in side effects (P > 0.05). Onabotulinumtoxin A and CBA were comparable in the efficacy and safety for masseter reduction.
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Fouré A, Besson T, Stauffer E, Skinner SC, Bouvier J, Féasson L, Connes P, Hautier CA, Millet GY. Sex-related differences and effects of short and long trail running races on resting muscle-tendon mechanical properties. Scand J Med Sci Sports 2022; 32:1477-1492. [PMID: 35730335 DOI: 10.1111/sms.14203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/13/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
The purpose of the study was to assess sex-related differences in resting mechanical properties and adaptations of skeletal muscles and tendons in response to trail running races of different distances using multi-site shear wave elastography assessments of the lower limb, force capacity and blood analyses. Sex differences in resting mechanical properties of knee extensor and plantar flexor muscles and tendons were characterized by shear wave velocity measurements in healthy males (N=42) and females (N=25) trained in long distance running. Effects of running distance on muscle and tendon properties were assessed in short (<60km, N=23) vs. long (>100km, N=26) distance races. Changes in isometric maximal voluntary contraction torque, serum C-reactive protein and creatine kinase activity were also quantified after running races. Higher shear wave velocity of relaxed triceps surae muscle was detected in females as compared to males before running races (+4.8%, p=0.006), but the significant increases in triceps surae muscle group (+7.0%, p=0.001) and patellar tendon shear wave velocity (+15.4%, p=0.001) after short-distance races were independent of sex. A significant decrease in triceps surae muscle shear wave velocity was found after long-distance races in the whole experimental population (-3.1%, p=0.049). Post-races increase in C-reactive protein and creatine kinase activity were significantly correlated to the relative decreases in triceps surae and quadriceps femoris skeletal muscle shear wave velocity (ρ=-0.56, p=0.001 and ρ=-0.51, p=0.001, respectively). Resting mechanical properties of muscles and tendons are affected by sex, and that adaptations to trail races are related to running distance. Exercise-induced changes in resting skeletal muscle mechanical properties are associated with enhanced indirect markers of inflammation and muscle damage.
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Affiliation(s)
- Alexandre Fouré
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France
| | - Thibault Besson
- Université Jean Monnet de Saint-Etienne, Université de Lyon, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Campus Santé Innovations-IRMIS, Saint Priest en Jarez, France
| | - Emeric Stauffer
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France.,Hospices Civils de Lyon, Exploration Fonctionnelle Respiratoire, Médecine du Sport et de l'Activité Physique, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Sarah C Skinner
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Jérémie Bouvier
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France
| | - Léonard Féasson
- Université Jean Monnet de Saint-Etienne, Université de Lyon, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Campus Santé Innovations-IRMIS, Saint Priest en Jarez, France.,CHU St Etienne, Unité de Myologie, Centre Référent Maladies Neuromusculaires Rares, Euro-NmD, Saint-Etienne, France
| | - Philippe Connes
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France, Paris, France
| | - Christophe A Hautier
- Univ Lyon, Université Claude Bernard Lyon 1 (UCBL1), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Villeurbanne, France
| | - Guillaume Y Millet
- Université Jean Monnet de Saint-Etienne, Université de Lyon, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), Campus Santé Innovations-IRMIS, Saint Priest en Jarez, France.,Institut Universitaire de France, Paris, France
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11
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Voglar M, Vatovec R, Kozinc Ž, Šarabon N. The effects of eccentric exercise on passive hamstring muscle stiffness: Comparison of shear-wave elastography and passive knee torque outcomes. Eur J Transl Myol 2022; 32. [PMID: 35666465 PMCID: PMC9295161 DOI: 10.4081/ejtm.2022.10567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of our study was to assess eccentric-exercise-induced changes in passive knee joint torque, passive knee joint stiffness and shear modulus at of the hamstring muscles. We hypothesized that eccentric exercise would elicit an increase in all outcomes. Fourteen healthy volunteers (age = 25.5±4.7 years) performed eccentric exercise protocol. Before and after 0h, 1h, 24h and 48h, we measured the shear modulus of hamstring muscles using shear-wave elastography and passive knee joint stiffness on isokinetic dynamometer. After eccentric exercise, the shear modulus of biceps femoris increased after 0h (22.4 ± 34.1 %; p = 0.021) and for semitendinosus after 0h (14.5 ± 4.9 %), 1h (16.2 ± 6.5 %) and 24h (16.6 ± 8.3 %) (p = 0.005-0.015). There were no changes for semimembranosus and no changes in passive knee joint moment measures. There were also no correlations between the two methods. Eccentric exercise increased shear modulus of hamstring muscles, while passive joint torque was not affected. This suggests that shear-wave elastography could be more sensitive than torque measures to intra-muscular changes induced by eccentric exercise.
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Affiliation(s)
- Matej Voglar
- University of Primorska, Faculty of Health Sciences, Izola.
| | - Rok Vatovec
- University of Primorska, Faculty of Health Sciences, Izola.
| | - Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia; University of Primorska, Andrej Marušič Institute, Koper.
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia; InnoRenew CoE, Human Health Department, Izola, Slovenia; S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana.
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12
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Goreau V, Pigne R, Bernier N, Nordez A, Hug F, Lacourpaille L. Hamstring muscle activation strategies during eccentric contractions are related to the distribution of muscle damage. Scand J Med Sci Sports 2022; 32:1335-1345. [PMID: 35611628 PMCID: PMC9541962 DOI: 10.1111/sms.14191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/07/2022] [Accepted: 05/20/2022] [Indexed: 01/25/2023]
Abstract
Large inter‐individual variability of activation strategies is observed during hamstring strengthening exercises but their consequences remain unexplored. The objective of this study was to determine whether individual activation strategies are related to the distribution of damage across the hamstring muscle heads semimembranosus (SM), semitendinosus (ST), and biceps femoris (BF) after eccentric contractions. 24 participants performed 5 sets of 15 maximal eccentric contractions of knee flexors on a dynamometer, while activation of each muscle head was assessed using surface electromyography. Knee flexion maximal isometric strength was assessed before exercise and 48 h afterward. Shear modulus was measured using shear wave elastography before exercise and 30 min afterward to quantify the distribution of damage across the hamstring muscle heads. At 48 h, maximal knee flexion torque had decreased by 15.9% ± 16.9% (p < 0.001). Although no differences between activation ratios of each muscle were found during the eccentric exercise (all p > 0.364), we reported a heterogeneous distribution of damage, with a larger change in shear modulus of ST/Hams than SM/Hams (+70.8%, p < 0.001) or BF/Hams (+50.3%, p < 0.001). A large correlation was found between the distribution of activation and the distribution of damage for ST/Hams (r = 0.69; p < 001). This study provides evidence that the distribution of activation during maximal eccentric contractions has mechanical consequences for synergist muscles. Further studies are needed to understand whether individual activation strategies influence the distribution of structural adaptations after a training program.
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Affiliation(s)
- Valentin Goreau
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
| | - Robin Pigne
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
| | - Nathan Bernier
- CIAMS, Université d'Orléans, Orléans, France.,CIAMS, Université Paris-Saclay, Orsay, France
| | - Antoine Nordez
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France.,Institut Universitaire de France (IUF), Paris, France
| | - François Hug
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France.,Institut Universitaire de France (IUF), Paris, France.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Lilian Lacourpaille
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
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Chalchat E, Siracusa J, Bourrilhon C, Charlot K, Martin V, Garcia-Vicencio S. Muscle Shear Elastic Modulus Provides an Indication of the Protection Conferred by the Repeated Bout Effect. Front Physiol 2022; 13:877485. [PMID: 35574495 PMCID: PMC9098813 DOI: 10.3389/fphys.2022.877485] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The neuromuscular system is able to quickly adapt to exercise-induced muscle damage (EIMD), such that it is less affected by subsequent damaging exercise, a phenomenon known as the repeated bout effect (RBE). The objective was to determine whether the mechanical properties of the quadriceps, as evaluated by shear wave elastography (SWE), were less affected when a second bout of eccentric-biased exercise was performed 2 weeks later. It was hypothesized that the first bout would confer protection against extensive muscle damage through an adaptation of the muscle stiffness before the second bout (i.e., higher muscle stiffness).Methods: Sixteen males performed two identical bouts of downhill walking separated by 2 weeks (45 min at 4.5 km.h−1; gradient: 25%; load: 30% of the body mass). Rectus femoris (RF) and vastus lateralis (VL) resting shear elastic modulus (µ) and EIMD symptoms were measured before and up to 7 days following the exercise bouts. Changes in neuromuscular function was evaluated by maximal voluntary contraction torque, voluntary activation level, evoked mechanical response to single and double (10 and 100 Hz doublets) electrical stimulation. An index of protection (IP) was calculated for EIMD symptoms to assess magnitude the RBE.Results: EIMD symptoms were less affected after the second than the first exercise bout. RF and VL-µ increased (p < 0.001) only after the first exercise. RF µ was elevated up to 2 weeks after the end of the first exercise (p < 0.001) whereas VL µ was only increased up to 24 h. The increase in µ observed 2 weeks after the end of the first exercise was correlated with the IP; i.e., attenuation of alterations in muscle µ, 10 Hz-doublet amplitude and rate of torque development after the second exercise bout (p < 0.05).Conclusion: We showed that muscle µ assessed by SWE was sensitive to the RBE, with a differential effect between VL and RF. The persistent increase in µ was associated with the attenuation of neuromuscular impairments observed after the second bout, suggesting that the increased muscle stiffness could be a “protective” adaptation making muscles more resistant to the mechanical strain associated to eccentric contractions.
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Affiliation(s)
- Emeric Chalchat
- Institut de Recherche Biomédicale des Armées, Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Bretigny-Sur-Orge, France
- AME2P, Université Clermont Auvergne, Clermont-Ferrand, France
- *Correspondence: Emeric Chalchat,
| | - Julien Siracusa
- Institut de Recherche Biomédicale des Armées, Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Cyprien Bourrilhon
- Institut de Recherche Biomédicale des Armées, Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Keyne Charlot
- Institut de Recherche Biomédicale des Armées, Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Vincent Martin
- AME2P, Université Clermont Auvergne, Clermont-Ferrand, France
- Institut Universitaire de France (IUF), Paris, France
| | - Sebastian Garcia-Vicencio
- Institut de Recherche Biomédicale des Armées, Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Bretigny-Sur-Orge, France
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
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14
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Decreasing patellar tendon stiffness during exercise therapy for patellar tendinopathy is associated with better outcome. J Sci Med Sport 2022; 25:372-378. [DOI: 10.1016/j.jsams.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/18/2021] [Accepted: 01/09/2022] [Indexed: 11/15/2022]
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Bravo-Sánchez A, Abián P, Sánchez-Infante J, Jimenez F, Abián-Vicén J. Influence of Bias in the Assessment of Patellar Tendon Stiffness: A Systematic Review and Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1151-1162. [PMID: 33589353 DOI: 10.1016/j.ultrasmedbio.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The aim of the present study was to provide a systematic review and meta-analysis of the main biases in practical applications of the different types of elastography in assessment of the stiffness of healthy patellar tendons. A literature search on four databases (Scopus, Web of Science, Pubmed and SportDiscus) was conducted on March 25, 2020. After analysis of 1,052 resultant articles, studies were included if they met two inclusion criteria: (1) studies were observational or randomized controlled trials; (2) studies included outcomes of patellar tendon stiffness. Twenty-one studies met the inclusion criteria and were included in this meta-analysis. Four meta-analyses were performed with respect to assessment procedure and participant characteristics. This meta-analysis found a low effect of examined portion of patellar tendon (standardized mean difference [SMD] = 0.27, 95% confidence interval [CI]: 0.01-0.54, n = 379, Z = 2.01, p = 0.04) and a high effect of knee flexion angle during assessment (SMD = -2.12; 95% CI: -2.67 to -1.58, n = 97, Z = 7.68, p < 0.01) in stiffness outcomes. The risk of bias was generally low, but the heterogenicity of the results downgraded the level of evidence. There is evidence in the elastography assessment of patellar tendon suggesting that the knee position and patellar tendon portion evaluated influence stiffness outcomes for patellar tendon in healthy volunteers.
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Affiliation(s)
- Alfredo Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Pablo Abián
- Faculty of Humanities and Social Sciences, Comillas Pontifical University, Madrid, Spain
| | - Jorge Sánchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Fernando Jimenez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain.
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16
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Stiffness of the iliotibial band and associated muscles in runner’s knee: Assessing the effects of physiotherapy through ultrasound shear wave elastography. Phys Ther Sport 2020; 45:126-134. [DOI: 10.1016/j.ptsp.2020.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023]
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17
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Taş S, Özkan Ö, Karaçoban L, Dönmez G, Çetin A, Korkusuz F. Knee muscle and tendon stiffness in professional soccer players: a shear-wave elastography study. J Sports Med Phys Fitness 2020; 60:276-281. [DOI: 10.23736/s0022-4707.19.09938-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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18
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Siracusa J, Charlot K, Malgoyre A, Conort S, Tardo-Dino PE, Bourrilhon C, Garcia-Vicencio S. Resting Muscle Shear Modulus Measured With Ultrasound Shear-Wave Elastography as an Alternative Tool to Assess Muscle Fatigue in Humans. Front Physiol 2019; 10:626. [PMID: 31178757 PMCID: PMC6537456 DOI: 10.3389/fphys.2019.00626] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/02/2019] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to investigate the time course of the resting vastus lateralis (VL) muscle shear elastic modulus (μ) measured with ultrasound shear-wave elastography during repetition of isometric maximal voluntary contractions (MVCs) of the knee extensors (KE). Fifteen well-trained young males repeated 60 5-s isometric MVCs. Evoked electrical stimulations and the VLμ were measured every ten MVCs at rest. The resting VLμ significantly decreased (−34.7 ± 6.7%; P < 0.001) by the end of the fatigue protocol. There was also a 38.4 ± 12.6 % decrease in MVC after exercise (P < 0.001). The potentiated doublet and single twitch torque amplitudes and properties were significantly modified by the end of exercise (P < 0.001). This study shows the time course of the resting VLμ during the repetition of maximal voluntary fatiguing exercise of the KE muscles. The decrease of the resting VLμ could directly affect the force transmission capabilities accounting for peripheral fatigue.
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Affiliation(s)
- Julien Siracusa
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Keyne Charlot
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Alexandra Malgoyre
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | | | - Pierre-Emmanuel Tardo-Dino
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Cyprien Bourrilhon
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Sebastian Garcia-Vicencio
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
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