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Cesanelli L, Minderis P, Degens H, Satkunskiene D. Passive mechanical properties of adipose tissue and skeletal muscle from C57BL/6J mice. J Mech Behav Biomed Mater 2024; 155:106576. [PMID: 38744119 DOI: 10.1016/j.jmbbm.2024.106576] [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: 12/06/2023] [Revised: 02/01/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Skeletal muscle and adipose tissue are characterized by unique structural features finely tuned to meet specific functional demands. In this study, we investigated the passive mechanical properties of soleus (SOL), extensor digitorum longus (EDL) and diaphragm (DIA) muscles, as well as subcutaneous (SAT), visceral (VAT) and brown (BAT) adipose tissues from 13 C57BL/6J mice. Thereto, alongside stress-relaxation assessments we subjected isolated muscles and adipose tissues (ATs) to force-extension tests up to 10% and 30% of their optimal length, respectively. Peak passive stress was highest in the DIA, followed by the SOL and lowest in the EDL (p < 0.05). SOL displayed also the highest Young's modulus and hysteresis among muscles (p < 0.05). BAT demonstrated highest peak passive stress and Young's modulus followed by VAT (p < 0.05), while SAT showed the highest hysteresis (p < 0.05). When comparing data across all six biological specimens at fixed passive force intervals (i.e., 20-40 and 50-70 mN), skeletal muscles exhibited significantly higher peak stresses and strains than ATs (p < 0.05). Young's modulus was higher in skeletal muscles than in ATs (p < 0.05). Muscle specimens exhibited slower force relaxation in the first phase compared to ATs (p < 0.05), while there was no significant difference in behavior between muscles and AT in the second phase of relaxation. The study revealed distinctive mechanical behaviors specific to different tissues, and even between different muscles and ATs. These variations in mechanical properties are likely such to optimize the specific functions performed by each biological tissue.
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Affiliation(s)
- L Cesanelli
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania; Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania.
| | - P Minderis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - H Degens
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania; Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - D Satkunskiene
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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Lunardi M, Sakugawa RL, Furtado FE, Sampaio LT, Diefenthaeler F. Morphological characteristics of the patellar tendon in runners, cyclists, triathletes, and physically active individuals. J Ultrasound 2024:10.1007/s40477-023-00865-6. [PMID: 38393454 DOI: 10.1007/s40477-023-00865-6] [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: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 02/25/2024] Open
Abstract
The objective of the study was to compare measurements of length, thickness, and cross-section area (CSA) of the patellar tendon (PT) among cyclists, runners, triathletes, and physically active individuals (control group). Forty healthy individuals (10 cyclists, 10 runners, 10 triathletes, and 10 physically active individuals) aged between 18 and 45 years (30.3 ± 8.6 years) participated in the study. PT was measured by a B-mode ultrasound system. To measure the length and thickness (in 5, 10, 15, and 20 mm of the PT length) the probe was positioned parallel to the tendon and to measure the CSA the probe was positioned perpendicularly in 25, 50, and 75% of the PT length. PT length data were analyzed using a one-way ANOVA to compare between groups and PT CSA and thickness were analyzed using a two-way ANOVA (group vs. position) to compare the variables among the groups with the post-hoc Tukey test. All statistical analyses were performed considering p < 0.05. We observed a significant difference, where cyclists had smaller PT thickness (regardless of the location measured) compared to the group of triathletes (p = 0.001) and the physically active group (p = 0.043). All other variables (length, thickness, and CSA) and interactions (local and position) were not significant. We concluded that regardless of the position where PT thickness is measured, cyclists have smaller PT thickness compared to triathletes and physically active individuals but similar when compared to runners. And no differences in the length and CSA of the PT between groups.
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Affiliation(s)
- Morgana Lunardi
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Raphael Luiz Sakugawa
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Franklin Everaldo Furtado
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Lucas Tavares Sampaio
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Fernando Diefenthaeler
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil.
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3
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Bontemps B, Gruet M, Louis J, Owens DJ, Miríc S, Vercruyssen F, Erskine RM. Patellar Tendon Adaptations to Downhill Running Training and Their Relationships With Changes in Mechanical Stress and Loading History. J Strength Cond Res 2024; 38:21-29. [PMID: 38085619 DOI: 10.1519/jsc.0000000000004617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
ABSTRACT Bontemps, B, Gruet, M, Louis, J, Owens, DJ, Miríc, S, Vercruyssen, F, and Erskine, RM. Patellar tendon adaptations to downhill running training and their relationships with changes in mechanical stress and loading history. J Strength Cond Res 38(1): 21-29, 2024-It is unclear whether human tendon adapts to moderate-intensity, high-volume long-term eccentric exercise, e.g., downhill running (DR) training. This study aimed to investigate the time course of patellar tendon (PT) adaptation to short-term DR training and to determine whether changes in PT properties were related to changes in mechanical stress or loading history. Twelve untrained, young, healthy adults (5 women and 7 men) took part in 4 weeks' DR training, comprising 10 sessions. Running speed was equivalent to 60-65% V̇O2max, and session duration increased gradually (15-30 minutes) throughout training. Isometric knee extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle physiological cross-sectional area (PCSA) and volume, and PT CSA, stiffness, and Young's modulus were assessed at weeks 0, 2, and 4 using ultrasound and isokinetic dynamometry. Patellar tendon stiffness (+6.4 ± 7.4%), Young's modulus (+6.9 ± 8.8%), isometric MVT (+7.5 ± 12.3%), VL volume (+6.6 ± 3.2%), and PCSA (+3.8 ± 3.3%) increased after 4 weeks' DR (p < 0.05), with no change in PT CSA. Changes in VL PCSA correlated with changes in PT stiffness (r = 0.70; p = 0.02) and Young's modulus (r = 0.63; p = 0.04) from 0 to 4 weeks, whereas changes in MVT did not correlate with changes in PT stiffness and Young's modulus at any time point (p > 0.05). To conclude, 4 weeks' DR training promoted substantial changes in PT stiffness and Young's modulus that are typically observed after high-intensity, low-volume resistance training. These tendon adaptations seemed to be driven primarily by loading history (represented by VL muscle hypertrophy), whereas increased mechanical stress throughout the training period did not seem to contribute to changes in PT stiffness or Young's modulus.
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Affiliation(s)
- Bastien Bontemps
- Université de Toulon, Laboratoire IAPS (n°201723207F), Toulon, France
- Université Côte d'Azur, LAMHESS, Nice, France
| | - Mathieu Gruet
- Université de Toulon, Laboratoire IAPS (n°201723207F), Toulon, France
| | - Julien Louis
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | - Daniel J Owens
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | - Stella Miríc
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | | | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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4
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Monte A, Skypala J, Vilimek D, Juras V, Jandacka D. Correlations between Achilles tendon material and structural properties and quantitative magnetic resonance imagining in different athletic populations. J Biomech 2023; 159:111796. [PMID: 37696235 DOI: 10.1016/j.jbiomech.2023.111796] [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: 05/02/2023] [Revised: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
Achilles tendon stiffness (kAT) and Young's modulus (yAT) are important determinants of tendon function. However, their evaluation requires sophisticated equipment and time-consuming procedures. The goal of this study was twofold: to compare kAT and yAT between populations using the classical approach proposed in the literature (a combination of ultrasound and force data) and the MRI technique to understand the MRI's capability in determining differences in kAT and yAT. Furthermore, we investigated potential correlations between short and long T2* relaxation time, kAT and yAT to determine whether T2* relaxation time may be associated with material or structural properties. Twelve endurance and power athlete, and twelve healthy controls were recruited. AT T2* short and long components were measured using standard gradient echo MRI at rest, while kAT and yAT were evaluated using the classical method (combination of ultrasound and dynamometric measurements). Power athletes had the highest kAT (3064 ± 260, 2714 ± 260 and 2238 ± 189 N/mm for power athletes, endurance athletes and healthy control, respectively) and yAT (2.39 ± 0.28, 1.64 ± 0.22 and 1.97 ± 0.32 GPa for power athletes, endurance athletes and healthy control, respectively) and the lowest T2* short component (0.58 ± 0.07, 0.77 ± 0.06 and 0.74 ± 0.08 ms for power athletes, endurance athletes and healthy control, respectively). Endurance athletes had the highest T2* long component value. No correlations were reported between T2* long component, kAT or yAT in the investigated populations, whereas the T2* short component was negatively correlated with yAT. These results suggest that T2* short component could be used to investigate the differences in AT material properties in different populations.
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Affiliation(s)
- Andrea Monte
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Jiri Skypala
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic
| | - Dominik Vilimek
- Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VSB - Technical University of Ostrava, 17. listopadu 15, Ostrava - Poruba 70800, Czech Republic
| | - Vladimir Juras
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Daniel Jandacka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic
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Götschi T, Held V, Klucker G, Niederöst B, Aagaard P, Spörri J, Passini FS, Snedeker JG. PIEZO1 gain-of-function gene variant is associated with elevated tendon stiffness in humans. J Appl Physiol (1985) 2023; 135:165-173. [PMID: 37227181 PMCID: PMC10625831 DOI: 10.1152/japplphysiol.00573.2022] [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: 09/27/2022] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 05/26/2023] Open
Abstract
Prolonged periods of increased physical demands can elicit anabolic tendon adaptations that increase stiffness and mechanical resilience or conversely can lead to pathological processes that deteriorate tendon structural quality with ensuing pain and potential rupture. Although the mechanisms by which tendon mechanical loads regulate tissue adaptation are largely unknown, the ion channel PIEZO1 has been implicated in tendon mechanotransduction, with human carriers of the PIEZO1 gain-of-function variant E756del displaying improved dynamic vertical jump performance compared with noncarriers. Here, we sought to examine whether increased tendon stiffness in humans could explain this increased performance. We assessed tendon morphological and mechanical properties with ultrasound-based techniques in 77 participants of Middle- and West-African descent, and we measured their vertical jumping performance to assess potential functional consequences in the context of high tendon strain-rate loading. Carrying the E756del gene variant (n = 30) was associated with 46.3 ± 68.3% (P = 0.002) and 45.6 ± 69.2% (P < 0.001) higher patellar tendon stiffness and Young's modulus compared with noncarrying controls, respectively. Although these tissue level measures strongly corroborate the initial postulate that PIEZO1 plays an integral part in regulating tendon material properties and stiffness in humans, we found no detectable correlation between tendon stiffness and jumping performance in the tested population that comprised individuals of highly diverse physical fitness level, dexterity, and jumping ability.NEW & NOTEWORTHY The E756del gene variant causes overactivity of the mechanosensitive membrane channel PIEZO1 and is suspected to upregulate tendon collagen cross linking. In human carriers of E756del, we found increased patellar tendon stiffness but similar tendon lengths and cross-sectional areas, directly supporting the premise that PIEZO1 regulates human tendon stiffness at the level of tissue material properties.
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Affiliation(s)
- Tobias Götschi
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Victoria Held
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Gianna Klucker
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Barbara Niederöst
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Per Aagaard
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Fabian S Passini
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Jess G Snedeker
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
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6
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Anthropometric Parameters on Achilles Tendon Stiffness of Professional Athletes Measured by Shear Wave Elastography. J Clin Med 2023; 12:jcm12082963. [PMID: 37109299 PMCID: PMC10145458 DOI: 10.3390/jcm12082963] [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: 03/06/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Shear wave elastography (SWE) is currently used to detect tissue pathologies and, in the setting of preventive medicine, may have the potential to reveal structural changes before they lead to functional impairment. Hence, it would be desirable to determine the sensitivity of SWE and to investigate how Achilles tendon stiffness is affected by anthropometric variables and sport-specific locomotion. METHODS To investigate the influence of anthropometric parameters on Achilles tendon stiffness using SWE and examine different types of sports to develop approaches in preventive medicine for professional athletes, standardized SWE of Achilles tendon stiffness was performed in 65 healthy professional athletes (33 female, 32 male) in the longitudinal plane and relaxed tendon position. Descriptive analysis and linear regression were performed. Furthermore, subgroup analysis was performed for different sports (soccer, handball, sprint, volleyball, hammer throw). RESULTS In the total study population (n = 65), Achilles tendon stiffness was significantly higher in male professional athletes (p < 0.001) than in female professional athletes (10.98 m/s (10.15-11.65) vs. 12.19 m/s (11.25-14.74)). Multiple linear regression for AT stiffness did not reveal a significant impact of age or body mass index (BMI) (p > 0.05). Subgroup analysis for type of sport showed the highest AT stiffness values in sprinters (14.02 m/s (13.50-14.63)). CONCLUSION There are significant gender differences in AT stiffness across different types of professional athletes. The highest AT stiffness values were found in sprinters, which needs to be considered when diagnosing tendon pathologies. Future studies are needed to investigate the benefit of pre- and post-season musculoskeletal SWE examinations of professional athletes and a possible benefit of rehabilitation or preventive medicine.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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7
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Kneifel P, Moewis P, Damm P, Schütz P, Dymke J, Taylor WR, Duda GN, Trepczynski A. Patellar tendon elastic properties derived from in vivo loading and kinematics. J Biomech 2023; 151:111549. [PMID: 36948000 DOI: 10.1016/j.jbiomech.2023.111549] [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: 07/07/2022] [Revised: 02/03/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Patellar complications frequently limit the success of total knee arthroplasty. In addition to the musculoskeletal forces themselves, patellar tendon elastic properties are essential for driving patellar loading. Elastic properties reported in the literature exhibit high variability and appear to differ according to the methodologies used. Specifically in total knee arthroplasty patients, only limited knowledge exists on in vivo elastic properties and their corresponding loads. For the first time, we report stiffness, Young's modulus, and forces of the patellar tendon, derived from four patients with telemetric total knee arthroplasties using a combined imaging and measurement approach. To achieve this, synchronous in vivo telemetric assessment of tibio-femoral contact forces and fluoroscopic assessment of knee kinematics, along with full body motion capture and ground reaction forces, fed musculoskeletal multi-body models to quantify patellar tendon loading and elongation. Mechanical patellar tendon properties were calculated during a squat and a sit-stand-sit activity, with resulting tendon stiffness and Young's modulus ranging from 511 to 1166 N/mm and 259 to 504 MPa, respectively. During these activities, the patellar tendon force reached peak values between 1.31 and 2.79 bodyweight, reaching levels of just ∼0.5 bodyweight below the tibio-femoral forces. The results of this study provide valuable input data for mechanical simulations of the patellar tendon and the whole resurfaced knee.
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Affiliation(s)
- Paul Kneifel
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
| | - Philippe Moewis
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Philipp Damm
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Pascal Schütz
- Laboratory for Movement Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Jörn Dymke
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - William R Taylor
- Laboratory for Movement Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Georg N Duda
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Adam Trepczynski
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
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8
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Werkhausen A, Gløersen Ø, Nordez A, Paulsen G, Bojsen-Møller J, Seynnes OR. Rate of force development relationships to muscle architecture and contractile behavior in the human vastus lateralis. Sci Rep 2022; 12:21816. [PMID: 36528647 PMCID: PMC9759581 DOI: 10.1038/s41598-022-26379-5] [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: 08/26/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
In this study, we tested the hypotheses that (i) rate of force development (RFD) is correlated to muscle architecture and dynamics and that (ii) force-length-velocity properties limit knee extensor RFD. Twenty-one healthy participants were tested using ultrasonography and dynamometry. Vastus lateralis optimal fascicle length, fascicle velocity, change in pennation angle, change in muscle length, architectural gear ratio, and force were measured during rapid fixed-end contractions at 60° knee angle to determine RFD. Isokinetic and isometric tests were used to estimate individual force-length-velocity properties, to evaluate force production relative to maximal potential. Correlation analyses were performed between force and muscle parameters for the first three 50 ms intervals. RFD was not related to optimal fascicle length for any measured time interval, but RFD was positively correlated to fascicle shortening velocity during all intervals (r = 0.49-0.69). Except for the first interval, RFD was also related to trigonometry-based changes in muscle length and pennation angle (r = 0.45-0.63) but not to architectural gear ratio. Participants reached their individual vastus lateralis force-length-velocity potential (i.e. their theoretical maximal force at a given length and shortening velocity) after 62 ± 24 ms. Our results confirm the theoretical importance of fascicle shortening velocity and force-length-velocity properties for rapid force production and suggest a role of fascicle rotation.
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Affiliation(s)
- Amelie Werkhausen
- grid.412285.80000 0000 8567 2092Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Øyvind Gløersen
- grid.4319.f0000 0004 0448 3150SINTEF Digital, Smart Sensors and Microsystems, Oslo, Norway
| | - Antoine Nordez
- grid.4817.a0000 0001 2189 0784Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, 44000 Nantes, France ,grid.440891.00000 0001 1931 4817Institut Universitaire de France (IUF), Paris, France
| | - Gøran Paulsen
- grid.412285.80000 0000 8567 2092Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jens Bojsen-Møller
- grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Olivier R. Seynnes
- grid.412285.80000 0000 8567 2092Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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9
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Nonnenmacher CH, Nunes I, de Moura BM, Diefenthaeler F, Lima KMME. Does static stretching change uniformly the quadriceps elasticity in physically actives subjects? J Ultrasound 2022; 25:915-921. [PMID: 35412126 PMCID: PMC9705688 DOI: 10.1007/s40477-021-00649-w] [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: 11/09/2021] [Accepted: 12/11/2021] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Verify the acute responses of static stretching (SS) on the rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) elasticity and knee/hip range of motion (ROM). Additionally, to investigate if there are consistency among quadriceps muscle elasticity after SS. METHODS Acute effect of SS on pre-post-intervention design. Thirtheen healthy participants (both genders) proposed for a pre-post experimental design. RF, VM, and VL elasticity (strain ratio, SR) was evaluated bilaterally by ultrasound with quasi-static elastography. Higher SR values refer to more rigid tissues. A SS protocol of 3 series of 30 s was applied at right lower limb. The left lower limb was considered as control group. Also, photogrammetry evaluated the knee/hip ROM. RESULTS For SR muscle comparisons, VM was lower (less stiff) than VL and RF at pre- and post-SS. For time comparisons, no differences were observed for SR and ROM at pre- and post-SS. However, the effect size of the quadriceps SR at SS lower limb was higher than control. CONCLUSION Acute effects of SS did not change the quadriceps SR or knee/hip ROM in healthy and active subjects. Non-uniform quadriceps SR are observed (VM < VL and RF) independently of SS. Future studies should consider different protocols, muscles, and populations.
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Affiliation(s)
- Carolina Holz Nonnenmacher
- Physiotherapy Course, Department of Health Sciences, Federal University of Santa Catarina, Governador Jorge Lacerda, 3201, Araranguá, Santa Catarina, 88906-072, Brazil.
| | - Iohana Nunes
- Post-Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, 88906-072, Brazil
| | - Bruno Monteiro de Moura
- Biomechanics Laboratory, Department of Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, 88040-900, Brazil
| | - Fernando Diefenthaeler
- Biomechanics Laboratory, Department of Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, 88040-900, Brazil
| | - Kelly Mônica Marinho E Lima
- Physiotherapy Course, Department of Health Sciences, Federal University of Santa Catarina, Governador Jorge Lacerda, 3201, Araranguá, Santa Catarina, 88906-072, Brazil
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10
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Rieder F, Wiesinger HP, Herfert J, Lampl K, Hecht S, Niebauer J, Maffulli N, Kösters A, Müller E, Seynnes OR. Whole body vibration for chronic patellar tendinopathy: A randomized equivalence trial. Front Physiol 2022; 13:1017931. [PMID: 36338477 PMCID: PMC9633993 DOI: 10.3389/fphys.2022.1017931] [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: 08/12/2022] [Accepted: 10/06/2022] [Indexed: 02/02/2023] Open
Abstract
Purpose: Whole body vibration (WBV) triggers anabolic responses in various tissues, including tendons, without requiring high force production. In this waitlist-controlled equivalence trial, we tested its clinical effectiveness as an alternative treatment for patellar tendinopathy against conventional heavy slow resistance training (HSR). Methods: Thirty-nine patients were randomized to either 3 months of WBV training (n = 13), HSR training (n = 11), or a waitlist control (WLC) group (n = 15). In a partly cross-over design, 14 patients of the WLC group were redistributed to one of the two intervention groups (5 in WBV, 9 in HSR). Pre- and post-intervention testing included pain assessments (VAS), functional limitations (VISA-P), knee extension strength and tendon morphological, mechanical and material properties. Follow-up measurements (VAS, VISA-P) were performed in the WBV and HSR groups 6 months after the intervention. Results: Comparisons with the WLC group revealed significant improvements in VISA-P and VAS scores after HSR (41%, p = 003; 54%, p = 0.005) and WBV (22%, p = 0.022; 56%, p = 0.031) training. These improvements continued until follow-up (HSR: 43%, 56%; WBV: 24%, 37%). Pre-post improvements in VAS scores were equivalent between WBV and HSR groups but inconclusive for the VISA-P score and all pre-test to follow up comparisons. The mid-tendon cross-sectional area was significantly reduced after WBV (-5.7%, p = 0.004) and HSR (-3.0%, p = 0.004) training compared to WLC although the equivalence test between interventions was inconclusive. Conclusion: Whole body vibration improved symptoms typically associated with patellar tendinopathy. This type of intervention is as effective as HSR against maximum pain, although equivalence could not be confirmed for other variables. The beneficial responses to WBV and HSR treatments persisted for 6 months after the end of the intervention. Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do, identifier DRKS00011338.
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Affiliation(s)
- Florian Rieder
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria,*Correspondence: Florian Rieder,
| | - Hans-Peter Wiesinger
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Jürgen Herfert
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Red Bull Athlete Performance Center, Thalgau, Austria
| | - Katrin Lampl
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Hecht
- Institute of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy,Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, United Kingdom,School of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire, United Kingdom
| | - Alexander Kösters
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Erich Müller
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Olivier R. Seynnes
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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11
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Abián P, Bravo-Sánchez A, Jiménez F, Abián-Vicén J. CARACTERÍSTICAS DEL TENDÓN ROTULIANO Y DE AQUILES EN JUGADORES SENIOR DE BÁDMINTON. REVISTA INTERNACIONAL DE MEDICINA Y CIENCIAS DE LA ACTIVIDAD FÍSICA Y DEL DEPORTE 2022. [DOI: 10.15366/rimcafd2022.87.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Los objetivos del estudio fueron describir las propiedades estructurales y mecánicas de los tendones rotuliano y de Aquiles en jugadores senior (>35 años) de bádminton y detectar posibles asimetrías entre el lado dominante y no dominante. La muestra estuvo compuesta por 206 jugadores senior de bádminton (Edad: 52.2±9.6 años) que participaron en el campeonato de Europa Senior en 2018. Se evaluaron las propiedades estructurales (grosor, anchura y área de sección transversal) por medio de un ecógrafo Logiq® S8 y las propiedades mecánicas (elasticidad, tono, rigidez e índice de elastografía) con miotonometría y sonoelastografía de los tendones rotuliano y de Aquiles. Los resultados mostraron que fueron mayores el grosor (5.34±19.90%, p = 0.027) y la anchura (1.57±8.52%, p=0.036) en el tendón de Aquiles no dominante mientras que el tendón rotuliano dominante mostró unos valores mayores para el tono (2.09±12.96%, p=0.002) y para la rigidez (4.41±21.11%, p=0.002) respecto al no dominante.
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12
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Merry K, Napier C, Waugh CM, Scott A. Foundational Principles and Adaptation of the Healthy and Pathological Achilles Tendon in Response to Resistance Exercise: A Narrative Review and Clinical Implications. J Clin Med 2022; 11:4722. [PMID: 36012960 PMCID: PMC9410084 DOI: 10.3390/jcm11164722] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
Therapeutic exercise is widely considered a first line fundamental treatment option for managing tendinopathies. As the Achilles tendon is critical for locomotion, chronic Achilles tendinopathy can have a substantial impact on an individual's ability to work and on their participation in physical activity or sport and overall quality of life. The recalcitrant nature of Achilles tendinopathy coupled with substantial variation in clinician-prescribed therapeutic exercises may contribute to suboptimal outcomes. Further, loading the Achilles tendon with sufficiently high loads to elicit positive tendon adaptation (and therefore promote symptom alleviation) is challenging, and few works have explored tissue loading optimization for individuals with tendinopathy. The mechanism of therapeutic benefit that exercise therapy exerts on Achilles tendinopathy is also a subject of ongoing debate. Resultingly, many factors that may contribute to an optimal therapeutic exercise protocol for Achilles tendinopathy are not well described. The aim of this narrative review is to explore the principles of tendon remodeling under resistance-based exercise in both healthy and pathologic tissues, and to review the biomechanical principles of Achilles tendon loading mechanics which may impact an optimized therapeutic exercise prescription for Achilles tendinopathy.
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Affiliation(s)
- Kohle Merry
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver, BC V5Z 1M9, Canada
| | - Christopher Napier
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver, BC V5Z 1M9, Canada
| | - Charlie M. Waugh
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver, BC V5Z 1M9, Canada
| | - Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver, BC V5Z 1M9, Canada
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13
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Arntz F, Mkaouer B, Markov A, Schoenfeld BJ, Moran J, Ramirez-Campillo R, Behrens M, Baumert P, Erskine RM, Hauser L, Chaabene H. Effect of Plyometric Jump Training on Skeletal Muscle Hypertrophy in Healthy Individuals: A Systematic Review With Multilevel Meta-Analysis. Front Physiol 2022; 13:888464. [PMID: 35832484 PMCID: PMC9271893 DOI: 10.3389/fphys.2022.888464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022] Open
Abstract
Objective: To examine the effect of plyometric jump training on skeletal muscle hypertrophy in healthy individuals. Methods: A systematic literature search was conducted in the databases PubMed, SPORTDiscus, Web of Science, and Cochrane Library up to September 2021. Results: Fifteen studies met the inclusion criteria. The main overall finding (44 effect sizes across 15 clusters median = 2, range = 1–15 effects per cluster) indicated that plyometric jump training had small to moderate effects [standardised mean difference (SMD) = 0.47 (95% CIs = 0.23–0.71); p < 0.001] on skeletal muscle hypertrophy. Subgroup analyses for training experience revealed trivial to large effects in non-athletes [SMD = 0.55 (95% CIs = 0.18–0.93); p = 0.007] and trivial to moderate effects in athletes [SMD = 0.33 (95% CIs = 0.16–0.51); p = 0.001]. Regarding muscle groups, results showed moderate effects for the knee extensors [SMD = 0.72 (95% CIs = 0.66–0.78), p < 0.001] and equivocal effects for the plantar flexors [SMD = 0.65 (95% CIs = −0.25–1.55); p = 0.143]. As to the assessment methods of skeletal muscle hypertrophy, findings indicated trivial to small effects for prediction equations [SMD = 0.29 (95% CIs = 0.16–0.42); p < 0.001] and moderate-to-large effects for ultrasound imaging [SMD = 0.74 (95% CIs = 0.59–0.89); p < 0.001]. Meta-regression analysis indicated that the weekly session frequency moderates the effect of plyometric jump training on skeletal muscle hypertrophy, with a higher weekly session frequency inducing larger hypertrophic gains [β = 0.3233 (95% CIs = 0.2041–0.4425); p < 0.001]. We found no clear evidence that age, sex, total training period, single session duration, or the number of jumps per week moderate the effect of plyometric jump training on skeletal muscle hypertrophy [β = −0.0133 to 0.0433 (95% CIs = −0.0387 to 0.1215); p = 0.101–0.751]. Conclusion: Plyometric jump training can induce skeletal muscle hypertrophy, regardless of age and sex. There is evidence for relatively larger effects in non-athletes compared with athletes. Further, the weekly session frequency seems to moderate the effect of plyometric jump training on skeletal muscle hypertrophy, whereby more frequent weekly plyometric jump training sessions elicit larger hypertrophic adaptations.
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Affiliation(s)
- F. Arntz
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - B. Mkaouer
- Department of Individual Sports, Higher Institute of Sport and Physical Education of Ksar Said, University of Manouba, Tunis, Tunisia
| | - A. Markov
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - B. J. Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, NY, United States
| | - J. Moran
- Rehabilitation and Exercise Sciences, School of Sport, University of Essex, Colchester, United Kingdom
| | - R. Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile
- Exercise and Rehabilitation Sciences Laboratory, Faculty of Rehabilitation Sciences, School of Physical Therapy, Universidad Andres Bello, Santiago, Chile
| | - M. Behrens
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - P. Baumert
- Exercise Biology Group, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - R. M. Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - L. Hauser
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - H. Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- *Correspondence: H. Chaabene,
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14
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Sichting F, Kram NC, Legerlotz K. An Identical Twin Study on Human Achilles Tendon Adaptation: Regular Recreational Exercise at Comparatively Low Intensities Can Increase Tendon Stiffness. Front Physiol 2022; 12:777403. [PMID: 35069241 PMCID: PMC8766644 DOI: 10.3389/fphys.2021.777403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Achilles tendon adaptation is a key aspect of exercise performance and injury risk prevention. However, much debate exists about the adaptation of the Achilles tendon in response to exercise activities. Most published research is currently limited to elite athletes and selected exercise activities. Also, existing studies on tendon adaptation do not control for genetic variation. Our explorative cross-sectional study investigated the effects of regular recreational exercise activities on Achilles tendon mechanical properties in 40 identical twin pairs. Using a handheld oscillation device to determine Achilles tendon mechanical properties, we found that the Achilles tendon appears to adapt to regular recreational exercise at comparatively low intensities by increasing its stiffness. Active twins showed a 28% greater Achilles tendon stiffness than their inactive twin (p < 0.05). Further, our research extends existing ideas on sport-specific adaptation by showing that tendon stiffness seemed to respond more to exercise activities that included an aerial phase such as running and jumping. Interestingly, the comparison of twin pairs revealed a high variation of Achilles tendon stiffness (305.4–889.8 N/m), and tendon adaptation was only revealed when we controlled for genetic variance. Those results offer new insights into the impact of genetic variation on individual Achilles tendon stiffness, which should be addressed more closely in future studies.
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Affiliation(s)
- Freddy Sichting
- Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
| | - Nicolai C Kram
- Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
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15
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Differences in Knee Extensors’ Muscle–Tendon Unit Passive Stiffness, Architecture, and Force Production in Competitive Cyclists Versus Runners. J Appl Biomech 2022; 38:412-423. [DOI: 10.1123/jab.2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/01/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
To describe the possible effects of chronic specific exercise training, the present study compared the anthropometric variables, muscle–tendon unit (MTU) architecture, passive stiffness, and force production capacity between a group of competitive cyclists and runners. Twenty-seven competitive male cyclists (n = 16) and runners (n = 11) participated. B-mode ultrasound evaluation of the vastus lateralis muscle and patellar tendon as well as passive stiffness of the knee extensors MTU were assessed. The athletes then performed a test of knee extensor maximal voluntary isometric contractions. Cyclists displayed greater thigh girths, vastus lateralis pennation angle and muscle thickness, patellar tendon cross-sectional area, and MTU passive stiffness than runners (P < .05). Knee extensor force production capacity also differed significantly, with cyclists showing greater values compared with runners (P < .05). Overall, the direct comparison of these 2 populations revealed specific differences in the MTU, conceivably related to the chronic requirements imposed through the training for the different disciplines.
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16
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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices. Sci Rep 2021; 11:13417. [PMID: 34183742 PMCID: PMC8239011 DOI: 10.1038/s41598-021-92929-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/16/2021] [Indexed: 12/11/2022] Open
Abstract
Hamstring injuries are endemic, but influences of test-specific training and the application of different test methods on decision making remain elusive. Sport-students were randomised to isokinetic (IG) or Nordic hamstring (NG) exercise or a control group (CG) for six weeks. Training and testing procedures were matched to biomechanical parameters. Hamstring strength (EPT), work, muscle soreness (visual analogue scale (VAS)), biceps femoris (BFlh) muscle size and architecture were assessed. Anthropometrics and strength parameters did not differ at baseline. Yet, body mass normalised EPT, and work revealed a significant group × time × device effect, with a significant main effect for devices. Experimental conditions triggered meaningful increases in EPT compared to the control group, but the effects were higher when recorded on the training device. Despite significant group × time interactions, normalised average work on the NHD was only higher in the NG compared to CG of the left leg (+ 35%). No effects were found for BFlh parameters. Hamstrings showed a high training specificity, but adaptations likely remain undetected owing to the low sensitivity of conventional test devices. Moreover, strength increase of ~ 15% does not necessarily have to be reflected in BFlh parameters.
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17
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Sarto F, Spörri J, Fitze DP, Quinlan JI, Narici MV, Franchi MV. Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions. Sports Med 2021; 51:1151-1170. [PMID: 33683628 PMCID: PMC8124062 DOI: 10.1007/s40279-021-01436-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 12/16/2022]
Abstract
Ultrasound (US) imaging has been widely used in both research and clinical settings to evaluate the morphological and mechanical properties of muscle and tendon. In elite sports scenarios, a regular assessment of such properties has great potential, namely for testing the response to training, detecting athletes at higher risks of injury, screening athletes for structural abnormalities related to current or future musculoskeletal complaints, and monitoring their return to sport after a musculoskeletal injury. However, several practical and methodological aspects of US techniques should be considered when applying this technology in the elite sports context. Therefore, this narrative review aims to (1) present the principal US measures and field of applications in the context of elite sports; (2) to discuss, from a methodological perspective, the strengths and shortcomings of US imaging for the assessment of muscle and tendon properties; and (3) to provide future directions for research and application.
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Affiliation(s)
- Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Daniel P Fitze
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jonathan I Quinlan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- CIR-MYO Myology Centre, University of Padova, Padova, Italy
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy.
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18
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Acromio-Humeral Distance Is Associated with Shoulder External Strength in National Elite Badminton Players-A Preliminary Study. Sports (Basel) 2021; 9:sports9040048. [PMID: 33807130 PMCID: PMC8065938 DOI: 10.3390/sports9040048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/21/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: To examine acromio-humeral distance (AHD) and shoulder isometric strength for external rotation (ER) and internal rotation (IR) in national elite badminton players. Methods: Seven elite badminton players with asymptomatic shoulders aged 24 ± 4 (mean ± SD) from the Danish national badminton team were investigated. Shoulder AHD, isometric strength in ER and IR were bilaterally assessed with ultrasonography and a hand-held dynamometer (HHD). Results: AHD was greater on the dominant vs. the nondominant side (p = 0.018). Moreover, IR strength was greater on the dominant side vs. the nondominant side (p = 0.041). Furthermore, AHD and ER strength were highly correlated on the dominant side (p = 0.007, r = 0.900). A correlation was also shown between AHD and the ER/IR strength ratio on the dominant side (p = 0.033, r = 0.793). Conclusion: This preliminary study demonstrates that shoulder ER strength is strongly associated with AHD size, largely reflecting supraspinatus tendon-muscle hypertrophy as a result of sport-specific adaptation in national elite badminton players with asymptomatic shoulders. These novel data also suggest that habitual loading of the shoulder improves the supraspinatus tendon size, which may lower the mechanical stress and potentially reduce the risk of injury. This warrants strengthening the shoulder external rotators as a potential strategy to reduce the risk of future shoulder injury.
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19
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Quantifying mechanical loading and elastic strain energy of the human Achilles tendon during walking and running. Sci Rep 2021; 11:5830. [PMID: 33712639 PMCID: PMC7955091 DOI: 10.1038/s41598-021-84847-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/19/2021] [Indexed: 01/31/2023] Open
Abstract
The purpose of the current study was to assess in vivo Achilles tendon (AT) mechanical loading and strain energy during locomotion. We measured AT length considering its curve-path shape. Eleven participants walked at 1.4 m/s and ran at 2.5 m/s and 3.5 m/s on a treadmill. The AT length was defined as the distance between its origin at the gastrocnemius medialis myotendinous junction (MTJ) and the calcaneal insertion. The MTJ was tracked using ultrasonography and projected to the reconstructed skin surface to account for its misalignment. Skin-to-bone displacements were assessed during a passive rotation (5°/s) of the ankle joint. Force and strain energy of the AT during locomotion were calculated by fitting a quadratic function to the experimentally measured tendon force-length curve obtained from maximum voluntary isometric contractions. The maximum AT strain and force were affected by speed (p < 0.05, ranging from 4.0 to 4.9% strain and 1.989 to 2.556 kN), yet insufficient in magnitude to be considered as an effective stimulus for tendon adaptation. Besides the important tendon energy recoil during the propulsion phase (7.8 to 11.3 J), we found a recoil of elastic strain energy at the beginning of the stance phase of running (70-77 ms after touch down) between 1.7 ± 0.6 and 1.9 ± 1.1 J, which might be functionally relevant for running efficiency.
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20
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Morphological Characteristics of Passive and Active Structures of the Foot Across Populations With Different Levels of Physical Activity. J Sport Rehabil 2021; 30:935-941. [PMID: 33662932 DOI: 10.1123/jsr.2020-0423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities. OBJECTIVE To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle. DESIGN Cross-sectional and observational. PARTICIPANTS The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements). RESULTS Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P = .007 and P = .005). This was also the case for the cross-sectional area (P < .01) and the plantar fascia at the heel insertion in both limbs (P = .034 and P = .026) and for patellar tendon thickness for the longitudinal measurement (P < .01). At the transversal level, however, the differences were only significant in the right limb (P = .040). CONCLUSION The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary.
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21
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Achilles Tendon Length Is Not Related to 100-m Sprint Time in Sprinters. J Appl Biomech 2020; 37:30-35. [PMID: 33176276 DOI: 10.1123/jab.2020-0125] [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: 04/28/2020] [Revised: 08/04/2020] [Accepted: 08/19/2020] [Indexed: 11/18/2022]
Abstract
This study examined the relationship between Achilles tendon (AT) length and 100-m sprint time in sprinters. The AT lengths at 3 different portions of the triceps surae muscle in 48 well-trained sprinters were measured using magnetic resonance imaging. The 3 AT lengths were calculated as the distance from the calcaneal tuberosity to the muscle-tendon junction of the soleus, gastrocnemius medialis, and gastrocnemius lateralis, respectively. The absolute 3 AT lengths did not correlate significantly with personal best 100-m sprint time (r = -.023 to .064, all Ps > .05). Furthermore, to minimize the differences in the leg length among participants, the 3 AT lengths were normalized to the shank length, and the relative 3 AT lengths did not correlate significantly with personal best 100-m sprint time (r = .023 to .102, all Ps > .05). Additionally, no significant correlations were observed between the absolute and relative (normalized to body mass) cross-sectional areas of the AT and personal best 100-m sprint time (r = .012 and .084, respectively, both Ps > .05). These findings suggest that the AT morphological variables, including the length, may not be related to superior 100-m sprint time in sprinters.
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22
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Salinero JJ, Lara B, Gutierrez-Hellin J, Gallo-Salazar C, Areces F, Jiménez F, Coso JD. THICKNESS AND CROSS-SECTIONAL AREA OF THE ACHILLES TENDON IN MARATHON RUNNERS: A CROSS-SECTIONAL STUDY. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202605205659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: This study aimed to measure thickness and cross-sectional area of the Achilles tendon (AT), and the range of motion of the ankle joint in dorsiflexion of amateur marathon runners compared to non-active people. Objectives: To analyze the relationship between cross-sectional area and thickness of the Achilles tendon in marathon runners and age, anthropometric characteristics (height and body mass), training habits, running experience, marathon performance, and range of motion in the ankle joint. Methods: Achilles tendon thickness and cross-sectional area were measured using ultrasound images of the left leg in 97 male amateur marathon runners (age 42.0 ± 9.6 years; height 175 ± 6 cm; and body mass 73.7 ± 8.6 kg), and 47 controls (39.9 ± 11.6 years; 176 ± 7 cm; 79.6 ± 16.1 kg). Results: Achilles tendon thickness (4.81 ± 0.77 vs. 4.60 ± 0.66 mm; p = 0.01) and cross-sectional area (60.41 ± 14.36 vs. 53.62 ± 9.90 mm2; p < 0.01) were greater in the marathon runners than in non-active people. Achilles tendon thickness has been correlated, in a weak but significant manner, with years of running experience. Moreover, marathon runners showed increased ankle range of motion (81.81 ± 6.93 vs. 77.86 ± 7.27 grades; p<0.01). Conclusion: Male amateur marathon runners have hypertrophy of the Achilles tendon compared to non-active people, and this enlargement is mediated by running experience. In addition, range of motion in ankle dorsiflexion is favored by marathon training. Level of evidence III; Retrospective study.
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Sato Y, Kösters A, Rieder F, Sasho T, Müller E, Wiesinger HP. Quantitative Analysis of Patellar Tendon After Total Knee Arthroplasty Using Echo Intensity: A Nonrandomized Controlled Trial of Alpine Skiing. J Arthroplasty 2020; 35:2858-2864. [PMID: 32561260 DOI: 10.1016/j.arth.2020.05.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/10/2020] [Accepted: 05/20/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Despite the knee extensor weakness, less attention has been paid to the evaluation of patellar tendon after total knee arthroplasty (TKA). We previously observed patellar tendon hypertrophy after TKA. The purpose of this study is to reanalyze these ultrasound data to detect whether brightness mode ultrasound imaging reflects pathological changes of the patellar tendon after TKA. METHODS Twenty-eight participants with post unilateral TKA were assigned to an intervention group or control group. The intervention group underwent a 12-week skiing program. Patellar tendon mechanical properties were obtained by combining isometric dynamometry, ultrasound imaging, and electromyography in operated knee and nonoperated knee. Luminosity ratio (LR) was measured using echo intensity in a relaxed and maximally loaded phase. RESULTS Baseline comparisons revealed significant effects of the surgical side (P < .001) and loading phase (P = .017), but no interaction between leg and phase (P < .149). LR of the operated knee was significantly lower than LR of the nonoperated knee in relaxed (P < .001) and maximally loaded phases (P = .003). In addition, there was a significant correlation between LR of maximum phase and isometric knee extension torque (r2 = 0.156, P = .038). However, LR was not related to patellar tendon stiffness, Young's modulus, or strain. There was a significant time effect in knee extension torque, but no time effects on LR and tendon force. CONCLUSION Patellar tendon LR is decreased along with degenerative change after TKA. Ultrasound imaging provides a promising metric to acquire in vivo patellar tendon pathological assessment after TKA.
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Affiliation(s)
- Yusuke Sato
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria; Department of Orthopedic Surgery, Chiba University Hospital, Chiba, Japan
| | - Alexander Kösters
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Florian Rieder
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria; Department of Physical Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Takahisa Sasho
- Department of Orthopedic Surgery, Chiba University Hospital, Chiba, Japan
| | - Erich Müller
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Hans-Peter Wiesinger
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria
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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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25
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Wiesinger HP, Seynnes OR, Kösters A, Müller E, Rieder F. Mechanical and Material Tendon Properties in Patients With Proximal Patellar Tendinopathy. Front Physiol 2020; 11:704. [PMID: 32733263 PMCID: PMC7358637 DOI: 10.3389/fphys.2020.00704] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/28/2020] [Indexed: 01/20/2023] Open
Abstract
Introduction The effect of chronic patellar tendinopathy on tissue function and integrity is currently unclear and underinvestigated. The aim of this cohort comparison was to examine morphological, material, and mechanical properties of the patellar tendon and to extend earlier findings by measuring the ability to store and return elastic energy in symptomatic tendons. Methods Seventeen patients with chronic (>3 months, VISA-P < 80), inferior pole patellar tendinopathy (24 ± 4 years; male = 12, female = 5) were carefully matched to controls (25 ± 3 years) for training status, pattern, and history of loading of the patellar tendon. Individual knee extension force, patellar tendon stiffness, stress, strain, Young’s modulus, hysteresis, and energy storage capacity, were obtained with combined dynamometry, ultrasonography, magnetic resonance imaging, and electromyography. Results Anthropometric parameters did not differ between groups. VISA-P scores ranged from 28 to 78 points, and symptoms had lasted from 10 to 120 months before testing. Tendon proximal cross-sectional area was 61% larger in the patellar tendinopathy group than in the control group. There were no differences between groups in maximal voluntary isometric knee extension torque (p = 0.216; d < −0.31) nor in tensile tendon force produced during isometric ramp contractions (p = 0.185; d < −0.34). Similarly, tendon strain (p = 0.634; d < 0.12), hysteresis (p = 0.461; d < 0.18), and strain energy storage (p = 0.656; d < 0.36) did not differ between groups. However, patellar tendon stiffness (−19%; p = 0.007; d < −0.74), stress (−27%; p< 0.002; d < −0.90) and Young’s modulus (−32%; p = 0.001; d < −0.94) were significantly lower in tendinopathic patients compared to healthy controls. Discussion In this study, we observed lower stiffness in affected tendons. However, despite the substantial structural and histological changes occurring with tendinopathy, the tendon capacity to store and dissipate energy did not differ significantly.
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Affiliation(s)
- Hans-Peter Wiesinger
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Olivier R Seynnes
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Alexander Kösters
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Erich Müller
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Florian Rieder
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria.,Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
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26
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Schneebeli A, Visconti L, Cescon C, Clijsen R, Giardini G, Arizzio ME, Barbero M. Tendon morphological changes after a prolonged ski race can be detected by ultrasound echo intensity. J Foot Ankle Res 2020; 13:34. [PMID: 32522217 PMCID: PMC7288471 DOI: 10.1186/s13047-020-00398-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/21/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Ultrasound imaging techniques have been used to assess the characteristics of skeletal muscles and tendons. Such techniques (gray scale analysis) allow qualitative evaluation and have been used recently to assess the internal structure of muscles and tendons by computer-aided gray scale analysis. We hypothesized that changes in the internal structure of the Achilles and patellar tendons after a ski mountaineering race competition could be detected with ultrasound. METHODS Twenty athletes were recruited during the 19th Millet Tour du Rutor extreme, a three-day ski mountaineering competition. Ultrasound measurements of the Achilles and patellar tendons were carried out before the first race and immediately after each of the three competition days. Tendon thickness, cross-sectional area (CSA), and ultrasound gray scale analysis were calculated. RESULTS Significant differences (p < 0.05) were observed between the pre- and post-race measurements for the Achilles tendon thickness and CSA, while no significant differences were noted for the patellar tendon thickness and CSA. However, gray scale analysis of both the Achilles and patellar tendons showed significantly higher post-race values, than the pre-race values (p < 0.05). CONCLUSIONS Achilles and patellar tendons of healthy athletes are highly responsive to an acute increase in mechanical load. Those changes can be detected from classical (thickness and CSA) and innovative (gray scale) ultrasound-based parameters. TRIAL REGISTRATION This study was approved by the Azienda USL Valle d'Aosta Ethics Committee (protocol no. 23/03/2018.0026243.I).
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Affiliation(s)
- Alessandro Schneebeli
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland.
| | | | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland.,International university of applied sciences THIM, Thim van der Laan AG, Landquart, Switzerland.,Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Guido Giardini
- SC Neurologia Centro Medicina di Montagna, Ospedale U.Parini, Aosta, Italy
| | | | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
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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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28
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Stenroth L, Sefa S, Arokoski J, Töyräs J. Does Magnetic Resonance Imaging Provide Superior Reliability for Achilles and Patellar Tendon Cross-Sectional Area Measurements Compared with Ultrasound Imaging? ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:3186-3198. [PMID: 31493954 DOI: 10.1016/j.ultrasmedbio.2019.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/28/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
This study investigated the reliability of Achilles and patellar tendon cross-sectional area (CSA) measurement using ultrasound imaging (USI) and magnetic resonance imaging (MRI). Fifteen healthy adults were imaged twice on two occasions, interrupted by a tendon loading protocol. Tendon CSA segmentations were conducted by an experienced and an inexperienced rater blinded to information regarding subject, session and loading status. USI provided good test-retest reliability (intra-class correlation coefficient [ICC] 2,1 > 0.85, standard error of measurement [SEM] 5%-6%), while with MRI it was excellent (ICC 2,1 > 0.92, SEM 4%) for the experienced rater. This study suggests that MRI provides superior reliability for tendon CSA measurements compared with USI. However, the difference in reliability between the methods was small, and the results were inconclusive regarding objectivity and sensitivity to change when assessed based on the effect of loading. We concluded that both methods can be used for reliable CSA measurements of the Achilles and patellar tendons when using a highly standardized measurement protocol and when conducted by an experienced rater.
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Affiliation(s)
- Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Sandra Sefa
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
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Devaprakash D, Lloyd DG, Barrett RS, Obst SJ, Kennedy B, Adams KL, Hunter A, Vlahovich N, Pease DL, Pizzolato C. Magnetic Resonance Imaging and Freehand 3-D Ultrasound Provide Similar Estimates of Free Achilles Tendon Shape and 3-D Geometry. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2898-2905. [PMID: 31471069 DOI: 10.1016/j.ultrasmedbio.2019.07.679] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to assess the similarity of free Achilles tendon shape and 3-D geometry between magnetic resonance imaging (MRI) and freehand 3-D ultrasound (3-DUS) imaging methods. Fourteen elite/sub-elite middle-distance runners participated in the study. MRI and 3-DUS scans of the Achilles tendon were acquired on two separate imaging sessions, and all 3-D reconstructions were performed using identical methods. Shape similarity of free Achilles tendon reconstructed from MRI and 3-DUS data was assessed using Jaccard index, Hausdorff distance and root mean square error (RMSE). The Jaccard index, Hausdorff distance and RMSE values were 0.76 ± 0.05, 2.70 ± 0.70 and 0.61 ± 0.10 mm, respectively. The level of agreement between MRI and 3-DUS for free Achilles tendon volume, length and average cross-sectional area (CSA) was assessed using Bland-Altman analysis. Compared to MRI, freehand 3-DUS overestimated volume, length and average CSA by 30.6 ± 15.8 mm3 (1.1% ± 0.6%), 0.3 ± 0.7 mm (0.6% ± 1.9%) and 0.3 ± 1.42 mm2 (0.4% ± 2.0%), respectively. The upper and lower limits of agreement between MRI and 3-DUS for volume, length and average CSA were -0.4 to 61.7 mm3 (-0.2% to 2.3%), -1.0 to 1.5 mm (-3.2% to 4.5%) and -2.5 to 3.1 mm2 (-3.5% to 4.3%), respectively. There were no significant differences between imaging methods in CSA along the length of the tendon. In conclusion, MRI and freehand 3-DUS may be considered equivalent methods for estimating shape and 3-D geometry of the free Achilles tendon. These findings, together with the practical benefits of being able to assess 3-D Achilles tendon shape and geometry in a laboratory environment and under isometric loading, make 3-DUS an attractive alternative to MRI for assessing 3-D free Achilles tendon macro-structure in future studies.
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Affiliation(s)
- Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Queensland, Australia; Gold Coast Orthopaedic Research Engineering and Education Alliance (GCORE), Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Queensland, Australia; Gold Coast Orthopaedic Research Engineering and Education Alliance (GCORE), Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Rod S Barrett
- School of Allied Health Sciences, Griffith University, Queensland, Australia; Gold Coast Orthopaedic Research Engineering and Education Alliance (GCORE), Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Steven J Obst
- School of Allied Health Sciences, Griffith University, Queensland, Australia; School of Health, Medical, and Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia
| | - Ben Kennedy
- School of Allied Health Sciences, Griffith University, Queensland, Australia; QSCAN Radiology Clinics, Queensland, Australia
| | - Kahlee L Adams
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
| | - Adam Hunter
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
| | - Nicole Vlahovich
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
| | - David L Pease
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Queensland, Australia; Gold Coast Orthopaedic Research Engineering and Education Alliance (GCORE), Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Edama M, Okuyama R, Goto S, Sasaki M. Influence of loading rate and limb position on patellar tendon mechanical properties in vivo. Clin Biomech (Bristol, Avon) 2019; 61:52-57. [PMID: 30471637 DOI: 10.1016/j.clinbiomech.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 11/04/2018] [Accepted: 11/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aims of this study were to clarify the changes of patellar tendon length during isometric knee joint extension and the double leg squat position using ultrasonography. METHODS The left legs of 17 healthy adults were investigated. Isometric knee extension motion was performed at three positions of knee flexion 30° (knee 30°), knee flexion 60° (knee 60°), knee flexion 90° (knee 90°), and at each limb position, 0% (0% peak torque (PT)), 40% (40% PT), 50% (50% PT), and 60% (60% PT) of the maximum knee joint extension torque were executed at random. Both double leg squat motions were randomly performed in three positions: hip flexion 30°, knee flexion 30°, ankle dorsiflexion 10° (squat 30°); hip joint flexion 60°, knee joint flexion 60°, ankle dorsiflexion 20° (squat 60°); and hip joint flexion 90°, knee joint flexion 90°, ankle dorsiflexion 30° (squat 90°). Ultrasonography was used to measure patellar tendon length. FINDINGS There were no significant changes in patellar tendon length and strain between knee flexion angles of 30°, 60°, and 90° in isometric knee joint extension and the double leg squat limb position. INTERPRETATION The loading rate and limb position do not appear to affect the length and strain of the patellar tendon.
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Affiliation(s)
- M Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan.
| | - R Okuyama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan
| | - S Goto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan
| | - M Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan
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Carrard A, Fontana E, Malatesta D. Mechanical Determinants of the U-Shaped Speed-Energy Cost of Running Relationship. Front Physiol 2018; 9:1790. [PMID: 30618803 PMCID: PMC6305502 DOI: 10.3389/fphys.2018.01790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/28/2018] [Indexed: 12/05/2022] Open
Abstract
Purpose: The aim of this study was to investigate the relationship between the energy cost of running (Cr) and speed and its mechanical determinants by comparing running in normal [100% body weight (BW)] and reduced (20% and 60% BW) gravity conditions at several speeds (2.25, 3.17, 4.08, and 5.00 m·s−1) in experienced runners. Methods: Twelve experienced runners (24.6 ± 5.4 year) ran on an AlterG treadmill in a partially randomized order at the four running speeds and at the three gravity conditions in order to assess Cr, spatiotemporal parameters, spring-mass characteristics and elastic energy (EL) during running. Results: For the three gravity conditions, the speed-Cr per kg of body mass relationship was curvilinear (significant speed effect: P < 0.001) and was significantly downward shifted with reduced gravity (100%>60%>20% BW; P < 0.001). EL, expressed in J·step−1, was significantly higher at 100% BW than at 60 and 20% BW and at 60% BW than at 20% BW (significant gravity effect: P < 0.001) with a significant increase in EL per step at faster speeds for the 3 gravity conditions (P < 0.001). EL, expressed in J·kg−1·m−1, was significantly downward shifted with gravity (100%>60%>20% BW; P < 0.001), with no significant speed effect (P = 0.39). Conclusions: Our findings showed that, for the three gravity conditions, the speed-Cr relationship was curvilinear, and the optimization of the stretch-shortening cycle and muscle activation in the muscle-tendon unit may be involved to explain these U-shaped relationships, especially at normal terrestrial gravitational conditions (100% BW). The U-shaped speed-Cr per kg of the body mass relationship was shifted downward in hypogravity conditions, which was characterized by decreased EL compared to 100% BW. These mechanisms may contribute to the less than proportional decrease in Cr per kg of body mass relative to gravity.
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Affiliation(s)
- Apolline Carrard
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Elisa Fontana
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Davide Malatesta
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Murtagh CF, Stubbs M, Vanrenterghem J, O'Boyle A, Morgans R, Drust B, Erskine RM. Patellar tendon properties distinguish elite from non-elite soccer players and are related to peak horizontal but not vertical power. Eur J Appl Physiol 2018; 118:1737-1749. [PMID: 29860681 PMCID: PMC6060780 DOI: 10.1007/s00421-018-3905-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate potential differences in patellar tendon properties between elite and non-elite soccer players, and to establish whether tendon properties were related to power assessed during unilateral jumps performed in different directions. METHODS Elite (n = 16; age 18.1 ± 1.0 years) and non-elite (n = 13; age 22.3 ± 2.7 years) soccer players performed vertical, horizontal-forward and medial unilateral countermovement jumps (CMJs) on a force plate. Patellar tendon (PT) cross-sectional area, elongation, strain, stiffness, and Young's modulus (measured at the highest common force interval) were assessed with ultrasonography and isokinetic dynamometry. RESULTS Elite demonstrated greater PT elongation (6.83 ± 1.87 vs. 4.92 ± 1.88 mm, P = 0.011) and strain (11.73 ± 3.25 vs. 8.38 ± 3.06%, P = 0.009) than non-elite soccer players. Projectile range and peak horizontal power during horizontal-forward CMJ correlated positively with tendon elongation (r = 0.657 and 0.693, P < 0.001) but inversely with Young's modulus (r = - 0.376 and - 0.402; P = 0.044 and 0.031). Peak medial power during medial CMJ correlated positively with tendon elongation (r = 0.658, P < 0.001) but inversely with tendon stiffness (r = - 0.368, P = 0.050). CONCLUSIONS Not only does a more compliant patellar tendon appear to be an indicator of elite soccer playing status but it may also facilitate unilateral horizontal-forward and medial, but not vertical CMJ performance. These findings should be considered when prescribing talent selection and development protocols related to direction-specific power in elite soccer players.
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Affiliation(s)
- Conall F Murtagh
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
- Liverpool Football Club, Liverpool, UK.
| | - Michael Stubbs
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Jos Vanrenterghem
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, 3000, Leuven, Belgium
| | - Andrew O'Boyle
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Liverpool Football Club, Liverpool, UK
| | | | - Barry Drust
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Liverpool Football Club, Liverpool, UK
| | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Institute of Sport, Exercise and Health, University College London, London, UK
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Obst SJ, Heales LJ, Schrader BL, Davis SA, Dodd KA, Holzberger CJ, Beavis LB, Barrett RS. Are the Mechanical or Material Properties of the Achilles and Patellar Tendons Altered in Tendinopathy? A Systematic Review with Meta-analysis. Sports Med 2018; 48:2179-2198. [DOI: 10.1007/s40279-018-0956-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Ueno H, Suga T, Miyake Y, Takao K, Tanaka T, Misaki J, Otsuka M, Nagano A, Isaka T. Specific adaptations of patellar and Achilles tendons in male sprinters and endurance runners. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- H. Ueno
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Suga
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - Y. Miyake
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - K. Takao
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Tanaka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - J. Misaki
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - M. Otsuka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - A. Nagano
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Isaka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
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Mersmann F, Seynnes OR, Legerlotz K, Arampatzis A. Effects of tracking landmarks and tibial point of resistive force application on the assessment of patellar tendon mechanical properties in vivo. J Biomech 2018; 71:176-182. [PMID: 29463386 DOI: 10.1016/j.jbiomech.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/01/2018] [Accepted: 02/04/2018] [Indexed: 12/20/2022]
Abstract
The different methods used to assess patellar tendon elongation in vivo may partly explain the large variation of mechanical properties reported in the literature. The present study investigated the effects of tracking landmark position and tibial point of resistive force application during leg extensions in a dynamometer. Nineteen adults performed isometric contractions with a proximal and distal dynamometer shank pad position. Knee joint moments were calculated employing an inverse dynamics approach. Tendon elongation was measured using the patellar apex and either the tibial tuberosity (T) or plateau (P) as tracking landmark. Using P for tracking introduced a bias towards greater values of tendon elongation at all force levels from 100 N to maximum tendon force (TFmax; p < 0.05). The differences between landmarks considering maximum tendon strain were greater at the proximal shank pad position (p < 0.05). Tendon stiffness was lower for P compared with T, but only in intervals up to 50% of TFmax (p < 0.05). The agreement between T and P for stiffness calculated between 50% and TFmax was acceptable with the distal, but poor with the proximal pad position. We demonstrated that using the tibia plateau and not the insertion as tracking landmark clearly affects the assessment of the force-elongation curve of the patellar tendon. However, using a distal point of resistive force application and calculating tendon stiffness between 50% and TFmax seems to yield an acceptable agreement between landmarks. These findings have important implications for the assessment of tendon properties in vivo and cross-study comparisons.
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Affiliation(s)
- Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin School of Movement Science, Berlin, Germany.
| | - Olivier R Seynnes
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - Kirsten Legerlotz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin School of Movement Science, Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin School of Movement Science, Berlin, Germany
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36
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Massey GJ, Balshaw TG, Maden-Wilkinson TM, Folland JP. Tendinous tissue properties after short- and long-term functional overload: Differences between controls, 12 weeks and 4 years of resistance training. Acta Physiol (Oxf) 2018; 222:e13019. [PMID: 29253326 DOI: 10.1111/apha.13019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/27/2017] [Accepted: 12/08/2017] [Indexed: 01/20/2023]
Abstract
AIM The potential for tendinous tissues to adapt to functional overload, especially after several years of exposure to heavy-resistance training, is largely unexplored. This study compared the morphological and mechanical characteristics of the patellar tendon and knee extensor tendon-aponeurosis complex between young men exposed to long-term (4 years; n = 16), short-term (12 weeks; n = 15) and no (untrained controls; n = 39) functional overload in the form of heavy-resistance training. METHODS Patellar tendon cross-sectional area, vastus lateralis aponeurosis area and quadriceps femoris volume, plus patellar tendon stiffness and Young's modulus, and tendon-aponeurosis complex stiffness, were quantified with MRI, dynamometry and ultrasonography. RESULTS As expected, long-term trained had greater muscle strength and volume (+58% and +56% vs untrained, both P < .001), as well as a greater aponeurosis area (+17% vs untrained, P < .01), but tendon cross-sectional area (mean and regional) was not different between groups. Only long-term trained had reduced patellar tendon elongation/strain over the whole force/stress range, whilst both short-term and long-term overload groups had similarly greater stiffness/Young's modulus at high force/stress (short-term +25/22%, and long-term +17/23% vs untrained; all P < .05). Tendon-aponeurosis complex stiffness was not different between groups (ANOVA, P = .149). CONCLUSION Despite large differences in muscle strength and size, years of resistance training did not induce tendon hypertrophy. Both short-term and long-term overload demonstrated similar increases in high-force mechanical and material stiffness, but reduced elongation/strain over the whole force/stress range occurred only after years of overload, indicating a force/strain specific time-course to these adaptations.
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Affiliation(s)
- G. J. Massey
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis; Loughborough University; Leicestershire UK
- School of Sport, Exercise, and Health Sciences; Loughborough University; Leicestershire UK
| | - T. G. Balshaw
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis; Loughborough University; Leicestershire UK
- School of Sport, Exercise, and Health Sciences; Loughborough University; Leicestershire UK
| | - T. M. Maden-Wilkinson
- School of Sport, Exercise, and Health Sciences; Loughborough University; Leicestershire UK
- Faculty of Health and Wellbeing; Sheffield Hallam University; Sheffield UK
| | - J. P. Folland
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis; Loughborough University; Leicestershire UK
- School of Sport, Exercise, and Health Sciences; Loughborough University; Leicestershire UK
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Lima K, Martins N, Pereira W, Oliveira L. Triceps surae elasticity modulus measured by shear wave elastography is not correlated to the plantar flexion torque. Muscles Ligaments Tendons J 2017; 7:347-352. [PMID: 29264348 DOI: 10.11138/mltj/2017.7.2.347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Supersonic Shear Imaging (SSI) is a technique which analyses quantitatively the tissue properties in real time. The relation between joint torque and Young's modulus (E) of the agonist muscles is important for obtaining stratification values and ranges of normality. The aim of this study was to evaluate the intra and intersessions reliability of the E values of the Achilles tendon and medial gastrocnemius muscle, bilaterally, during rest, and correlate them with the isometric plantarflexion peak torque. Methods Shear modulus maps were acquired bilaterally in Achilles tendon (AT) and medial gastrocnemius (MG) muscle of 24 healthy male volunteers. Two 5-second plantarflexion maximal voluntary contractions were performed with a 40-seconds interval and correlated with E values. Results a good intrasession reliability (intraclass correlation coefficient- ICC= 0.821-0.986) and a weak Pearson's correlation was found between E values and peak torque (r= 0.022 to -0.202) for both limbs (P > .05). Conclusion E values cannot be predictive of the triceps surae force production in untrained men. It could be helpful, otherwise, to monitor a chronic strength adaptation after an exercise intervention or rehabilitation program. Level of evidence IIb, individual cohort study.
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Affiliation(s)
- Kelly Lima
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Martins
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wagner Pereira
- Laboratory of Ultrasound of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Liliam Oliveira
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Slane LC, Slane JA, D'hooge J, Scheys L. The challenges of measuring in vivo knee collateral ligament strains using ultrasound. J Biomech 2017; 61:258-262. [PMID: 28802742 PMCID: PMC5581255 DOI: 10.1016/j.jbiomech.2017.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/10/2017] [Accepted: 07/17/2017] [Indexed: 12/13/2022]
Abstract
Ultrasound-based methods have shown promise in their ability to characterize non-uniform deformations in large energy-storing tendons such as the Achilles and patellar tendons, yet applications to other areas of the body have been largely unexplored. The noninvasive quantification of collateral ligament strain could provide an important clinical metric of knee frontal plane stability, which is relevant in ligament injury and for measuring outcomes following total knee arthroplasty. In this pilot cadaveric experiment, we investigated the possibility of measuring collateral ligament strain with our previously validated speckle-tracking approach, but encountered a number of challenges during both data acquisition and processing. Given the clinical interest in this type of tool, and the fact that this is a developing area of research, the goal of this article is to transparently describe this pilot study, both in terms of methods and results, while also identifying specific challenges to this work and areas for future study. Some challenges faced relate generally to speckle-tracking of soft tissues (e.g. the limitations of using a 2D imaging modality to characterize 3D motion), while others are specific to this application (e.g. the small size and complex anatomy of the collateral ligaments). This work illustrates a clear need for additional studies, particularly relating to the collection of ground-truth data and more thorough validation work. These steps will be critical prior to the translation of ultrasound-based measures of collateral ligament strains into the clinic.
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Affiliation(s)
- Laura C Slane
- KU Leuven, Institute for Orthopaedic Research and Training, Leuven, Belgium.
| | - Josh A Slane
- KU Leuven, Institute for Orthopaedic Research and Training, Leuven, Belgium
| | - Jan D'hooge
- KU Leuven, Lab on Cardiovascular Imaging and Dynamics, Dept. of Cardiovascular Sciences, Leuven, Belgium
| | - Lennart Scheys
- KU Leuven, Institute for Orthopaedic Research and Training, Leuven, Belgium; University Hospitals Leuven, Dept. of Orthopaedics, Campus Pellenberg, Pellenberg, Belgium
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Wiesinger HP, Rieder F, Kösters A, Müller E, Seynnes OR. Sport-Specific Capacity to Use Elastic Energy in the Patellar and Achilles Tendons of Elite Athletes. Front Physiol 2017; 8:132. [PMID: 28348529 PMCID: PMC5346584 DOI: 10.3389/fphys.2017.00132] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/21/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction: During running and jumping activities, elastic energy is utilized to enhance muscle mechanical output and efficiency. However, training-induced variations in tendon spring-like properties remain under-investigated. The present work extends earlier findings on sport-specific profiles of tendon stiffness and cross-sectional area to examine whether years of distinct loading patterns are reflected by tendons' ability to store and return energy. Methods:Ultrasound scans were performed to examine the morphological features of knee extensor and plantar flexor muscle-tendon units in elite ski jumpers, distance runners, water polo players, and sedentary controls. Tendon strain energy and hysteresis were measured with combined motion capture, ultrasonography, and dynamometry. Results: Apart from the fractional muscle-to-tendon cross-sectional area ratio being lower in the knee extensors of ski jumpers (-31%) and runners (-33%) than in water polo players, no difference in the considered muscle-tendon unit morphological features was observed between groups. Similarly, no significant difference in tendon energy storage or energy return was detected between groups. In contrast, hysteresis was lower in the patellar tendon of ski jumpers (-33%) and runners (-30%) compared to controls, with a similar trend for the Achilles tendon (significant interaction effect and large effect sizes η2 = 0.2). Normalized to body mass, the recovered strain energy of the patellar tendon was ~50% higher in ski jumpers than in water polo players and controls. For the Achilles tendon, recovered strain energy was ~40% higher in ski jumpers and runners than in controls. Discussion: Advantageous mechanical properties related to tendon spring-like function are observed in elite athletes whose sport require effective utilization of elastic energy. However, the mechanisms underpinning the better tendon capacity of some athletes to retain elastic energy could not be ascribed to intrinsic or morphological features of the lower limb muscle-tendon unit.
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Affiliation(s)
- Hans-Peter Wiesinger
- Department of Sport Science and Kinesiology, University of Salzburg Salzburg, Austria
| | - Florian Rieder
- Department of Sport Science and Kinesiology, University of SalzburgSalzburg, Austria; Institute of Physical Medicine and Rehabilitation, Paracelsus Medical UniversitySalzburg, Austria
| | - Alexander Kösters
- Department of Sport Science and Kinesiology, University of Salzburg Salzburg, Austria
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg Salzburg, Austria
| | - Olivier R Seynnes
- Department of Physical Performance, Norwegian School of Sport Sciences Oslo, Norway
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40
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Maganaris CN, Chatzistergos P, Reeves ND, Narici MV. Quantification of Internal Stress-Strain Fields in Human Tendon: Unraveling the Mechanisms that Underlie Regional Tendon Adaptations and Mal-Adaptations to Mechanical Loading and the Effectiveness of Therapeutic Eccentric Exercise. Front Physiol 2017; 8:91. [PMID: 28293194 PMCID: PMC5328946 DOI: 10.3389/fphys.2017.00091] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/02/2017] [Indexed: 12/23/2022] Open
Abstract
By virtue of their anatomical location between muscles and bones, tendons make it possible to transform contractile force to joint rotation and locomotion. However, tendons do not behave as rigid links, but exhibit viscoelastic tensile properties, thereby affecting the length and contractile force in the in-series muscle, but also storing and releasing elastic stain energy as some tendons are stretched and recoiled in a cyclic manner during locomotion. In the late 90s, advancements were made in the application of ultrasound scanning that allowed quantifying the tensile deformability and mechanical properties of human tendons in vivo. Since then, the main principles of the ultrasound-based method have been applied by numerous research groups throughout the world and showed that tendons increase their tensile stiffness in response to exercise training and chronic mechanical loading, in general, by increasing their size and improving their intrinsic material. It is often assumed that these changes occur homogenously, in the entire body of the tendon, but recent findings indicate that the adaptations may in fact take place in some but not all tendon regions. The present review focuses on these regional adaptability features and highlights two paradigms where they are particularly evident: (a) Chronic mechanical loading in healthy tendons, and (b) tendinopathy. In the former loading paradigm, local tendon adaptations indicate that certain regions may “see,” and therefore adapt to, increased levels of stress. In the latter paradigm, local pathological features indicate that certain tendon regions may be “stress-shielded” and degenerate over time. Eccentric exercise protocols have successfully been used in the management of tendinopathy, without much sound understanding of the mechanisms underpinning their effectiveness. For insertional tendinopathy, in particular, it is possible that the effectiveness of a loading/rehabilitation protocol depends on the topography of the stress created by the exercise and is not only reliant upon the type of muscle contraction performed. To better understand the micromechanical behavior and regional adaptability/mal-adaptability of tendon tissue it is important to estimate its internal stress-strain fields. Recent relevant advancements in numerical techniques related to tendon loading are discussed.
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Affiliation(s)
| | | | - Neil D Reeves
- School of Healthcare Science, Manchester Metropolitan University Manchester, UK
| | - Marco V Narici
- Faculty of Medicine and Health Sciences, School of Medicine, University of Nottingham Derby, UK
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41
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Alegre LM, Hasler M, Wenger S, Nachbauer W, Csapo R. Does knee joint cooling change in vivo patellar tendon mechanical properties? Eur J Appl Physiol 2016; 116:1921-9. [PMID: 27473447 PMCID: PMC5020126 DOI: 10.1007/s00421-016-3444-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/24/2016] [Indexed: 12/26/2022]
Abstract
Purpose This study aimed to assess the influence of knee joint cooling on the in vivo mechanical properties of the patellar tendon. Methods Twenty young, healthy women volunteered for the study. B-mode ultrasonography was used to record patellar tendon elongation during isometric ramp contraction of the knee extensors (5–7 s, 90° knee angle) and calculate tendon stiffness. Skin temperature was measured by infrared thermometry. Data were acquired before and after 30 min of local icing of the knee joint and compared by paired samples t-tests. Results After cold exposure, skin temperature as measured over the patellar tendon dropped by 16.8 ± 2.0 °C. Tendon stiffness increased from 2189 ± 551 to 2705 ± 902 N mm−1 (+25 %, p = 0.007). Tendon strain decreased by 9 % (p = 0.004). A small, albeit significant reduction in maximum tendon force was observed (−3.3 %, p = 0.03). Conclusions Knee cooling is associated with a significant increase in patellar tendon stiffness. The observed tendon stiffening may influence the operating range of sarcomeres, possibly limiting the maximal force generation capacity of knee extensor muscles. In addition, a stiffer tendon might benefit rate of force development, thus countering the loss in explosiveness typically described for cold muscles.
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Affiliation(s)
- Luis M Alegre
- GENUD Toledo Research Group, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
| | - Michael Hasler
- Centre of Technology of Ski and Alpine Sport, Fürstenweg 187, Innsbruck, Austria
| | - Sebastian Wenger
- Centre of Technology of Ski and Alpine Sport, Fürstenweg 187, Innsbruck, Austria
| | - Werner Nachbauer
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, Innsbruck, Austria
| | - Robert Csapo
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, Innsbruck, Austria.
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