Bilateral differences in muscle fascicle architecture are not related to the preferred leg in jumping athletes

Structure and function of Achilles and patellar tendons following moderate slow resistance training in young and old men

The aim of this study was to investigate the effect of aging and resistance training with a moderate load on the size and mechanical properties of the patellar (PT) and Achilles tendon (AT) and their associated aponeuroses; medial gastrocnemius (MG) and vastus lateralis (VL). Young (Y55; 24.8 ± 3.8 yrs, n = 11) and old men (O55; 70.0 ± 4.6 yrs, n = 13) were assigned to undergo a training program (12 weeks; 3 times/week) of moderate slow resistance training [55% of one repetition maximum (RM)] of the triceps surae and quadriceps muscles. Tendon dimensions were assessed using 1.5 T magnetic resonance imaging before and after 12 weeks. AT and PT cross sectional area (CSA) were determined every 10% of tendon length. Mechanical properties of the free AT, MG aponeurosis, PT, and VL aponeurosis were assessed using ultrasonography (deformation) and tendon force measurements. CSA of the AT but not PT was greater in O55 compared with Y55. At baseline, mechanical properties were generally lower in O55 than Y55 for AT, MG aponeurosis and VL aponeurosis (Young's modulus) but not for PT. CSA of the AT and PT increased equally in both groups following training. Further, for a given force, stiffness and Young's modulus also increased equally for VL aponeurosis and AT, for boths groups. The present study highlights that except for the PT, older men have lower tendon (AT, MG aponeurosis, and VL aponeurosis) mechanical properties than young men and 12-weeks of moderate slow resistance training appears sufficient to improve tendon size and mechanical adaptations in both young and older men. New and Noteworthy: These novel findings suggest that short-term moderate slow resistance training induces equal improvements in tendon size and mechanics regardless of age.

Towards modern understanding of the Achilles tendon properties in human movement research

The Achilles tendon (AT) is the strongest tendon in humans, yet it often suffers from injury. The mechanical properties of the AT afford efficient movement, power amplification and power attenuation during locomotor tasks. The properties and the unique structure of the AT as a common tendon for three muscles have been studied frequently in humans using in vivo methods since 1990's. As a part of the celebration of 50 years history of the International Society of Biomechanics, this paper reviews the history of the AT research focusing on its mechanical properties in humans. The questions addressed are: What are the most important mechanical properties of the Achilles tendon, how are they studied, what is their significance to human movement, and how do they adapt? We foresee that the ongoing developments in experimental methods and modeling can provide ways to advance knowledge of the complex three-dimensional structure and properties of the Achilles tendon in vivo, and to enable monitoring of the loading and recovery for optimizing individual adaptations.

Medial gastrocnemius muscle-tendon unit ratios of young females and males

A muscle's contractile element length relative to its muscle-tendon unit (MTU) length is a fundamental design feature affecting MTU function, with high (0.9) or low ratios (0.1) favouring either rapid or economical force production, respectively. Despite the importance for MTU function, little in vivo work has been done to understand contractile element-MTU length ratio variability between individuals and sexes. We therefore compared the medial gastrocnemius (MG) MTU ratios of thirteen females and eighteen males, and explored whether individual ratios could be predicted based on anatomical features. At the presumed tendon slack length ankle joint angle, lengths of MG's MTU, Achilles tendon, muscle belly and its muscle fascicles were measured from B-mode ultrasound images. Contractile element length was represented by the in-series muscle fascicle length (FL) and was calculated by multiplying FL by the cosine of fascicle angle. The mean ± standard deviation in-series FL-MTU length ratio was 0.09 ± 0.02 and ranged from 0.06 to 0.11, whereas the muscle belly length-MTU length ratio was 0.54 ± 0.38 and ranged from 0.47 to 0.60. Neither ratio was significantly different between females and males (p ≥ 0.116). In-series FL was not significantly correlated with MTU length (r = -0.115, p =.538), muscle belly length (r = 0.05, p =.788), or shank length (r = 0.169, p =.364), but MTU length was significantly correlated with muscle belly length (r = 0.641, p <.001), and shank length (r = 0.575, p =.001). A low in-series FL-MTU length ratio suggests that the MG of young, healthy individuals is specialised for energy-efficient stretch-shortening cycles. These findings provide useful inputs for the MTU actuator design of Hill-type models.

Regional variation in lateral and medial gastrocnemius muscle fibre lengths obtained from diffusion tensor imaging

Assessment of regional muscle architecture is primarily done through the study of animals, human cadavers, or using b-mode ultrasound imaging. However, there remain several limitations to how well such measurements represent in vivo human whole muscle architecture. In this study, we developed an approach using diffusion tensor imaging and magnetic resonance imaging to quantify muscle fibre lengths in different muscle regions along a muscle's length and width. We first tested the between-day reliability of regional measurements of fibre lengths in the medial (MG) and lateral gastrocnemius (LG) and found good reliability for these measurements (intraclass correlation coefficient [ICC] = 0.79 and ICC = 0.84, respectively). We then applied this approach to a group of 32 participants including males (n = 18), females (n = 14), young (24 ± 4 years) and older (70 ± 2 years) adults. We assessed the differences in regional muscle fibre lengths between different muscle regions and between individuals. Additionally, we compared regional muscle fibre lengths between sexes, age groups, and muscles. We found substantial variability in fibre lengths between different regions within the same muscle and between the MG and the LG across individuals. At the group level, we found no difference in mean muscle fibre length between males and females, nor between young and older adults, or between the MG and the LG. The high variability in muscle fibre lengths between different regions within the same muscle, possibly expands the functional versatility of the muscle for different task requirements. The high variability between individuals supports the use of subject-specific measurements of muscle fibre lengths when evaluating muscle function.

Does different activation between the medial and the lateral gastrocnemius during walking translate into different fascicle behavior?

The functional difference between the medial gastrocnemius (MG) and lateral gastrocnemius (LG) during walking in humans has not yet been fully established. Although evidence highlights that the MG is activated more than the LG, the link with potential differences in mechanical behavior between these muscles remains unknown. In this study, we aimed to determine whether differences in activation between the MG and LG translate into different fascicle behavior during walking. Fifteen participants walked at their preferred speed under two conditions: 0% and 10% incline treadmill grade. We used surface electromyography and B-mode ultrasound to estimate muscle activation and fascicle dynamics in the MG and LG. We observed a higher normalized activation in the MG than in the LG during stance, which did not translate into greater MG normalized fascicle shortening. However, we observed significantly less normalized fascicle lengthening in the MG than in the LG during early stance, which matched with the timing of differences in activation between muscles. This resulted in more isometric behavior of the MG, which likely influences the muscle-tendon interaction and enhances the catapult-like mechanism in the MG compared with the LG. Nevertheless, this interplay between muscle activation and fascicle behavior, evident at the group level, was not observed at the individual level, as revealed by the lack of correlation between the MG-LG differences in activation and MG-LG differences in fascicle behavior. The MG and LG are often considered as equivalent muscles but the neuromechanical differences between them suggest that they may have distinct functional roles during locomotion.

Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions

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.

Muscle and tendon properties of the spastic lower leg after stroke defined by ultrasonography: a systematic review

INTRODUCTION

Peripheral muscle and tendon changes after stroke can influence the functional outcome of patients. The aim of this systematic review was to summarize the evidence of ultrasonographic changes in morphological muscle and tendon properties of the spastic hemiparetic lower leg in patients with first ever stroke.

EVIDENCE ACQUISITION

A systematic search was conducted through PubMed, Embase, Scopus, Cinahl, Cochrane Library, and manual searches from inception until May 1, 2020. Observational case control or cohort studies were included. Risk of bias was evaluated by using the Newcastle-Ottawa Quality Assessment Scale. Outcome parameters of interest included muscle thickness, muscle and tendon length, fascicle length, pennation angle and echo-intensity.

EVIDENCE SYNTHESIS

Nine studies investigated outcome parameters beyond one-month after stroke. We are unable to make a comprehensive statement. Nevertheless, there are some arguments for reduced muscle thickness and reduced fascicle length of the hemiplegic, spastic leg.

CONCLUSIONS

Despite the fact that objective assessment by ultrasonography holds promise for diagnosis and follow-up of spastic hemiparesis after stroke, more evidence is needed to determine how changes in morphological muscle and tendon properties are related to muscle weakness, severity of spasticity and compensation strategies such as disuse or overuse in longitudinal studies starting early after stroke.

The Time-Course of Changes in Muscle Mass, Architecture and Power During 6 Weeks of Plyometric Training

Purpose

To investigate the time-course of changes in knee-extensors muscle mass, architecture and function in response to plyometric training (PLT) performed on a novel training device, the Tramp-Trainer. This machine consists in a trampoline connected to an inclined sledge which allows the performance of repeated jumps while the subject is sitting on a chair.

Methods

Eight healthy males (173.6 ± 4.7 cm, 69.7 ± 13.5 kg, 25.3 ± 4.6 years) underwent 6 weeks of bilateral PLT on the tramp-trainer machine. Training was performed three times per week (between 120 and 150 bounces per session). Knee-extensor maximum voluntary torque (MVT) and power, quadriceps femoris (QF) volume (VOL), cross-sectional area from the 20% to the 60% of femur length and CSA_mean, together with vastus lateralis (VL) architecture (fascicle length, Lf, and pennation angle, PA) were assessed after 2, 4, and 6 weeks of PLT.

Results

All results are presented as changes versus baseline values. MVT increased by 17.8% (week 2, p < 0.001) and 22.2% (week 4, p < 0.01), respectively, and declined to 13.3% (p < 0.05) at week 6 of PLT. Power increased by 18.2% (week 4, p < 0.05) and 19.7% (week 6, p < 0.05). QF VOL increased by 4.7% (week 4, p < 0.05) and 5.8% (week 6, p < 0.01); VL VOL increased by 5.2%, (p < 0.05), 8.2%, (p < 0.01), and 9.6% (p < 0.05) at weeks 2, 4, and 6, respectively. An increase in Lf was detected already at wk 2 (2.2%, p < 0.05), with further increase at 4 and 6 weeks of PLT (4 and 4.4%, respectively, p < 0.01). PA increased by 5.8% (p < 0.05) at week 6. Significant positive correlations were found between CSA_mean and Power (R² = 0.46, p < 0.001) and between QF VOL and Power (R² = 0.44, p < 0.024).

Conclusions

PLT induced rapid increases in muscle volume, fascicle length, pennation angle, torque and power in healthy younger adults. Notably, changes in VL VOL and Lf were detectable already after 2 weeks, followed by increases in knee extensors VOL and power from week 4 of PLT. Since the increase in CSA_mean and QF VOL cannot fully explain the increment in muscle power, it is likely that other factors (such as adaptations in neural drive or tendon mechanical properties) may have contributed to such fucntional changes.

Medial Gastrocnemius Muscle Architecture Is Altered After Exhaustive Stretch-Shortening Cycle Exercise

Muscle architecture is an important component of muscle function, and recent studies have shown changes in muscle architecture with fatigue. The stretch-shortening cycle is a natural way to study human locomotion, but little is known about how muscle architecture is affected by this type of exercise. This study investigated potential changes in medial gastrocnemius (MG) muscle architecture after exhaustive stretch-shortening cycle exercise. Male athletes (n = 10) performed maximal voluntary contractions (MVC) and maximal drop jump (DJ) tests before and after an exercise task consisting of 100 maximal DJs followed by successive rebound jumping to 70% of the initial maximal height. The exercise task ceased upon failure to jump to 50% of maximal height or volitional fatigue. Muscle architecture of MG was measured using ultrasonography at rest and during MVC, and performance variables were calculated via a force plate and motion analysis. After SSC exercise, MVC (−13.1%; p = 0.005; d_z = 1.30), rebound jump height (−14.8%, p = 0.004; d_z = 1.32), and ankle joint stiffness (−26.3%; p = 0.008; d_z = 1.30) decreased. Ankle joint range of motion (+20.2%; p = 0.011; d_z = 1.09) and MG muscle-tendon unit length (+12.0%; p = 0.037; d_z = 0.91) during the braking phase of DJ, the immediate drop-off in impact force (termed peak force reduction) (Δ27.3%; p = 0.033; d_z = 0.86), and lactate (+9.5 mmol/L; p < 0.001; d_z = 3.58) increased. Fascicle length increased at rest (+4.9%; p = 0.013; d_z = 1.16) and during MVC (+6.8%; p = 0.048; d_z = 0.85). Pennation angle decreased at rest (−6.5%; p = 0.034, d_z = 0.93) and during MVC (−9.8%; p = 0.012; d_z = 1.35). No changes in muscle thickness were found at rest (−2.6%; p = 0.066; d_z = 0.77) or during MVC (−1.6%; p = 0.204; d_z = 0.49). The greater MG muscle-tendon stretch during the DJ braking phase after exercise indicates that muscle damage likely occurred. The lower peak force reduction and ankle joint stiffness, indicative of decreased active stiffness, suggests activation was likely reduced, causing fascicles to shorten less during MVC.

Muscle structure governs joint function: linking natural variation in medial gastrocnemius structure with isokinetic plantar flexor function

Despite the robust findings linking plantar flexor muscle structure to gross function within athletes, the elderly and patients following Achilles tendon ruptures, the link between natural variation in plantar flexor structure and function in healthy adults is unclear. In this study, we determined the relationship between medial gastrocnemius structure and peak torque and total work about the ankle during maximal effort contractions. We measured resting fascicle length and pennation angle using ultrasound in healthy adults (N=12). Subjects performed maximal effort isometric and isokinetic contractions on a dynamometer. We found that longer fascicles were positively correlated with higher peak torque and total work (R²>0.41, P<0.013) across all isokinetic velocities, ranging from slow (30°/s) to fast (210°/s) contractions. Higher pennation angles were negatively correlated with peak torque and total work (R²>0.296, P<0.067). These correlations were not significant in isometric conditions. We further explored this relationship using a simple computational model to simulate isokinetic contractions. These simulations confirmed that longer fascicle lengths generate more joint torque and work throughout a greater range of motion. This study provides evidence that ankle function is strongly influenced by muscle structure in healthy adults.

Summary: Using ultrasound measurements of muscle structure and dynamometer measurements of ankle function, we found that longer muscle fascicles positively correlated with increased ankle kinetics.

Do Stretch-Shortening Cycles Really Occur in the Medial Gastrocnemius? A Detailed Bilateral Analysis of the Muscle-Tendon Interaction During Jumping

The effect of stretch-shortening cycles (SSCs) is often studied in laboratory settings, yet it remains unclear whether highly active muscle SSCs actually occur during in vivo movement. Nine highly trained jumping athletes performed single-leg pre-hop forward jumps at maximal effort. We hypothesized that these jumps would induce a SSC at the level of the muscle in the medial gastrocnemius. Kinematic and kinetic data were collected together with electromyography signals (EMG) and muscle fascicle length and pennation angle changes of the medial gastrocnemius of both legs and combined with a musculoskeletal model to calculate the stretch-shortening behavior of the muscle (fascicles) and tendon (series-elastic element). The length changes of the fascicles, longitudinal muscle displacement, series-elastic element, and whole muscle-tendon unit further allowed for a detailed analysis of the architectural gearing ratio between different phases of the SSC within a single movement. We found a SSC at the level of the joint, muscle-tendon unit and tendon but not at the muscle. We further found that the average architectural gearing ratio was higher during the stretching of the series-elastic element as compared to when the series-elastic element was shortening, yet this was not statistically tested because of low sample size for this parameter. However, we found no correlation when plotting the architectural gearing ratio as a function of the fascicle velocities at each instance in time. Despite the athletes having a clear preferred leg for jumping, we found no differences in any kinematic or kinetic parameter between the preferred and non-preferred leg or any parameter from the muscle-tendon interaction analysis other than a reduced longitudinal muscle shortening in the non-preferred leg (p = 0.008). We conclude that, although common at the level of the joints, MTUs, and tendon (series-elastic element), highly active SSCs very rarely occur in the medial gastrocnemius, even in movements that induce high loading. This has important implications for the translation of ex vivo findings on SSC effects, such as residual force enhancement, in this muscle. We further conclude that there is no precise tuning of the architectural gearing ratio in the medial gastrocnemius throughout the whole movement.

Myotendinous asymmetries derived from the prolonged practice of badminton in professional players

Background

The continued practice of a sport linked to the unilateral predominance of the dominant side can provoke chronic asymmetric adaptations in the myotendinous structure and mechanical properties. Objectives: The main purpose was to determine whether asymmetry between the preferred and non-preferred lower limb is present in the lower limb tendon structure, muscle architecture and stiffness values of professional badminton players.

Methods

Sixteen male professional badminton players (age = 24.1 ± 6.7 years; body height = 177.90 ± 7.53 cm) participated in this study. The muscle architecture of the vastus lateralis (VL), medial gastrocnemius (MG) and lateral gastrocnemius (LG) and the structure of patellar and Achilles tendons were measured in the dominant and non-dominant lower limb with ultrasonography. Stiffness was also measured at the same points with a hand-held MyotonPro. Significant differences between the dominant and non-dominant lower limb were determined using Student’s t test for related samples.

Results

Bilateral differences were observed for thickness, width and cross-sectional area (CSA) in both tendons showing higher values for the dominant side: patellar tendon CSA (2.02 ± 0.64 vs. 1.51 ± 0.42 cm²; p < 0.05) and Achilles tendon CSA (1.12 ± 0.18 vs. 0.92 ± 0.28 cm²; p < 0.05). No significant differences were observed in muscle architecture and myotonic variables between the dominant and non-dominant lower limb.

Conclusions

The prolonged practice of badminton caused asymmetries in the CSA, width and thickness of the patellar and Achilles tendon between the dominant and non-dominant lower limbs. No bilateral differences were found in the muscle architecture of VL, MG and LG or in the stiffness of any muscle or tendon analyzed.

Evidence of a Uniform Muscle-Tendon Unit Adaptation in Healthy Elite Track and Field Jumpers: A Cross Sectional Investigation

Different adaptive responses to mechanical loading between muscle and tendon can lead to non-uniform biomechanical properties within the muscle-tendon unit. The current study aimed to analyze the mechanical properties of the triceps surae muscle-tendon unit in healthy male and female elite track and field jumpers in order to detect possible inter-limb differences and intra-limb non-uniformities in muscle and tendon adaptation. The triceps surae muscle strength and tendon stiffness were analyzed in both limbs during maximal voluntary isometric plantar flexion contractions using synchronous dynamometry and ultrasonography in sixty-seven healthy young male (n = 35) and female (n = 32) elite international level track and field jumpers (high jump, long jump, triple jump, pole vault). Triceps surae muscle-tendon unit intra-limb uniformity was assessed using between limb symmetry indexes in the muscle strength and tendon stiffness. Independent from sex and jumping discipline the take-off leg showed a significantly higher (p < 0.05) triceps surae muscle strength and tendon stiffness, suggesting different habitual mechanical loading between legs. However, despite these inter-limb discrepancies no differences were detected in the symmetry indexes of muscle strength (5.9 ± 9.4%) and tendon stiffness (8.1 ± 11.5%). This was accompanied by a significant correlation between the symmetry indexes of muscle strength and tendon stiffness (r = 0.44; p < 0.01; n = 67). Thus, the current findings give evidence for a uniform muscle-tendon unit adaptation in healthy elite track and field jumpers, which can be reflected as a protective mechanism to maintain its integrity to meet the functional demand.

Training-induced increase in Achilles tendon stiffness affects tendon strain pattern during running

Background

During the stance phase of running, the elasticity of the Achilles tendon enables the utilisation of elastic energy and allows beneficial contractile conditions for the triceps surae muscles. However, the effect of changes in tendon mechanical properties induced by chronic loading is still poorly understood. We tested the hypothesis that a training-induced increase in Achilles tendon stiffness would result in reduced tendon strain during the stance phase of running, which would reduce fascicle strains in the triceps surae muscles, particularly in the mono-articular soleus.

Methods

Eleven subjects were assigned to a training group performing isometric single-leg plantarflexion contractions three times per week for ten weeks, and another ten subjects formed a control group. Before and after the training period, Achilles tendon stiffness was estimated, and muscle-tendon mechanics were assessed during running at preferred speed using ultrasonography, kinematics and kinetics.

Results

Achilles tendon stiffness increased by 18% (P < 0.01) in the training group, but the associated reduction in strain seen during isometric contractions was not statistically significant. Tendon elongation during the stance phase of running was similar after training, but tendon recoil was reduced by 30% (P < 0.01), while estimated tendon force remained unchanged. Neither gastrocnemius medialis nor soleus fascicle shortening during stance was affected by training.

Discussion

These results show that a training-induced increase in Achilles tendon stiffness altered tendon behaviour during running. Despite training-induced changes in tendon mechanical properties and recoil behaviour, the data suggest that fascicle shortening patterns were preserved for the running speed that we examined. The asymmetrical changes in tendon strain patterns supports the notion that simple in-series models do not fully explain the mechanical output of the muscle-tendon unit during a complex task like running.

Effect of habitual foot-strike pattern on the gastrocnemius medialis muscle-tendon interaction and muscle force production during running

The interaction between gastrocnemius medialis (GM) muscle and Achilles tendon, i.e., muscle-tendon unit (MTU) interaction, plays an important role in minimizing the metabolic cost of running. Foot-strike pattern (FSP) has been suggested to alter MTU interaction and subsequently the metabolic cost of running. However, metabolic data from experimental studies on FSP are inconsistent, and a comparison of MTU interaction between FSP is still lacking. We, therefore, investigated the effect of habitual rearfoot and mid-/forefoot striking on MTU interaction, ankle joint work, and plantar flexor muscle force production while running at 10 and 14 km/h. GM muscle fascicles of 9 rearfoot and 10 mid-/forefoot strikers were tracked using dynamic ultrasonography during treadmill running. We collected kinetic and kinematic data and used musculoskeletal models to determine joint angles and calculate MTU lengths. In addition, we used dynamic optimization to assess plantar flexor muscle forces. During ground contact, GM fascicle shortening ( P = 0.02) and average contraction velocity ( P = 0.01) were 40-45% greater in rearfoot strikers than mid-/forefoot strikers. Differences in contraction velocity were especially prominent during early ground contact. Moreover, GM ( P = 0.02) muscle force was greater during early ground contact in mid-/forefoot strikers than rearfoot strikers. Interestingly, we did not find differences in stretch or recoil of the series elastic element between FSP. Our results suggest that, for the GM, the reduced muscle energy cost associated with lower fascicle contraction velocity in mid-/forefoot strikers may be counteracted by greater muscle forces during early ground contact. NEW & NOTEWORTHY Kinetic and kinematic differences between foot-strike patterns during running imply (not previously reported) altered muscle-tendon interaction. Here, we studied muscle-tendon interaction using ultrasonography. We found greater fascicle contraction velocities and lower muscle forces in rearfoot compared with mid-/forefoot strikers. Our results suggest that the higher metabolic energy demand due to greater fascicle contraction velocities might offset the lower metabolic energy demand due to lower muscle forces in rearfoot compared with mid-/forefoot strikers.

Information from dynamic length changes improves reliability of static ultrasound fascicle length measurements

Purpose

Various strategies for improving reliability of fascicle identification on ultrasound images are used in practice, yet these strategies are untested for effectiveness. Studies suggest that the largest part of differences between fascicle lengths on one image are attributed to the error on the initial image. In this study, we compared reliability results between different strategies.

Methods

Static single-image recordings and image sequence recordings during passive ankle rotations of the medial gastrocnemius were collected. Images were tracked by three different raters. We compared results from uninformed fascicle identification (UFI) and results with information from dynamic length changes, or data-informed tracking (DIT). A second test compared tracking of image sequences of either fascicle shortening (initial-long condition) or fascicle lengthening (initial-short condition).

Results

Intra-class correlations (ICC) were higher for the DIT compared to the UFI, yet yielded similar standard error of measurement (SEM) values. Between the initial-long and initial-short conditions, similar ICC values, coefficients of multiple determination, mean squared errors, offset-corrected mean squared errors and fascicle length change values were found for the DIT, yet with higher SEM values and greater absolute fascicle length differences between raters on the first image in the initial-long condition and on the final image in the initial-short condition.

Conclusions

DIT improves reliability of fascicle length measurements, without lower SEM values. Fascicle length on the initial image has no effect on subsequent tracking results. Fascicles on ultrasound images should be identified by a single rater and care should be taken when comparing absolute fascicle lengths between studies.