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Frouin A, Guenanten H, Le Sant G, Lacourpaille L, Liebard M, Sarcher A, McNair PJ, Ellis R, Nordez A. Validity and Reliability of 3-D Ultrasound Imaging to Measure Hamstring Muscle and Tendon Volumes. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1457-1464. [PMID: 36948893 DOI: 10.1016/j.ultrasmedbio.2023.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The validity and reliability of 3-D ultrasound (US) in estimation of muscle and tendon volume was assessed in a very limited number of muscles that can be easily immersed. The objective of the present study was to assess the validity and reliability of muscle volume measurements for all hamstring muscle heads and gracilis (GR), as well as tendon volume for the semitendinosus (ST) and GR using freehand 3-D US. METHODS Three-dimensional US acquisitions were performed for 13 participants in two distinct sessions on separate days, in addition to one session dedicated to magnetic resonance imaging (MRI). Volumes of ST, semimembranosus (SM), biceps femoris short (BFsh) and long (BFlh) heads, and GR muscles and from the tendon from semitendinosus (STtd) and gracilis (GRtd) were collected. RESULTS The bias and the 95% confidence intervals of 3-D US compared with MRI ranged from -1.9 mL (-0.8%) to 1.2 mL (1.0%) for muscle volume and from 0.01 mL (0.2%) to -0.03 mL (-2.6%) for tendon volume. For muscle volume assessed using 3-D US, intraclass correlation coefficients (ICCs) ranged from 0.98 (GR) to 1.00, and coefficients of variation (CV) from 1.1% (SM) to 3.4% (BFsh). For tendon volume, ICCs were 0.99, and CVs between 3.2% (STtd) and 3.4% (GRtd). CONCLUSION Three-dimensional US can provide a valid and reliable inter-day measurement of hamstrings and GR for both muscle and tendon volumes. In the future, this technique could be used as an outcome for strengthening interventions and potentially in clinical environments.
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Affiliation(s)
- Antoine Frouin
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; Institut Sport Atlantique (ISA), Nantes, France
| | - Hugo Guenanten
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Guillaume Le Sant
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; School of Physiotherapy, IFM3R, Nantes, France
| | - Lilian Lacourpaille
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Martin Liebard
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; School of Physiotherapy, IFM3R, Nantes, France
| | - Aurélie Sarcher
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Peter J McNair
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Richard Ellis
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation: Aotearoa, Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Antoine Nordez
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Institut Universitaire de France (IUF), Paris, France.
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2
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Intra-operator Repeatability of Manual Segmentations of the Hip Muscles on Clinical Magnetic Resonance Images. J Digit Imaging 2023; 36:143-152. [PMID: 36219348 PMCID: PMC9984589 DOI: 10.1007/s10278-022-00700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/11/2022] [Accepted: 09/02/2022] [Indexed: 01/10/2023] Open
Abstract
The manual segmentation of muscles on magnetic resonance images is the gold standard procedure to reconstruct muscle volumes from medical imaging data and extract critical information for clinical and research purposes. (Semi)automatic methods have been proposed to expedite the otherwise lengthy process. These, however, rely on manual segmentations. Nonetheless, the repeatability of manual muscle volume segmentations performed on clinical MRI data has not been thoroughly assessed. When conducted, volumetric assessments often disregard the hip muscles. Therefore, one trained operator performed repeated manual segmentations (n = 3) of the iliopsoas (n = 34) and gluteus medius (n = 40) muscles on coronal T1-weighted MRI scans, acquired on 1.5 T scanners on a clinical population of patients elected for hip replacement surgery. Reconstructed muscle volumes were divided in sub-volumes and compared in terms of volume variance (normalized variance of volumes - nVV), shape (Jaccard Index-JI) and surface similarity (maximal Hausdorff distance-HD), to quantify intra-operator repeatability. One-way repeated measures ANOVA (or equivalent) tests with Bonferroni corrections for multiple comparisons were conducted to assess statistical significance. For both muscles, repeated manual segmentations were highly similar to one another (nVV: 2-6%, JI > 0.78, HD < 15 mm). However, shape and surface similarity were significantly lower when muscle extremities were included in the segmentations (e.g., iliopsoas: HD -12.06 to 14.42 mm, P < 0.05). Our findings show that the manual segmentation of hip muscle volumes on clinical MRI scans provides repeatable results over time. Nonetheless, extreme care should be taken in the segmentation of muscle extremities.
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Callow JH, Cresswell M, Damji F, Seto J, Hodgson AJ, Scott A. The Distal Free Achilles Tendon Is Longer in People with Tendinopathy than in Controls: A Retrospective Case-Control Study. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:6585980. [PMID: 38655157 PMCID: PMC11022772 DOI: 10.1155/2022/6585980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 04/26/2024]
Abstract
Objectives The free Achilles tendon is defined as the region of tendon distal to the soleus which is "unbuttressed," i.e., unsupported by muscular tissue. We reasoned that a relative lack of distal buttressing could place the tendon at a greater risk for developing Achilles tendinopathy. Therefore, our primary goal was to compare the free Achilles tendon length between those with midportion or insertional Achilles tendinopathy and healthy controls. Design This is a retrospective case-control study. Setting. Hospital in Vancouver, Canada. Participants. 66 cases with Achilles tendinopathy (25 insertional, 41 midportion) consecutively drawn from a hospital database within a 5-year period and matched to 66 controls (without tendinopathy) based on sex, age, and weight. Main outcome measures. Odds ratio of the risk of developing Achilles tendinopathy given the length of free tendon, defined anatomically on MRI, after adjustment for confounders. Results MRI-defined free Achilles tendon length is a statistically significant predictor of having midportion Achilles tendinopathy (odds ratio = 0.53, 95% confidence interval 1.13 to 2.07). Midportion Achilles tendinopathy cases had significantly longer free tendons (Mdn = 51.2 mm, IQR = 26.9 mm) compared to controls (Mdn = 40.8 mm, IQR = 20.0 mm), p = 0.007. However, there was no significant difference between the free Achilles tendon lengths in insertional AT cases (Mdn = 47.9 mm, IQR = 15.1 mm) and controls (Mdn = 39.2 mm, IQR = 17.9 mm), p = 0.158. Free Achilles tendon length was also correlated with the tendon thickness among those with Achilles tendinopathy, rτ = 0.25, and p = 0.003. Conclusions The MRI-defined length of the free Achilles tendon is positively associated with the risk of midportion Achilles tendinopathy. A relative lack of distal muscular buttressing of the Achilles tendon may therefore influence the development of tendinopathy.
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Affiliation(s)
- Joanne H. Callow
- Department of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
| | - Mark Cresswell
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Faraz Damji
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Joshua Seto
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, Canada
| | - Antony J. Hodgson
- Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada
| | - Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
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4
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Merza EY, Pearson SJ, Lichtwark GA, Malliaras P. The acute effects of higher versus lower load duration and intensity on morphological and mechanical properties of the healthy Achilles tendon: a randomized crossover trial. J Exp Biol 2022; 225:275126. [PMID: 35470387 PMCID: PMC9167578 DOI: 10.1242/jeb.243741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/19/2022] [Indexed: 11/20/2022]
Abstract
The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared with interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age 24.4±9.4 years, body mass 70.9±16.1 kg, height 1.7±0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55% and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force–elongation curve over these force levels represented individual stiffness (N mm−1). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways. Summary: High levels of load duration and intensity have the greatest acute effect on the free Achilles tendon volume and stiffness.
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Affiliation(s)
- Eman Y Merza
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
| | - Stephen J Pearson
- Centre for Health, Sport and Rehabilitation Sciences Research, University of Salford, Greater Manchester, M5 4WT, UK
| | - Glen A Lichtwark
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Brisbane, Australia
| | - Peter Malliaras
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
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5
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Devaprakash D, Graham DF, Barrett RS, Lloyd DG, Obst SJ, Kennedy B, Adams KL, Kiely RJ, Hunter A, Vlahovich N, Pease DL, Shim VB, Besier TF, Zheng M, Cook JL, Pizzolato C. Free Achilles tendon strain during selected rehabilitation, locomotor, jumping, and landing tasks. J Appl Physiol (1985) 2022; 132:956-965. [PMID: 35142563 DOI: 10.1152/japplphysiol.00662.2021] [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] [Indexed: 11/22/2022] Open
Abstract
A better understanding of the strains experienced by the Achilles tendon during commonly prescribed exercises and locomotor tasks is needed to improve efficacy of Achilles tendon training and rehabilitation programs. The aim of this study was to estimate in vivo free Achilles tendon strain during selected rehabilitation, locomotor, jumping, and landing tasks. Sixteen trained runners with no symptoms of Achilles tendinopathy participated in this study. Personalised free Achilles tendon moment arm and force-strain curve were obtained from imaging data and used in conjunction with motion capture and surface electromyography to estimate free Achilles tendon strain using electromyogram-informed neuromusculoskeletal modelling. There was a strong correspondence between Achilles tendon force estimates from the present study and experimental data reported in the literature (R2 > 0.85). The average tendon strain was highest for maximal hop landing (8.8±1.6%), lowest for walking at 1.4 m/s (3.1±0.8%) and increased with locomotor speed during running (run 3.0 m/s: 6.5±1.6%; run 5.0 m/s: 7.9±1.7%) and during heel rise exercise with added mass (BW: 5.8±1.3%; 1.2 BW: 6.9±1.7%). The peak tendon strain was highest during running (5 m/s: 13.7±2.5%) and lowest during walking (1.4 m/s: 7±1.8%). Overall findings provide a preliminary evidence base for exercise selection to maximise anabolic tendon remodelling during training and rehabilitation of the Achilles tendon.
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Affiliation(s)
- Daniel Devaprakash
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University, Australia.,School of Health Sciences and Social Work, Griffith University, Australia
| | - David F Graham
- School of Health Sciences and Social Work, Griffith University, Australia.,Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Rod S Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University, Australia.,School of Health Sciences and Social Work, Griffith University, Australia
| | - David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University, Australia.,School of Health Sciences and Social Work, Griffith University, Australia
| | - Steven J Obst
- School of Health Sciences and Social Work, Griffith University, Australia.,School of Health, Medical, and Applied Sciences, Central Queensland University, Australia
| | - Ben Kennedy
- School of Health Sciences and Social Work, Griffith University, Australia.,Mermaid Beach Radiology, Gold Coast, Queensland, Australia
| | - Kahlee L Adams
- Australian Institute of Sport, Australian Capital Territory, Australia
| | - Ryan J Kiely
- Australian Institute of Sport, Australian Capital Territory, Australia
| | - Adam Hunter
- Australian Institute of Sport, Australian Capital Territory, Australia
| | - Nicole Vlahovich
- Australian Institute of Sport, Australian Capital Territory, Australia
| | - David L Pease
- Australian Institute of Sport, Australian Capital Territory, Australia
| | - Vickie B Shim
- School of Health Sciences and Social Work, Griffith University, Australia.,Auckland Bioengineering Institute, The University of Auckland, New Zealand
| | - Thor F Besier
- Auckland Bioengineering Institute, The University of Auckland, New Zealand
| | - Minghao Zheng
- Centre for Orthopaedic Translational Research, School of Surgery, The University of Western Australia, Nedlands, WA, Australia
| | - Jill L Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Claudio Pizzolato
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University, Australia.,School of Health Sciences and Social Work, Griffith University, Australia
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6
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Drakonaki EE, Gataa KG, Szaro P. The anatomical variant of high soleus muscle may predispose to tendinopathy: a preliminary MR study. Surg Radiol Anat 2021; 43:1681-1689. [PMID: 34032901 PMCID: PMC8455493 DOI: 10.1007/s00276-021-02768-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/12/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE This study aimed to examine the anatomic variations at the level of the distal soleus musculotendinous junction and the possible association between the length of the free tendon and the development of symptomatic Achilles tendinopathy. METHODS We retrospectively assessed 72 ankle MRI studies with findings of Achilles tendinopathy (study group, 26 females/46 males, mean age 52.6 ± 10.5 years, 30 right/42 left) and 72 ankle MRI studies with normal Achilles tendon (control group, 32 females/40 males, mean age 35.7 ± 13.7 years, 42 right/30 left side). We measured the distance from the lowest outline of the soleus myotendinous junction to the proximal outline of the Achilles tendon insertion (length of the free tendon, diameter a) and to the distal outline of the insertion (distance B). We also measured the maximum thickness of the free tendon (diameter c) and the distance between the levels of maximum thickness to the proximal outline of the Achilles tendon insertion (distance D). All measurements were assessed twice. Statistical analysis was performed using independent t test. RESULTS Distances A and B were significantly larger in tendinopathic tendons (59.7 and 83.4 mm, respectively) than normal Achilles tendons (38.5 and 60.8 mm, respectively) (p = 0.001). Mean distance C was larger in tendinopathic than normal tendons (11.2 versus 4.9 mm). Distances C and D were significantly larger in males than females. There was no significant difference in the measurements between sides. CONCLUSION There is wide anatomical variation in the length of the free Achilles tendon. Tendinopathy may be associated with the thicker free part of the Achilles tendon. The anatomical variant of the high soleus musculotendinous junction resulting in a longer free Achilles tendon may be a predisposing factor to the development of tendinopathy.
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Affiliation(s)
| | - Khaldun Ghali Gataa
- Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Göteborgsvägen 31, 431 80, Gothenburg, Sweden
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Göteborgsvägen 31, 431 80, Gothenburg, Sweden.
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
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7
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Lloyd D. The future of in-field sports biomechanics: wearables plus modelling compute real-time in vivo tissue loading to prevent and repair musculoskeletal injuries. Sports Biomech 2021:1-29. [PMID: 34496728 DOI: 10.1080/14763141.2021.1959947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/20/2021] [Indexed: 01/13/2023]
Abstract
This paper explores the use of biomechanics in identifying the mechanistic causes of musculoskeletal tissue injury and degeneration. It appraises how biomechanics has been used to develop training programmes aiming to maintain or recover tissue health. Tissue health depends on the functional mechanical environment experienced by tissues during daily and rehabilitation activities. These environments are the result of the interactions between tissue motion, loading, biology, and morphology. Maintaining health of and/or repairing musculoskeletal tissues requires targeting the "ideal" in vivo tissue mechanics (i.e., loading and deformation), which may be enabled by appropriate real-time biofeedback. Recent research shows that biofeedback technologies may increase their quality and effectiveness by integrating a personalised neuromusculoskeletal modelling driven by real-time motion capture and medical imaging. Model personalisation is crucial in obtaining physically and physiologically valid predictions of tissue biomechanics. Model real-time execution is crucial and achieved by code optimisation and artificial intelligence methods. Furthermore, recent work has also shown that laboratory-based motion capture biomechanical measurements and modelling can be performed outside the laboratory with wearable sensors and artificial intelligence. The next stage is to combine these technologies into well-designed easy to use products to guide training to maintain or recover tissue health in the real-world.
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Affiliation(s)
- David Lloyd
- School of Health Sciences and Social Work, Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), in the Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Griffith University, Australia
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8
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Obst SJ, Florance K, Barber L. Regional Variation in Muscle Echogenicity Is Related to Muscle Thickness in Young Children. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2467-2476. [PMID: 33941414 DOI: 10.1016/j.ultrasmedbio.2021.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Quantitative ultrasound of muscle echogenicity may be influenced by the size of the muscle and, so, corrections may be required when comparing echogenicity between populations with different muscle size. This study examined the relationship between regional muscle echogenicity and geometry in young, typically developing children (n = 49, mean ± standard deviation [SD] age = 70.8 ± 30.0 mo). Three-dimensional ultrasound was used to measure mean echo intensity (EI) and echo variation (EV), together with muscle thickness, cross-sectional area (CSA) and width, over the entire muscle length for the medial gastrocnemius (MG), rectus femoris (RF) and tibialis anterior muscles. Pearson's correlation coefficient (r) was used to assess the strength of the relationship between echogenicity and geometry using all images taken over the entire muscle length. There were moderate-strong correlations (r = 0.67-0.90) between EI and EV and thickness for each muscle, with the strongest correlations evident for the MG and RF. EI and EV were moderately correlated with muscle CSA and weakly correlated with muscle width. Normalisation of echogenicity to muscle thickness may help delineate between regions of contractile and non-contractile tissue and provide a useful measure of muscle echogenicity when comparing muscles of different cross-sectional dimensions. We recommend that researchers consider controlling for muscle size-dependent effects on echogenicity, by normalising EI and EV to muscle thickness, or including the latter as a covariate when comparing between groups.
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Affiliation(s)
- Steven J Obst
- School of Health Medical and Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia.
| | - Kaysie Florance
- School of Health Medical and Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia
| | - Lee Barber
- School of Allied Health Sciences, Griffith Health, Griffith University, Brisbane, Queensland, Australia
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9
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Szaro P, Ghali Gataa K. The correlations between dimensions of the normal tendon and tendinopathy changed Achilles tendon in routine magnetic resonance imaging. Sci Rep 2021; 11:6131. [PMID: 33731785 PMCID: PMC7969943 DOI: 10.1038/s41598-021-85604-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/03/2021] [Indexed: 12/15/2022] Open
Abstract
This comparative study aimed to investigate how tendinopathy-related lesions change correlations in the dimensions of the Achilles tendon. Our experimental group included 74 patients. The mean age was 52.9 ± 10.4 years. The control group included 81 patients with a mean age was 35.2 ± 13.6 years, p < .001. The most significant difference in correlation was the thickness of the tendon and the midportion's width, which was more significant in the tendinopathy (r = .49 vs. r = .01, p < .001). The correlation was positive between width and length of the insertion but negative in normal tendons (r = .21 vs. r = − .23, p < .001). The correlation was between the midportions width in tendinopathy and the tendon's length but negative in the normal tendon (r = .16 vs. r = − .23, p < .001). The average thickness of the midportion in tendinopathy was 11.2 ± 3.3 mm, and 4.9 ± 0.5 mm in the control group, p < .001. The average width of the midportion and insertion was more extensive in the experimental group, 17.2 ± 3.1 mm vs. 14.7 ± 1.8 mm for the midportion and 31.0 ± 3.9 mm vs. 25.7 ± 3.0 mm for insertion, respectively, p < .001. The tendon's average length was longer in tendinopathy (83.5 ± 19.3 mm vs. 61.5 ± 14.4 mm, p < .001). The dimensions correlations in normal Achilles tendon and tendinopathic tendon differ significantly.
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Affiliation(s)
- Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, 431 80, Gothenburg, Sweden. .,Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
| | - Khaldun Ghali Gataa
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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10
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Handsfield GG, Greiner J, Madl J, Rog-Zielinska EA, Hollville E, Vanwanseele B, Shim V. Achilles Subtendon Structure and Behavior as Evidenced From Tendon Imaging and Computational Modeling. Front Sports Act Living 2020; 2:70. [PMID: 33345061 PMCID: PMC7739789 DOI: 10.3389/fspor.2020.00070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/19/2020] [Indexed: 11/22/2022] Open
Abstract
The Achilles tendon is the largest and strongest tendon in the human body and is essential for storing elastic energy and positioning the foot for walking and running. Recent research into Achilles tendon anatomy and mechanics has revealed the importance of the Achilles subtendons, which are unique and semi-independent structures arising from each of the three muscular heads of the triceps surae. Of particular importance is the ability for the subtendons to slide, the role that this has in healthy tendons, and the alteration of this property in aging and disease. In this work, we discuss technical approaches that have led to the current understanding of Achilles subtendons, particularly imaging and computational modeling. We introduce a 3D geometrical model of the Achilles subtendons, built from dual-echo UTE MRI. We revisit and discuss computational models of Achilles subtendon twisting suggesting that optimal twist reduces both rupture loads and stress concentrations by distributing stresses. Second harmonic generation imaging shows collagenous subtendons within a rabbit Achilles tendon; a clear absence of signal between the subtendons indicates an inter-subtendon region on the order of 30 μm in our rabbit animal model. Entry of wheat germ agglutinin in both the inter-fascicular and the inter-subtendon regions suggests a glycoprotein-containing inter-subtendon matrix which may facilitate low friction sliding of the subtendons in healthy mammals. Lastly, we present a new computational model coupled with human exercise trials to demonstrate the magnitude of Achilles subtendon sliding which occurs during rehabilitation exercises for Achilles tendinopathy, and shows that specific exercise can maximize subtendon sliding and interface strains, without maximizing subtendon strains. This work demonstrates the value of imaging and computational modeling for probing tendon structure-function relationships and may serve to inform and develop treatments for Achilles tendinopathy.
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Affiliation(s)
| | - Joachim Greiner
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Josef Madl
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva A Rog-Zielinska
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Enzo Hollville
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Vickie Shim
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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11
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In Silico-Enhanced Treatment and Rehabilitation Planning for Patients with Musculoskeletal Disorders: Can Musculoskeletal Modelling and Dynamic Simulations Really Impact Current Clinical Practice? APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207255] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the past decades, the use of computational physics-based models representative of the musculoskeletal (MSK) system has become increasingly popular in many fields of clinically driven research, locomotor rehabilitation in particular. These models have been applied to various functional impairments given their ability to estimate parameters which cannot be readily measured in vivo but are of interest to clinicians. The use of MSK modelling and simulations allows analysis of relevant MSK biomarkers such as muscle and joint contact loading at a number of different stages in the clinical treatment pathway in order to benefit patient functional outcome. Applications of these methods include optimisation of rehabilitation programs, patient stratification, disease characterisation, surgical pre-planning, and assistive device and exoskeleton design and optimisation. This review provides an overview of current approaches, the components of standard MSK models, applications, limitations, and assumptions of these modelling and simulation methods, and finally proposes a future direction.
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12
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Lacey S, Jamal Y, List SM, McCormick K, Sathian K, Nygaard LC. Stimulus Parameters Underlying Sound-Symbolic Mapping of Auditory Pseudowords to Visual Shapes. Cogn Sci 2020; 44:e12883. [PMID: 32909637 PMCID: PMC7896554 DOI: 10.1111/cogs.12883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/06/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
Sound symbolism refers to non-arbitrary mappings between the sounds of words and their meanings and is often studied by pairing auditory pseudowords such as "maluma" and "takete" with rounded and pointed visual shapes, respectively. However, it is unclear what auditory properties of pseudowords contribute to their perception as rounded or pointed. Here, we compared perceptual ratings of the roundedness/pointedness of large sets of pseudowords and shapes to their acoustic and visual properties using a novel application of representational similarity analysis (RSA). Representational dissimilarity matrices (RDMs) of the auditory and visual ratings of roundedness/pointedness were significantly correlated crossmodally. The auditory perceptual RDM correlated significantly with RDMs of spectral tilt, the temporal fast Fourier transform (FFT), and the speech envelope. Conventional correlational analyses showed that ratings of pseudowords transitioned from rounded to pointed as vocal roughness (as measured by the harmonics-to-noise ratio, pulse number, fraction of unvoiced frames, mean autocorrelation, shimmer, and jitter) increased. The visual perceptual RDM correlated significantly with RDMs of global indices of visual shape (the simple matching coefficient, image silhouette, image outlines, and Jaccard distance). Crossmodally, the RDMs of the auditory spectral parameters correlated weakly but significantly with those of the global indices of visual shape. Our work establishes the utility of RSA for analysis of large stimulus sets and offers novel insights into the stimulus parameters underlying sound symbolism, showing that sound-to-shape mapping is driven by acoustic properties of pseudowords and suggesting audiovisual cross-modal correspondence as a basis for language users' sensitivity to this type of sound symbolism.
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Affiliation(s)
- Simon Lacey
- Department of Neurology, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033-0859, USA
- Department of Neural & Behavioral Sciences, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033-0859, USA
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Yaseen Jamal
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Sara M. List
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Kelly McCormick
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - K. Sathian
- Department of Neurology, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033-0859, USA
- Department of Neural & Behavioral Sciences, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033-0859, USA
- Department of Psychology, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033-0859, USA
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Lynne C. Nygaard
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
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Devaprakash D, Obst SJ, Lloyd DG, Barrett RS, Kennedy B, Ball I, Adams KL, Collings TJ, Davico G, Hunter A, Vlahovich N, Pease DL, Pizzolato C. The Free Achilles Tendon Is Shorter, Stiffer, Has Larger Cross-Sectional Area and Longer T2 * Relaxation Time in Trained Middle-Distance Runners Compared to Healthy Controls. Front Physiol 2020; 11:965. [PMID: 32973544 PMCID: PMC7482361 DOI: 10.3389/fphys.2020.00965] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/15/2020] [Indexed: 12/14/2022] Open
Abstract
Tendon geometry and tissue properties are important determinants of tendon function and injury risk and are altered in response to ageing, disease, and physical activity levels. The purpose of this study was to compare free Achilles tendon geometry and mechanical properties between trained elite/sub-elite middle-distance runners and a healthy control group. Magnetic resonance imaging (MRI) was used to measure free Achilles tendon volume, length, average cross-sectional area (CSA), regional CSA, moment arm, and T2* relaxation time at rest, while freehand three-dimensional ultrasound (3DUS) was used to quantify free Achilles tendon mechanical stiffness, Young’s modulus, and length normalised mechanical stiffness. The free Achilles tendon in trained runners was significantly shorter and the average and regional CSA (distal end) were significantly larger compared to the control group. Mechanical stiffness of the free Achilles tendon was also significantly higher in trained runners compared to controls, which was explained by the group differences in tendon CSA and length. T2* relaxation time was significantly longer in trained middle-distance runners when compared to healthy controls. There was no relationship between T2* relaxation time and Young’s modulus. The longer T2* relaxation time in trained runners may be indicative of accumulated damage, disorganised collagen, and increased water content in the free Achilles tendon. A short free Achilles tendon with large CSA and higher mechanical stiffness may enable trained runners to rapidly transfer high muscle forces and possibly reduce the risk of tendon damage from mechanical fatigue.
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Affiliation(s)
- Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Steven J Obst
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,School of Health, Medical, and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Rod S Barrett
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Ben Kennedy
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,QSCAN Radiology Clinics, Gold Coast, QLD, Australia
| | - Iain Ball
- Philips Healthcare, Australia and New Zealand, Sydney, NSW, Australia
| | | | - Tyler J Collings
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Giorgio Davico
- Department of Industrial Engineering, Alma Mater Studiorum-University of Bologna, Bologna, Italy.,Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Adam Hunter
- Australian Institute of Sport, Canberra, ACT, Australia
| | | | - David L Pease
- Australian Institute of Sport, Canberra, ACT, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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14
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Pizzolato C, Shim VB, Lloyd DG, Devaprakash D, Obst SJ, Newsham-West R, Graham DF, Besier TF, Zheng MH, Barrett RS. Targeted Achilles Tendon Training and Rehabilitation Using Personalized and Real-Time Multiscale Models of the Neuromusculoskeletal System. Front Bioeng Biotechnol 2020; 8:878. [PMID: 32903393 PMCID: PMC7434842 DOI: 10.3389/fbioe.2020.00878] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Musculoskeletal tissues, including tendons, are sensitive to their mechanical environment, with both excessive and insufficient loading resulting in reduced tissue strength. Tendons appear to be particularly sensitive to mechanical strain magnitude, and there appears to be an optimal range of tendon strain that results in the greatest positive tendon adaptation. At present, there are no tools that allow localized tendon strain to be measured or estimated in training or a clinical environment. In this paper, we first review the current literature regarding Achilles tendon adaptation, providing an overview of the individual technologies that so far have been used in isolation to understand in vivo Achilles tendon mechanics, including 3D tendon imaging, motion capture, personalized neuromusculoskeletal rigid body models, and finite element models. We then describe how these technologies can be integrated in a novel framework to provide real-time feedback of localized Achilles tendon strain during dynamic motor tasks. In a proof of concept application, Achilles tendon localized strains were calculated in real-time for a single subject during walking, single leg hopping, and eccentric heel drop. Data was processed at 250 Hz and streamed on a smartphone for visualization. Achilles tendon peak localized strains ranged from ∼3 to ∼11% for walking, ∼5 to ∼15% during single leg hop, and ∼2 to ∼9% during single eccentric leg heel drop, overall showing large strain variation within the tendon. Our integrated framework connects, across size scales, knowledge from isolated tendons and whole-body biomechanics, and offers a new approach to Achilles tendon rehabilitation and training. A key feature is personalization of model components, such as tendon geometry, material properties, muscle geometry, muscle-tendon paths, moment arms, muscle activation, and movement patterns, all of which have the potential to affect tendon strain estimates. Model personalization is important because tendon strain can differ substantially between individuals performing the same exercise due to inter-individual differences in these model components.
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Affiliation(s)
- Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Vickie B Shim
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Steven J Obst
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Richard Newsham-West
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - David F Graham
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Thor F Besier
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Ming Hao Zheng
- Centre for Orthopaedic Translational Research, School of Surgery, The University of Western Australia, Nedlands, WA, Australia
| | - Rod S Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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15
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Gerke O. Reporting Standards for a Bland-Altman Agreement Analysis: A Review of Methodological Reviews. Diagnostics (Basel) 2020; 10:E334. [PMID: 32456091 PMCID: PMC7278016 DOI: 10.3390/diagnostics10050334] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022] Open
Abstract
The Bland-Altman Limits of Agreement is a popular and widespread means of analyzing the agreement of two methods, instruments, or raters in quantitative outcomes. An agreement analysis could be reported as a stand-alone research article but it is more often conducted as a minor quality assurance project in a subgroup of patients, as a part of a larger diagnostic accuracy study, clinical trial, or epidemiological survey. Consequently, such an analysis is often limited to brief descriptions in the main report. Therefore, in several medical fields, it has been recommended to report specific items related to the Bland-Altman analysis. The present study aimed to identify the most comprehensive and appropriate list of items for such an analysis. Seven proposals were identified from a MEDLINE/PubMed search, three of which were derived by reviewing anesthesia journals. Broad consensus was seen for the a priori establishment of acceptability benchmarks, estimation of repeatability of measurements, description of the data structure, visual assessment of the normality and homogeneity assumption, and plotting and numerically reporting both bias and the Bland-Altman Limits of Agreement, including respective 95% confidence intervals. Abu-Arafeh et al. provided the most comprehensive and prudent list, identifying 13 key items for reporting (Br. J. Anaesth. 2016, 117, 569-575). An exemplification with interrater data from a local study accentuated the straightforwardness of transparent reporting of the Bland-Altman analysis. The 13 key items should be applied by researchers, journal editors, and reviewers in the future, to increase the quality of reporting Bland-Altman agreement analyses.
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Affiliation(s)
- Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 47, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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16
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Grant TM, Diamond LE, Pizzolato C, Killen BA, Devaprakash D, Kelly L, Maharaj JN, Saxby DJ. Development and validation of statistical shape models of the primary functional bone segments of the foot. PeerJ 2020; 8:e8397. [PMID: 32117607 PMCID: PMC7006516 DOI: 10.7717/peerj.8397] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
Introduction Musculoskeletal models are important tools for studying movement patterns, tissue loading, and neuromechanics. Personalising bone anatomy within models improves analysis accuracy. Few studies have focused on personalising foot bone anatomy, potentially incorrectly estimating the foot’s contribution to locomotion. Statistical shape models have been created for a subset of foot-ankle bones, but have not been validated. This study aimed to develop and validate statistical shape models of the functional segments in the foot: first metatarsal, midfoot (second-to-fifth metatarsals, cuneiforms, cuboid, and navicular), calcaneus, and talus; then, to assess reconstruction accuracy of these shape models using sparse anatomical data. Methods Magnetic resonance images of 24 individuals feet (age = 28 ± 6 years, 52% female, height = 1.73 ± 0.8 m, mass = 66.6 ± 13.8 kg) were manually segmented to generate three-dimensional point clouds. Point clouds were registered and analysed using principal component analysis. For each bone segment, a statistical shape model and principal components were created, describing population shape variation. Statistical shape models were validated by assessing reconstruction accuracy in a leave-one-out cross validation. Statistical shape models were created by excluding a participant’s bone segment and used to reconstruct that same excluded bone using full segmentations and sparse anatomical data (i.e. three discrete points on each segment), for all combinations in the dataset. Tali were not reconstructed using sparse anatomical data due to a lack of externally accessible landmarks. Reconstruction accuracy was assessed using Jaccard index, root mean square error (mm), and Hausdorff distance (mm). Results Reconstructions generated using full segmentations had mean Jaccard indices between 0.77 ± 0.04 and 0.89 ± 0.02, mean root mean square errors between 0.88 ± 0.19 and 1.17 ± 0.18 mm, and mean Hausdorff distances between 2.99 ± 0.98 mm and 6.63 ± 3.68 mm. Reconstructions generated using sparse anatomical data had mean Jaccard indices between 0.67 ± 0.06 and 0.83 ± 0.05, mean root mean square error between 1.21 ± 0.54 mm and 1.66 ± 0.41 mm, and mean Hausdorff distances between 3.21 ± 0.94 mm and 7.19 ± 3.54 mm. Jaccard index was higher (P < 0.01) and root mean square error was lower (P < 0.01) in reconstructions from full segmentations compared to sparse anatomical data. Hausdorff distance was lower (P < 0.01) for midfoot and calcaneus reconstructions using full segmentations compared to sparse anatomical data. Conclusion For the first time, statistical shape models of the primary functional segments of the foot were developed and validated. Foot segments can be reconstructed with minimal error using full segmentations and sparse anatomical landmarks. In future, larger training datasets could increase statistical shape model robustness, extending use to paediatric or pathological populations.
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Affiliation(s)
- Tamara M Grant
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Luke Kelly
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Jayishni N Maharaj
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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17
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Kositsky A, Gonçalves BAM, Stenroth L, Barrett RS, Diamond LE, Saxby DJ. Reliability and Validity of Ultrasonography for Measurement of Hamstring Muscle and Tendon Cross-Sectional Area. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:55-63. [PMID: 31668942 DOI: 10.1016/j.ultrasmedbio.2019.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/15/2019] [Accepted: 09/18/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to determine the reliability and validity of ultrasonography for measurement of hamstring muscle and semitendinosus (ST) tendon cross-sectional area (CSA). On two consecutive days, muscle anatomical CSA (ACSA) and ST tendon CSA were measured at standardized positions (30%-80% of thigh length; half the distance from the distal muscle-tendon junction to the popliteal crease) on 12 legs using ultrasonography and compared with corresponding magnetic resonance imaging measures. Inter-day intraclass correlation coefficients were good-to-excellent (0.882-0.996) for all assessed muscle and tendon sites. The limits of agreement widths were narrowest (range: 17%-52%) when muscle ACSA was large but were wide at sites with relatively small ACSA (≤184%) and for ST tendon CSA (range: 72%). Results suggest ultrasound-based measures of individual hamstring muscle maximal ACSA are reliable and valid and ST tendon CSA measures are reliable but require comparison with cadaveric or intra-operative measurements to verify validity.
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Affiliation(s)
- Adam Kositsky
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
| | - Basílio A M Gonçalves
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Rod S Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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18
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Pizzolato C, Saxby DJ, Palipana D, Diamond LE, Barrett RS, Teng YD, Lloyd DG. Neuromusculoskeletal Modeling-Based Prostheses for Recovery After Spinal Cord Injury. Front Neurorobot 2019; 13:97. [PMID: 31849634 PMCID: PMC6900959 DOI: 10.3389/fnbot.2019.00097] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/05/2019] [Indexed: 01/12/2023] Open
Abstract
Concurrent stimulation and reinforcement of motor and sensory pathways has been proposed as an effective approach to restoring function after developmental or acquired neurotrauma. This can be achieved by applying multimodal rehabilitation regimens, such as thought-controlled exoskeletons or epidural electrical stimulation to recover motor pattern generation in individuals with spinal cord injury (SCI). However, the human neuromusculoskeletal (NMS) system has often been oversimplified in designing rehabilitative and assistive devices. As a result, the neuromechanics of the muscles is seldom considered when modeling the relationship between electrical stimulation, mechanical assistance from exoskeletons, and final joint movement. A powerful way to enhance current neurorehabilitation is to develop the next generation prostheses incorporating personalized NMS models of patients. This strategy will enable an individual voluntary interfacing with multiple electromechanical rehabilitation devices targeting key afferent and efferent systems for functional improvement. This narrative review discusses how real-time NMS models can be integrated with finite element (FE) of musculoskeletal tissues and interface multiple assistive and robotic devices with individuals with SCI to promote neural restoration. In particular, the utility of NMS models for optimizing muscle stimulation patterns, tracking functional improvement, monitoring safety, and providing augmented feedback during exercise-based rehabilitation are discussed.
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Affiliation(s)
- Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Dinesh Palipana
- Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Gold Coast Hospital and Health Service, Gold Coast, QLD, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Rod S Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Yang D Teng
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, United States.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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