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Santos R, Valamatos MJ, Mil-Homens P, Armada-da-Silva PAS. Effect of Knee Angle, Contractile Activity, and Intensity of Force Production on Vastus Lateralis Stiffness: A Supersonic Shear Wave Elastography Pilot Study. Sports (Basel) 2024; 12:211. [PMID: 39195587 PMCID: PMC11359883 DOI: 10.3390/sports12080211] [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: 04/20/2024] [Revised: 07/05/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024] Open
Abstract
Supersonic shear image (SSI) ultrasound elastography provides a quantitative assessment of tissue stiffness using the velocity of shear waves. SSI's great potential has allowed researchers in fields like biomechanics and muscle physiology to study the function of complex muscle groups in different conditions. The aim of this study is to use SSI to investigate changes in the stiffness of the vastus lateralis (VL) muscle as a consequence of passive elongation, isometric contraction, and repeated muscle activity. In a single session, 15 volunteers performed a series of isometric, concentric, and eccentric contractions. SSI images were collected from the VL to assess its stiffness before and after the contractions and at various knee angles. Two-way within-subjects ANOVA was used to test the effects of muscle contraction type and knee angle on VL stiffness. Linear regression analysis was employed to assess the relationship between muscle stiffness and the intensity of isometric contractions. After maximal contractions, VL stiffness increased by approximately 10% compared to baseline values, and following maximal isometric (p < 0.01) and eccentric contractions (p < 0.05). Yet, there was no change in VL shear modulus at the end of concentric contractions. The relaxed VL shear modulus increased with knee flexion both before and after the knee extensor contractions (p < 0.001). A linear relationship between the shear modulus and the degree of isometric contraction was observed, although with notable individual variation (R2 = 0.125). Maximal contractile activity produces modest increases in relaxed muscle stiffness. The SSI-measured shear modulus increases linearly with the degree of isometric contraction.
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Affiliation(s)
- Rute Santos
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Estrada da Costa, Portugal; (M.J.V.); (P.M.-H.); (P.A.S.A.-d.-S.)
- Coimbra Health School, Polytechnic University of Coimbra, Rua da Misericórdia, Lagar dos Cortiços, S. Martinho do Bispo, 3045-093 Coimbra, Portugal
- H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal
- CIPER-UC—Interdisciplinary Center for the Study of Human Performance, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Maria João Valamatos
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Estrada da Costa, Portugal; (M.J.V.); (P.M.-H.); (P.A.S.A.-d.-S.)
| | - Pedro Mil-Homens
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Estrada da Costa, Portugal; (M.J.V.); (P.M.-H.); (P.A.S.A.-d.-S.)
| | - Paulo A. S. Armada-da-Silva
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Estrada da Costa, Portugal; (M.J.V.); (P.M.-H.); (P.A.S.A.-d.-S.)
- Centro para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Estrada da Costa, Portugal
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Miyamoto N, Yamazaki K, Iwasaki T, Mujika I, Yamashita D, Hirata K. Biceps femoris long head stiffens after 2 weeks of training cessation in highly trained sprinters. Eur J Appl Physiol 2024:10.1007/s00421-024-05536-w. [PMID: 38904773 DOI: 10.1007/s00421-024-05536-w] [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: 05/02/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Most athletes experience short-term training cessation because of illness, injury, post-season vacation, or other reasons. Passive muscle stiffness is a potential risk factor for a sprint-type hamstring strain injury, but limited information is available about the effect of short-term training cessation on passive muscle stiffness. The present study aimed to identify whether and how passive muscle stiffness of the biceps femoris long head (BFlh) would vary due to 2 weeks of training cessation in sprinters. METHODS Passive BFlh shear-wave speed (a proxy for stiffness) was measured using ultrasound shear-wave elastography in 28 male sprinters, before and after 2 weeks of intervention. During the 2 weeks, the participants in the training-cessation group (n = 14) were allowed to maintain their normal daily activities but not to perform any physical training, including stretching and resistance exercises. The participants in the training continuation group (n = 14) performed the training (including maximum speed sprint, plyometric, and weight training) prescribed by their coaches 5 days per week. RESULTS In the training-cessation group, passive BFlh shear-wave speed increased after the 2 weeks of training cessation (4.75 ± 0.77 to 5.00 ± 0.88 m/s, P < 0.001). In contrast, there was no significant difference before and after the 2 weeks of training continuation (4.90 ± 0.85 to 4.93 ± 0.85 m/s, P = 0.521). CONCLUSIONS The present findings indicate that muscles stiffen by training cessation in sprinting athletes.
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Affiliation(s)
- Naokazu Miyamoto
- Faculty of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.
- Department of Sport Science and Research, Japan Institute of Sports Sciences, Tokyo, Japan.
| | - Kazuhiko Yamazaki
- Faculty of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Takafumi Iwasaki
- Faculty of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country, Spain
- School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Daichi Yamashita
- Department of Sport Science and Research, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Kosuke Hirata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Sukanen M, Khair RM, Ihalainen JK, Laatikainen-Raussi I, Eon P, Nordez A, Finni T. Achilles tendon and triceps surae muscle properties in athletes. Eur J Appl Physiol 2024; 124:633-647. [PMID: 37950761 PMCID: PMC10858159 DOI: 10.1007/s00421-023-05348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE The aim of this study was to investigate internal Achilles tendon (AT) displacement, AT shear wave velocity (SWV), and triceps surae (TS) muscle shear modulus in athletes. METHODS Internal AT displacement was assessed using ultrasound during isometric contraction. Shear wave elastography was used to assess AT SWV (m × s-1) at rest and TS muscle shear modulus (kPa) during passive ankle dorsiflexion. RESULTS A total of 131 athletes participated in this study. Athletes who had not exercised within two days had greater AT non-uniformity and mean anterior tendon displacement, and lower SWV at the proximal AT measurement site (mean difference [95% CI]: 1.8 mm [0.6-2.9], p = 0.003; 1.6 mm [0.2-2.9], p = 0.021; - 0.9 m × s-1 [- 1.6 to - 0.2], p = 0.014, respectively). Male basketball players had a lower mean AT displacement compared to gymnasts (- 3.7 mm [- 6.9 to - 0.5], p = 0.042), with the difference localised in the anterior half of the tendon (- 5.1 mm [- 9.0 to - 1.1], p = 0.022). Male gymnasts had a smaller absolute difference in medial gastrocnemius-minus-soleus shear modulus than basketball players (59.6 kPa [29.0-90.2], p < 0.001) and track and field athletes (52.7 kPa [19.2-86.3], p = 0.004). Intraclass correlation coefficients of measurements ranged from 0.720 to 0.937 for internal AT displacement, from 0.696 to 0.936 for AT SWE, and from 0.570 to 0.890 for TS muscles. CONCLUSION This study provides a reliability assessment of muscle and tendon SWV. The relative differences in passive TS muscle shear modulus suggest sport-specific adaptation. Importantly, in healthy individuals, lower AT displacement after exercise may reflect the time required for tendon recovery.
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Affiliation(s)
- Maria Sukanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Ra'ad M Khair
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Pauline Eon
- Nantes Université, Movement-Interactions-Performance, MIP, UR 4334, F-44000, Nantes, France
| | - Antoine Nordez
- Nantes Université, Movement-Interactions-Performance, MIP, UR 4334, F-44000, Nantes, France
- Institut Universitaire de France, Paris, France
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Kobayashi T, Hirota K, Otsuki R, Onodera J, Kodesho T, Taniguchi K. Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet. Gait Posture 2024; 108:15-21. [PMID: 37976604 DOI: 10.1016/j.gaitpost.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/04/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The intrinsic and extrinsic foot softtissue structures that apply force and support the medial longitudinal arch (MLA) have been implicated in the development of flat feet. However, the relationship between the changes in MLA height under increasing load and the morphological and mechanical properties of individual intrinsic and extrinsic foot soft tissue structures is not fully understood. RESEARCH QUESTION To examine the morphological and mechanical characteristics of the foot soft tissue structures in flat feet when subjected to loading. METHODS This study consisted of two studies focusing on the extrinsic foot muscles (10 normal feet/11 flat feet) and intrinsic foot muscles (14 normal feet/13 flat feet). Images of the extrinsic and intrinsic foot muscles and plantar fascia (PF) under 10%, 50%, and 90% body weight conditions were obtained using ultrasound-based shear-wave elastography. RESULTS The cross-sectional area (CSA) of the peroneus brevis was larger in the flat-foot group than in the normal-foot group under all loading conditions. The CSAs of the intrinsic foot muscles (abductor hallucis, flexor digitorum brevis, and quadratus plantae) and thickness of the PF in the flat-foot group decreased significantly with increasing load. As for mechanical characteristics, the stiffness of the flexor digitorum longus and abductor hallucis was higher in the flat-foot group than in the normal group under high loading conditions. In addition, flat feet with greater flexibility tended to exhibit a greater decrease in PF thickness and smaller increase in stiffness. SIGNIFICANCE Excessive stretching of the intrinsic foot muscles and PF occurs in flat feet, and excessive contraction of the flexor digitorum longus may counteract the excessive lowering of the foot arch. Therefore, it is necessary to promote the contraction of the intrinsic foot musculature in feet with greater flexibility of the MLA during loading.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan; Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Kento Hirota
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan; Tokachi Physical Lab, Obihiro, Japan
| | - Ryo Otsuki
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Juri Onodera
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Belghith K, Zidi M, Fedele JM, Bou Serhal R, Maktouf W. Spatial distribution of stiffness between and within muscles in paretic and healthy individuals during prone and standing positions. J Biomech 2023; 161:111838. [PMID: 37922613 DOI: 10.1016/j.jbiomech.2023.111838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/08/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
This study investigated the inter- and intramuscular variability of plantar flexors stiffness during prone and standing positions at different muscle lengths in healthy and paretic individuals. To access tissue stiffness, shear wave elastography (SWE) measurements were carried out on two groups: control group (CG; n=14; age 43.9±9.6 years; body mass index [BMI]=24.5±2.5 kg/m2) and stroke survivor group (SSG; n=14; age 43.9±9.6 years; BMI=24.5±2.5 kg/m2). Shear Modulus (μ, kPa) within three plantar flexors (the gastrocnemius medialis [GM], gastrocnemius lateralis [GL], and soleus [SOL]) was obtained during two conditions: prone and standing position, at different angles of dorsiflexion (0°, 10°, and 20°). Measurements were also performed in different proximo-distal regions of each muscle. Muscle activation of the GM, GL, SOL, and tibialis anterior were evaluated during the two conditions. Results showed a high spatial stiffness variability between and within plantar flexors during dorsiflexion. The highest stiffness was observed in the GM, especially in the distal region at 20° in healthy and paretic muscles. In the prone position, the paretic muscle exhibits greater stiffness compared to the healthy muscle (p < 0.05). In contrast, in the standing position, an increase of stiffness in the healthy muscle compared to the paretic muscle was observed (p < 0.05). Thus, mechanical properties are differently affected by stroke depending on active and passive states of ankle muscles during dorsiflexion. In addition, the modification of ankle muscle state change stiffness distribution between and within plantar flexors.
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Affiliation(s)
- Kalthoum Belghith
- Bioengineering, Tissues and Neuroplasticity, ER 7377, University of Paris-Est Creteil, Faculty of Health/EPISEN, Creteil, France; CLINEA group, Clinique du Parc de Belleville, Paris, France.
| | - Mustapha Zidi
- Bioengineering, Tissues and Neuroplasticity, ER 7377, University of Paris-Est Creteil, Faculty of Health/EPISEN, Creteil, France.
| | | | | | - Wael Maktouf
- Bioengineering, Tissues and Neuroplasticity, ER 7377, University of Paris-Est Creteil, Faculty of Health/EPISEN, Creteil, France.
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Kobayashi T, Kodesho T, Kinami K, Takahashi A, Taniguchi K, Taniguchi K. Characteristics of the static muscle stiffness of ankle plantar flexors in individuals with chronic ankle instability. J Med Ultrason (2001) 2023; 50:561-570. [PMID: 37640966 DOI: 10.1007/s10396-023-01360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Individuals with chronic ankle instability (CAI) have deficits in closed kinetic chain dorsiflexion that may perpetuate injury. Determining the characteristics of muscle stiffness in the plantar flexors of individuals with CAI may help in developing appropriate treatments. We aimed to highlight the characteristics of static muscle stiffness in ankle plantar flexor muscles during the passive dorsiflexion of the ankle joint in individuals with CAI. METHODS A total of 30 patients were included in the study based on the International Ankle Consortium criteria. The patients were categorized evenly into healthy, coper, and CAI groups (i.e., 10 patients in each group). After measuring the dorsiflexion range of motion (non-weight-bearing/weight-bearing) of the ankle joint, the static muscle stiffness measurements of the medial gastrocnemius, lateral gastrocnemius, soleus, and peroneus longus were obtained. The measurements were performed during the knee joint's extension and 50° flexion and passive dorsiflexion between the range of 40° plantar flexion and 20° dorsiflexion. RESULTS The dorsiflexion range of motion of the CAI group was significantly smaller than that of the healthy and coper groups in the weight-bearing position. No interaction was observed for muscle stiffness in both the knee flexion and extension positions, and no significant differences were identified among the three groups. The shear modulus of the soleus at 20° ankle dorsiflexion with knee flexion had a significant negative correlation with the weight-bearing range of motion of the ankle. CONCLUSION The limitation in the weight-bearing dorsiflexion range of motion in CAI was largely due to factors other than the increased elasticity of the ankle plantar flexor muscles.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan.
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keita Kinami
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Ayuka Takahashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Konatsu Taniguchi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Xu X, Chen Y, Cai W, Huang J, Yao X, Zhao Q, Li H, Liang W, Zhang H. A Multivariable Model Based on Ultrasound Imaging Features of Gastrocnemius Muscle to Identify Patients With Sarcopenia. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2045-2055. [PMID: 36929858 DOI: 10.1002/jum.16223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Low skeletal muscle mass, strength, or somatic function are used to diagnose sarcopenia; however, effective assessment methods are still lacking. Therefore, we evaluated the effectiveness of ultrasound in identifying patients with sarcopenia. METHODS This study included 167 patients, 78 with sarcopenia and 89 healthy participants, from two hospitals. We evaluated clinical factors and five ultrasound imaging features, of which three ultrasound imaging features were used to create the model. In both the training and validation datasets, the sarcopenia detection performances of chosen ultrasonic characteristics and the constructed model were evaluated using receiver operating characteristic (ROC) curves. The predictive performance was evaluated by area under the ROC (AUROC), calibration, and decision curves. RESULTS There were statistically significant differences in muscle thickness (MT) of gastrocnemius medialis muscle (GM), flaky myosteatosis echo (FE), pennation angle (PA), average shear wave velocity (SWV) in the relaxed state (RASWV), and average SWV in the passive stretched state (PASWV) between sarcopenic and normal subjects. PA, RASWV, and PASWV were effective predictors of sarcopenia. The AUROC (95% confidence interval) for these three parameters were 0.930 (0.882-0.978), 0.865 (0.791-0.940), and 0.849 (0.770-0.928), respectively, in the training set, and 0.873 (0.777-0.969), 0.936 (0.878-0.993), and 0.826 (0.716-0.935), respectively, in the validation set. The combined model had better detection power. Finally, the calibration curve showed that the combined model had good prediction accuracy. CONCLUSION Our model can be used to identify sarcopenia in primary medical institutions, which is valuable for the early recognition and management of sarcopenia patients.
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Affiliation(s)
- Xuanshou Xu
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
- Department of Ultrasound Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuansen Chen
- Department of Ultrasound, The Third People's Hospital of Longgang District, Shenzhen, China
| | - Wenwen Cai
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Jing Huang
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Xiaohong Yao
- Department of Ultrasound, The Third People's Hospital of Longgang District, Shenzhen, China
| | - Qin Zhao
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Hong Li
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Weixiang Liang
- Department of Ultrasound Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Heng Zhang
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
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Yimin W, Jingtao L, Lei H, Lihai Z. Analysis and multiple index evaluation of SPO distribution of bone traction needles for pelvic fracture reduction. Med Eng Phys 2023; 119:104031. [PMID: 37634913 DOI: 10.1016/j.medengphy.2023.104031] [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: 01/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023]
Abstract
For robot-assisted pelvic fracture reduction, at least two bone needles need to be inserted into the ilium of the affected pelvis, and the robot clamping device is connected with the bone needles. The biomechanical properties of the pelvic musculoskeletal tissues are different with the different Spatial Position and Orientation (SPO) of the bone needles. In order to determine the optimal SPO of bone needle pairs, the constraints between the bone needles and the pelvis are analyzed, and the SPO vectors of 150 groups bone needles are obtained by the KNN-hierarchical clustering method; a batch modeling method of bone needles with different SPO is proposed. 150 finite element models of damaged pelvic musculoskeletal tissue with different SPO of bone needles are established and simulated. The stress and strain distribution homogenization of musculoskeletal tissue with bone needles as evaluation index, the simulation results of 150 models are evaluated. Results show that, the anterior superior iliac spine and the anterior inferior iliac spine are suitable regions to place bone needles in the pelvis, and the optimal distribution of the needle combination is found in this region. The overall stress and strain distribution of the damaged pelvic musculoskeletal tissue under the large reduction force is the best.
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Affiliation(s)
- Wei Yimin
- Department of Precision Machinery, School of Mechatronic Engineering and Automation, 200444, Shanghai University, Shanghai, China
| | - Lei Jingtao
- Department of Precision Machinery, School of Mechatronic Engineering and Automation, 200444, Shanghai University, Shanghai, China.
| | - Hu Lei
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China
| | - Zhang Lihai
- Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China
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Gachon B, Clergue O, Fritel X, Pierre F, Nordez A. In vivo assessment of the elastic properties of the external anal sphincter in term pregnant women using shear wave elastography. Int Urogynecol J 2023; 34:1705-1713. [PMID: 36700968 DOI: 10.1007/s00192-023-05456-x] [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: 08/16/2022] [Accepted: 12/21/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to assess the intraobserver intersession and interobserver intrasession reliability of shear wave elastography applied to the external anal sphincter in term pregnant women. METHODS This prospective study involved nulliparous pregnant women at 37 weeks or more with two visits (V1: one observer; V2 two observers) planned within a 12-h to 7-day interval. Measurements were performed using an Aixplorer V12® device with an SL 18-5 linear probe using a transperineal approach, allowing a measurement of the shear modulus (SM) in kPa. Measures were performed at rest, Valsalva maneuver, and maximal contraction. Reliability was assessed using the intraclass correlation coefficient (ICC). The study was approved by an ethics committee (ID RCB: 2020-A00764-65). RESULTS A total of 37 women were included. Intraobserver reliability was excellent at rest (ICC = 0.91 [0.84-0.95) and good during the Valsalva maneuver (ICC = 0.83 [0.72-0.90]) and contraction (ICC = 0.85 [0.75-0.91]). Interobserver reliability was good at rest (ICC = 0.79 [0.66-0.87]) and during Valsalva (ICC = 0.84 [0.73-0.90]), but moderate during contraction (ICC = 0.70 [0.53-0.82]). CONCLUSIONS Shear wave elastography is a reliable tool for assessing the elastic properties of the external anal sphincter in term pregnant women.
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Affiliation(s)
- Bertrand Gachon
- Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, 2 rue de la Miletrie, 86000, Poitiers, France.
- Mouvement - Interactions - Performance, MIP, EA4334, Université de Nantes, 44000, Nantes, France.
- Poitiers University, INSERM CIC 1402, Poitiers University Hospital, Poitiers, France.
| | - Océane Clergue
- Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, 2 rue de la Miletrie, 86000, Poitiers, France
- Poitiers University, INSERM CIC 1402, Poitiers University Hospital, Poitiers, France
| | - Xavier Fritel
- Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, 2 rue de la Miletrie, 86000, Poitiers, France
- Poitiers University, INSERM CIC 1402, Poitiers University Hospital, Poitiers, France
| | - Fabrice Pierre
- Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, 2 rue de la Miletrie, 86000, Poitiers, France
| | - Antoine Nordez
- Mouvement - Interactions - Performance, MIP, EA4334, Université de Nantes, 44000, Nantes, France
- Institut Universitaire de France (IUF), Roubaix, France
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Kato T, Taniguchi K, Kodesho T, Nakao G, Yokoyama Y, Saito Y, Katayose M. Quantifying the shear modulus of the adductor longus muscle during hip joint motion using shear wave elastography. Sci Rep 2023; 13:9510. [PMID: 37308569 DOI: 10.1038/s41598-023-36698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
The present study aims to assess the effect of the hip flexion angle on the shear modulus of the adductor longus (AL) muscle associated with passive hip abduction and rotation. Sixteen men participated in the study. For the hip abduction task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, and the hip abduction angles were 0, 10, 20, 30, and 40°. For the hip rotation task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, hip abduction angles were 0 and 40°, and hip rotation angles were 20° internal rotation, 0° rotation, and 20° external rotation. The shear modulus at 20° extension was significantly higher than that at 80° flexion for the 10, 20, 30 and 40° hip abduction (i.e., P < 0.05). The shear modulus at 20° internal rotation and 20° extension was significantly higher than that at 0° rotation and 20° external rotation, regardless of the hip abduction angle (i.e., P < 0.05). The mechanical stress of the AL muscle associated with hip abduction was higher in the extended position. Furthermore, the mechanical stress could increase with internal rotation only at the hip-extended position.
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Affiliation(s)
- Takuya Kato
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Gakuto Nakao
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yu Yokoyama
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuhei Saito
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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11
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Chen ZT, Jin FS, Guo LH, Li XL, Wang Q, Zhao H, Sun LP, Xu HX. Value of conventional ultrasound and shear wave elastography in the assessment of muscle mass and function in elderly people with type 2 diabetes. Eur Radiol 2023; 33:4007-4015. [PMID: 36648552 DOI: 10.1007/s00330-022-09382-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/01/2022] [Accepted: 12/12/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES We assessed muscle mass and function using ultrasound (US) and shear wave elastography (SWE) for sarcopenia in elderly patients with type 2 diabetes. METHODS There were 84 patients with type 2 diabetes enrolled in this study; of these, 30 had sarcopenia and 54 did not. We measured appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-m walking speed, and 5-time chair stand test. All patients were in the supine position with their knees in straight and bent poses in turn. The US-derived thickness (Tstraight, Tbent), cross-sectional area (CSAstraight, CSAbent), and SWE (SWEstraight, SWEbent) of the rectus femoris muscle (RFM) were measured and the differences (ΔT, ΔCSA, ΔSWE) were calculated. We assessed the correlations of clinical indicators with US and SWE features. We then compared the clinical indicators and US and SWE features between patients with and without sarcopenia to determine independent predictors. Diagnostic models were established based on these independent predictors. RESULTS The ASMI was correlated with Tbent (r = 0.57, p < 0.001) and CSAbent (r = 0.50, p < 0.001). Handgrip strength was correlated with Tbent (r = 0.53, p < 0.001) and CSAbent (r = 0.51, p < 0.001). Between patients with and without sarcopenia, the indicators of age, ΔCSA, and ΔSWE were statically different (all p ≤ 0.001). Based on these results, a diagnostic model for sarcopenia was established with 83.3% sensitivity, 83.3% specificity, and 83.3% accuracy. CONCLUSIONS In elderly people with type 2 diabetes, sarcopenia patients had smaller muscle CSA and less stiffness than non-sarcopenia patients. US and SWE might be useful to screen them. KEY POINTS • Sarcopenia is common in elderly people with type 2 diabetes. • Ultrasound and shear wave elastography might be useful methods for quantitatively assessing muscle mass and strength. • Ultrasound and shear wave elastography might be useful methods for screening sarcopenia in elderly patients with type 2 diabetes.
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Affiliation(s)
- Zi-Tong Chen
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Feng-Shan Jin
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Le-Hang Guo
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, China.
| | - Xiao-Long Li
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiao Wang
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui Zhao
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Li-Ping Sun
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
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12
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Bernabei M, Lee SSM, Perreault EJ, Sandercock TG. Axial stress determines the velocity of shear wave propagation in passive but not active muscles in vivo. J Appl Physiol (1985) 2023; 134:941-950. [PMID: 36861673 PMCID: PMC10069958 DOI: 10.1152/japplphysiol.00125.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Ultrasound shear wave elastography can be used to characterize mechanical properties of unstressed tissue by measuring shear wave velocity (SWV), which increases with increasing tissue stiffness. Measurements of SWV have often been assumed to be directly related to the stiffness of muscle. Some have also used measures of SWV to estimate stress, since muscle stiffness and stress covary during active contractions, but few have considered the direct influence of muscle stress on SWV. Rather, it is often assumed that stress alters the material properties of muscle, and in turn, shear wave propagation. The objective of this study was to determine how well the theoretical dependency of SWV on stress can account for measured changes of SWV in passive and active muscles. Data were collected from six isoflurane-anesthetized cats; three soleus muscles and three medial gastrocnemius muscles. Muscle stress and stiffness were measured directly along with SWV. Measurements were made across a range of passively and actively generated stresses, obtained by varying muscle length and activation, which was controlled by stimulating the sciatic nerve. Our results show that SWV depends primarily on the stress in a passively stretched muscle. In contrast, the SWV in active muscle is higher than would be predicted by considering only stress, presumably due to activation-dependent changes in muscle stiffness. Our results demonstrate that while SWV is sensitive to changes in muscle stress and activation, there is not a unique relationship between SWV and either of these quantities when considered in isolation.NEW & NOTEWORTHY Ultrasound shear wave elastography may be an inexpensive way to measure muscle stress in passive muscle. Here, using a cat model we directly measured shear wave velocity (SWV), muscle stress, and muscle stiffness. Our results show that SWV depends primarily on the stress in a passively stretched muscle. In contrast, the SWV in active muscle is higher than would be predicted by considering only stress, presumably due to activation-dependent changes in muscle stiffness.
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Affiliation(s)
- Michel Bernabei
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States
- Shirley Ryan Ability Lab, Chicago, Illinois, United States
| | - Sabrina S M Lee
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, United States
| | - Eric J Perreault
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States
- Shirley Ryan Ability Lab, Chicago, Illinois, United States
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States
| | - Thomas G Sandercock
- Department of Neuroscience, Northwestern University, Chicago, Illinois, United States
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13
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Zimmer M, Kleiser B, Marquetand J, Ates F. Characterization of Muscle Weakness Due to Myasthenia Gravis Using Shear Wave Elastography. Diagnostics (Basel) 2023; 13:diagnostics13061108. [PMID: 36980415 PMCID: PMC10047651 DOI: 10.3390/diagnostics13061108] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
Myasthenia gravis (MG) is often accompanied with muscle weakness; however, little is known about mechanical adaptions of the affected muscles. As the latter can be assessed using ultrasound shear wave elastography (SWE), this study characterizes the biceps brachii muscle of 11 patients with MG and compares them with that of 14 healthy volunteers. Simultaneous SWE, elbow torque and surface electromyography measurements were performed during rest, maximal voluntary contraction (MVC) and submaximal isometric contractions (up to 25%, 50% and 75% MVC) at different elbow angles from flexion to extension. We found that, with increasing elbow angle, maximum elbow torque decreased (p < 0.001), whereas muscle stiffness increased during rest (p = 0.001), MVC (p = 0.004) and submaximal contractions (p < 0.001). Muscle stiffness increased with increasing contraction intensities during submaximal contractions (p < 0.001). In comparison to the healthy cohort, muscle stiffness of MG patients was 2.1 times higher at rest (p < 0.001) but 8.93% lower in active state (75% MVC, p = 0.044). We conclude that (i) increased muscle stiffness shown by SWE during rest might be an indicator of MG, (ii) SWE reflects muscle weakness and (iii) SWE can be used to characterize MG muscle.
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Affiliation(s)
- Manuela Zimmer
- Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
- Correspondence: ; Tel.: +49-(711)-685-69528
| | - Benedict Kleiser
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Justus Marquetand
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Str. 25, 72076 Tübingen, Germany
- MEG-Center, University of Tübingen, Otfried-Müller-Str. 47, 72076 Tübingen, Germany
| | - Filiz Ates
- Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
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14
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Boulard C, Gautheron V, Lapole T. Acute passive stretching has no effect on gastrocnemius medialis stiffness in children with unilateral cerebral palsy. Eur J Appl Physiol 2023; 123:467-477. [PMID: 36318307 DOI: 10.1007/s00421-022-05046-7] [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: 03/29/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE The aim of this study was to investigate the effects of an acute high-intensity, long-duration passive stretching session of the plantar flexor muscles, on maximal dorsiflexion (DF) angle and passive stiffness at both ankle joint and gastrocnemius medialis (GM) muscle levels in children with unilateral cerebral palsy (CP). METHODS 13 children [mean age: 10 years 6 months, gross motor function classification system (GMFCS): I] with unilateral CP underwent a 5 min passive stretching session at 80% of maximal DF angle. Changes in maximal DF angle, slack angle, passive ankle joint and GM muscle stiffness from PRE- to POST-intervention were determined during passive ankle mobilization performed on a dynamometer coupled with shear wave elastography measurements (i.e., ultrasound) of the GM muscle. RESULTS Maximal DF angle and maximal passive torque were increased by 6.3° (P < 0.001; + 50.4%; 95% CI 59.9, 49.9) and 4.2 Nm (P < 0.01; + 38.9%; 95% CI 47.7, 30.1), respectively. Passive ankle joint stiffness remained unchanged (P = 0.9; 0%; 95% CI 10.6, - 10.6). GM muscle shear modulus was unchanged at maximal DF angle (P = 0.1; + 34.5%; 95% CI 44.7, 24.7) and at maximal common torque (P = 0.5; - 4%; 95% CI - 3.7, - 4.3), while it was decreased at maximal common angle (P = 0.021; - 35%; 95% CI - 11.4, - 58.5). GM slack angle was shifted in a more dorsiflexed position (P = 0.02; + 20.3%; 95% CI 22.6, 18). CONCLUSION Increased maximal DF angle can be obtained in the paretic leg in children with unilateral CP after an acute bout of stretching using controlled parameters without changes in passive stiffness at joint and GM muscle levels. CLINICAL TRIAL NUMBER NCT03714269.
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Affiliation(s)
- Clément Boulard
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de La Motricité, EA 7424, 42023, Saint-Etienne, France. .,Department of Pediatrics Physical Medicine and Rehabilitation, Faculty of Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France.
| | - Vincent Gautheron
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de La Motricité, EA 7424, 42023, Saint-Etienne, France
| | - Thomas Lapole
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de La Motricité, EA 7424, 42023, Saint-Etienne, France
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15
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Deng M, Zhou L, Chen Z, Yuan G, Zhou Y, Xiao Y. An ex-vivo validation of the modulus-length framework to characterize passive elastic properties of skeletal muscle. ULTRASONICS 2023; 129:106904. [PMID: 36463727 DOI: 10.1016/j.ultras.2022.106904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/09/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The passive elastic properties of skeletal muscles are related closely to muscle extensibility and flexibility. Recently, a single probe setup has been reported that measures the passive elastic properties of muscles in vivo. This uses a modulus-length framework to investigate sensitive dynamic parameters, termed as passive elastic coefficient k, slack length l0, and slack shear modulus G0 to quantify the passive elastic properties of human muscle. In particular, the parameter k calculated based on this framework reflects the change rate of the local shear modulus with respect to the muscle length, which remains constant during the entire passive stretching process. In this report, the modulus-length framework was validated in four groups of ex-vivo muscle samples (young and old chickens, pork, and beef). All the muscle samples were stretched mechanically whilst muscle length was monitored and recorded with simultaneous measurement of dynamic shear wave elastography (SWE). Agreement analyses using Bland-Altman diagrams and intraclass correlation coefficients (ICC) were then performed on coefficient k values obtained by mechanical stretching (k1) and real-time ultrasound imaging methods (k2). Bland-Altman diagrams show that the majority of the points lie within the 95 % LoA ([-1.87, 2.29]; p = 0.276) and the level of reliability was "good" to "excellent" based on the ICC results (ICC, 0.904; 95 % confidence interval, 0.813-0.953). This indicated that the ultrasound and mechanical methods produced very similar results. Meanwhile, the range of the coefficient k values in four muscle types and groups was significantly different (p < 0.05), a finding which strongly supports the potential use of this coefficient to characterize muscle quality and status.
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Affiliation(s)
- Miaoqin Deng
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liying Zhou
- Department of Obstetrics and Gynecology, Shenzhen Longhua District Central Hospital, Guangdong Medical University Affiliated Longhua District Central Hospital, Shenzhen, China
| | - Zengtong Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Guojian Yuan
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Yang Xiao
- National Innovation Center For Advanced Medical Devices, Shenzhen National Research Institute of High Performance Medical Devices Co, Ltd, Shenzhen, China
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16
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Chandra L, Ortiz J, Weitzel W, Hamilton JD, Gao J. Ultrasound Elastography Detects Age-Related Changes in Adult False Vocal Folds. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:575-583. [PMID: 35665952 DOI: 10.1002/jum.16033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/05/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To investigate the feasibility of ultrasound elastography for assessing the symmetry in stiffness values and movements of both false vocal folds (FVFs). METHODS After Institutional Review Board's approval and written informed consent obtained, we measured ultrasound strain and shear wave velocity (SWV) of the bilateral FVF in vocal fold abduction and adduction in 30 participants using a linear array transducer (4-10 MHz). Twenty-eight participants met inclusion criteria as healthy subjects for analysis. Mean strain of FVF produced by FVF movement from abduction to adduction was analyzed using 2D speckle-tracking software offline. A SWV ratio ([SWVadduction - SWabduction ]/SWabduction ) was developed to test the contractibility of FVF. Statistical analysis included one-way ANOVA to test the difference in mean strain, SWV (adduction and abduction), and SWV ratio among the three age groups; linear regression to analyze correlations of stiffness and movement between the right and left FVF; and intraclass correlation coefficient (ICC) to examine intra- and interobserver reliability in performing shear wave elastography (SWE) of FVF. RESULTS The 28 healthy participants were divided into 3 age groups (10 of young 20-44 years; 9 of mid-age 45-64 years; and 9 of senior ≥65 years). The SWV in FVF abduction was higher and the SWV ratio was lower in seniors compared to young participants (P < .05). Good to excellent correlation of mean strain and SWV between both FVFs (R2 > 0.89). The reliability of performing SWE of FVF was moderate to excellent. CONCLUSION Ultrasound elastography is feasible to assess the stiffness, dynamic movement, and symmetry of adult FVF, and healthy seniors may exhibit increased FVF stiffness.
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Affiliation(s)
| | | | - William Weitzel
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- University of Michigan, Ann Arbor, MI, USA
| | - James D Hamilton
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- University of Michigan, Ann Arbor, MI, USA
| | - Jing Gao
- Rocky Vista University, Ivins, UT, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
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17
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Ishikawa H, Muraki T, Yamamoto N, Itoi E, Izumi SI. Effect of shoulder immobilization position and activities of daily living on the stiffness of the repaired supraspinatus tendon. Clin Biomech (Bristol, Avon) 2023; 101:105856. [PMID: 36512943 DOI: 10.1016/j.clinbiomech.2022.105856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although tension on the supraspinatus tendon may be increased by wearing an abduction brace in an improper position or activities of daily living with the operated arm in the brace, the amount of tension has not been objectively evaluated. METHODS Eighteen patients who underwent arthroscopic rotator cuff repair were enrolled. The stiffness of the repaired supraspinatus tendon was measured with ultrasound elastography to estimate the tension on the repaired tendon. Measurements were performed in 5 immobilization positions (0°, 30°, and 45° of arm elevation in the scapular plane; 30° of arm elevation in the scapular plane+60° (horizontal adduction) and -60° (horizontal abduction)) and 3 static positions simulating drinking, brushing teeth, and dressing. FINDINGS Stiffness at 30° of scapular plane elevation was lower than 0° of scapular plane elevation (P = 0.034), 30° of elevation in the scapular plane+60° (P < 0.001), and -60° (P < 0.001). There was no significant difference in the stiffness between 30° and 45° of scapular plane elevation (P = 1.000). The stiffness was the greatest at 30° of elevation in the scapular plane-60° among the 5 immobilization positions. The stiffnesses at drinking and brushing teeth were greater than 30° of scapular plane elevation (P < 0.001). INTERPRETATION Immobilization with the arm ≥30° of elevation in the scapular plane may be an optimal position for minimizing stiffness or tension on the repaired tendon. Drinking and brushing teeth may need to be performed using the non-operated arm to protect the repaired tendon.
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Affiliation(s)
- Hiroaki Ishikawa
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takayuki Muraki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuyuki Yamamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
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18
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A shear-wave sonoelastography investigation of calf muscle pump biomechanics in patients with chronic venous disease and healthy controls. J Bodyw Mov Ther 2023; 33:53-59. [PMID: 36775526 DOI: 10.1016/j.jbmt.2022.09.026] [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: 04/07/2020] [Revised: 05/23/2022] [Accepted: 09/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND chronic venous disease (CVD) is a common progressive disorder with incompetence of calf muscle pump due to weakness and ankle mobility abnormality is an important etiological factor in CVD, but the biomechanical properties of calf muscle pump are remain unknown. OBJECTIVES The purpose of the present study was to evaluate group differences between the biomechanical properties changes of the medial gastrocnemius muscle (GM) and its fascias in participants with CVD and healthy controls. METHODS In this case-control study, thirty patients with CVD in three equal groups (mild: C1 - C2, moderate: C3 - C4, severe: C5 - C6) and 20 healthy subjects in a control group participated. The medial GM and its fascias shear modulus (stiffness) were measured using a shear-wave sonoelastography in rest and active dorsiflexion positions of ankle joint. RESULTS The results of variance (ANOVA) analysis showed a significant difference in shear wave elastography (SWE) value between the groups for medial GM and its fascias at rest and active dorsiflexion of the ankle joint (P < 0.05). There was a statistically significant increase in SWE value of the medial GM and its fascias in moderate (c3-c4) and severe CVD groups (C5-C6) compared to the control and mild (C1-C2) CVD groups. A positive correlation was discovered between disease grades and the medial GM and its fascias SWE in patients with CVD ranging between r = 0.846 to 0.891; P < 0.001. CONCLUSION An alteration stiffness in calf myofascial pump as compared to control group indicated an impaired myofascial biomechanics. Calf myofascial SWE may be valuable information in the diagnosis and follow-up processes of patients with CVD.
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Zimmer M, Kleiser B, Marquetand J, Ateş F. Shear wave elastography characterizes passive and active mechanical properties of biceps brachii muscle in vivo. J Mech Behav Biomed Mater 2023; 137:105543. [PMID: 36371993 DOI: 10.1016/j.jmbbm.2022.105543] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Mechanical characterization of individual muscles in their in vivo environment is not well studied. Shear wave elastography (SWE) as a non-invasive technique was shown to be promising in quantifying the local mechanical properties of skeletal muscles. This study aimed to investigate the mechanics of the biceps brachii muscle (BB) derived from SWE in relation to elbow joint position and contraction intensity during isometric contraction. 14 healthy, young subjects participated in the study and five different joint positions (60°-180° elbow angle) were investigated. Shear elastic modulus and surface electromyography (sEMG) of the BB and elbow torque were measured simultaneously, both in passive (i.e., resting) and active states during slow, sub-maximal isometric ramp contractions up to 25%, 50%, and 75% of the maximum voluntary contraction. At passive state, the shear elastic modulus of the BB increased with increasing elbow angle (p < 0.001). Maximum elbow flexion torque was produced at 60° and it decreased with increasing elbow angle (p = 0.001). During sub-maximal contractions, both elbow angle (p < 0.001) and contraction intensity (p < 0.001) had significant effects on the shear elastic modulus but only contraction intensity (p < 0.001) affected sEMG amplitude of the BB. Although torque was decreased at extended elbow positions (150°, 180°), higher active shear elastic modulus of BB muscle was found compared to flexed positions (60°, 90°). Linear regression of the BB sEMG amplitude over elbow torque showed good agreement for all joint positions (R2 between 0.69 and 0.89) while the linear agreement between shear elastic modulus of BB and elbow torque differed between flexed (R2 = 0.70 at 60° and R2 = 0.79 at 90°) and extended positions (with the lowest R2 = 0.57 at 150°). We conclude that using SWE, we can detect length-dependent mechanical changes of BB both in passive and active states. More importantly, SWE can be used to characterize active muscle properties in vivo. The present findings have critical importance for developing muscle stiffness as a measure of individual muscle force to validate muscle models and using SWE in clinical diagnostics.
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Affiliation(s)
- Manuela Zimmer
- Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Pfaffenwaldring 27, 70569, Stuttgart, Germany.
| | - Benedict Kleiser
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Justus Marquetand
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Str. 25, 72076, Tübingen, Germany; MEG-Center, University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany
| | - Filiz Ateş
- Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Pfaffenwaldring 27, 70569, Stuttgart, Germany
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Prolonged Sitting Causes Leg Discomfort in Middle Aged Adults: Evaluation of Shear Wave Velocity, Calf Circumference, and Discomfort Questionaries. J Clin Med 2022; 11:jcm11144024. [PMID: 35887787 PMCID: PMC9320137 DOI: 10.3390/jcm11144024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 01/27/2023] Open
Abstract
Introduction: Prolonged sitting causes leg discomfort. We evaluated shear wave velocity (SWV) of leg muscles, leg circumference, and leg discomfort associated with 2 h sitting. Methods: Twenty-one middle-aged men and 19 middle-aged women participated in the study. SWV and leg circumference was measured just after sitting, 60 min, 120 min, and after 3 min of leg raising. Leg discomfort was assessed before sitting and 120 min. Results: SWV was significantly greater in men than women and increased over time, and decreased with leg raising. The percentage increase in lower leg circumference was significantly greater in women than in men, and it increased over time. Leg discomfort significantly increased after 120 min in both men and women. Discussions: Because SWV is proportional to an increase in intramuscular compartment pressure in the lower leg, intramuscular compartment pressure increased over time with sitting and decreased with leg raising. Considering the changes in SWV and leg circumference, it was inferred that prolonged sitting causes an increase in intramuscular compartment pressure and intravascular blood volume, as well as an increase in water content in the leg subcutaneous tissue. Leg discomfort was estimated to be due to increased intra-leg fluid. Brief leg raising may resolve leg edema and discomfort.
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Turhan B, Maden T, Maden Ç. The comparison of tone and viscoelastic properties of superior orbicularis oris muscle in multiple sclerosis patients to healthy individuals. Mult Scler Relat Disord 2022; 65:103983. [PMID: 35753187 DOI: 10.1016/j.msard.2022.103983] [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: 06/02/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The orbicularis oris muscle is an important muscle for oral perception in mouth and swallowing rehabilitation. The muscle can be affected in patients with multiple sclerosis for many reasons. It is important to understand the quantitative changes in this muscle to determine the many problems associated with the cranio-facial region in multiple sclerosis. Therefore, this study aimed to compare the mechanical properties of the orbicularis oris muscle between MS patients and healthy individuals. METHODS A total of 55 individuals (28 with multiple sclerosis and 27 healthy) who met the inclusion criteria were evaluated. The tone and viscoelastic properties (elasticity and stiffness) of the superior orbicularis oris muscle of both groups were evaluated bilaterally in the supine position with the MyotonPro® (Myoton AS, Estonia) device. The reference point of the muscle is accepted as the right and left paramedial philtrum dimple. RESULTS It was observed that there was no difference in terms of stiffness values of the right and left orbicularis oris muscles of both groups (p>0.05). The tone and the elasticity of the muscle on both sides were higher in the HI group than MS group (p<0.05). CONCLUSION We think that the orbicularis oris muscle has a central location in the facial region, and that this muscle may be the key muscle for the symptoms arising from many neurological mechanisms. The decrease in muscle tone and elasticity may be the beginning of the changes in MS patients. We believe that the data from this muscle will be useful for comparative studies.
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Affiliation(s)
- Begumhan Turhan
- Hasan Kalyoncu University Faculty of Health Sciences Physiotherapy and Rehabilitation Department, Turkey.
| | - Tuba Maden
- Gaziantep University, Faculty of Health Sciences Physiotherapy and Rehabilitation Department, Turkey
| | - Çağtay Maden
- Gaziantep Islamic Science and Technology University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Turkey
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22
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Huang M, Miller T, Fu SN, Ying MTC, Pang MYC. Structural and passive mechanical properties of the medial gastrocnemius muscle in ambulatory individuals with chronic stroke. Clin Biomech (Bristol, Avon) 2022; 96:105672. [PMID: 35617816 DOI: 10.1016/j.clinbiomech.2022.105672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/08/2022] [Accepted: 05/12/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to investigate the structural, morphological and passive mechanical properties of the medial gastrocnemius muscle among ambulating chronic stroke survivors using a computational model previously established in healthy individuals without stroke. METHODS Individuals with chronic stroke (n = 14, age = 63.4 ± 6.0 years) and healthy controls (n = 15, age = 59.6 ± 8.4 years) participated in the study. The mechanical properties of the medial gastrocnemius were measured during continuous passive ankle motion using ultrasound elastography and a corresponding muscle mechanical property-angle curve was estimated where slack angle and elasticity were determined. Muscle thickness, fascicle length, pennation angle, and echo intensity were also assessed using B-mode ultrasound. FINDINGS No significant differences in slack angle (paretic: -16.2° ± 6.13°, non-paretic: -16.93° ± 6.80°, p = 0.82), or slack elasticity (paretic: 4.36 ± 1.94 kPa, non-paretic: 4.54 ± 1.24 kPa, p = 0.64) were found between sides or groups. Lower muscle pennation angle (paretic: 13.6 ± 2.9°, non-paretic: 15.9 ± 2.0°, p = 0.019) and higher echo intensity (paretic: 80.5 ± 13.6, non-paretic: 63.4 ± 17.1, p = 0.003) were observed for paretic muscles. No significant between-sides differences were found for muscle thickness (paretic: 1.5 ± 0.3 cm, non-paretic: 1.6 ± 0.2 cm, p = 0.255) or fascicle length (paretic: 6.6 ± 1.9 cm, non-paretic: 7.1 ± 2.2 cm, p = 0.216). Significant between-groups difference was also observed for fascicle length [non-dominant side (control): 6.2 ± 0.8 cm, paretic side (stroke): 6.6 ± 1.9 cm, p = 0.017]. INTERPRETATION Although muscle mechanical properties increased exponentially over the slack ankle, measures between paretic and non-paretic sides were similar in ambulating participants with chronic stroke. Side-to-side differences in structural and morphological measures suggest the impact of stroke was relatively more pronounced for these muscle parameters than for passive mechanical properties.
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Affiliation(s)
- Meizhen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Tiev Miller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Michael T C Ying
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong.
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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23
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Reliability of shear wave elastography for the assessment of gastrocnemius fascia elasticity in healthy individual. Sci Rep 2022; 12:8698. [PMID: 35610329 PMCID: PMC9130247 DOI: 10.1038/s41598-022-12786-1] [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: 12/28/2021] [Accepted: 05/13/2022] [Indexed: 11/08/2022] Open
Abstract
The mechanical properties of the deep fascia, particularly their stiffness, strongly affect the development of muscle pathologies (such as compartment syndrome) and the action of the muscles. However, the mechanical characteristics of the deep muscular fascia are still not clearly understood. The present study focuses on examining the reliability of ultrasonic shear wave elastography (USWE) devices in quantifying the shear modulus of the gastrocnemius fascia in healthy individuals, particularly their ability to measure the shear modulus of the deep fascia of the gastrocnemius during ankle dorsiflexion. Twenty-one healthy males (age: 21.48 ± 1.17 years) participated in the study. Using USWE, the shear moduli of the medial gastrocnemius fascia (MGF) and lateral gastrocnemius fascia (LGF) were quantified at different angles during passive lengthening. The two operators took turns measuring each subject's MGF and LGF over a 1-h period, and operator B took an additional measurement 2 h later. For the intra-operator test, the same subjects were measured again at the same time of day 5 days later. Both the intrarater [intraclass correlation coefficient (ICC) = 0.846-0.965)] and interrater (ICC = 0.877-0.961) reliability values for measuring the shear moduli of the MGF and LGF were rated as excellent; the standard error of the mean (SEM) was 3.49 kPa, and the minimal detectable change (MDC) was 9.68 kPa. Regardless of the ankle angle, the shear moduli of the LGF were significantly greater than that of the MGF (p < 0.001). Significant increases in the shear moduli of both the MGF and the LGF were observed in the neutral position compared to the relaxed position. These results indicate that USWE is a reliable technique to assess the shear modulus of the gastrocnemius fascia and detect its dynamic changes during ankle dorsiflexion. USWE can be used for biomechanical studies and intervention experiments concerning the deep fascia.
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Nakamura M, Akagi R. Ultrasonic shear-wave elastography: a novel method for assessing musculoskeletal soft tissue and nerves. Clin Neurophysiol 2022; 140:163-164. [DOI: 10.1016/j.clinph.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/03/2022]
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25
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Melo ASC, Cruz EB, Vilas-Boas JP, Sousa ASP. Scapular Dynamic Muscular Stiffness Assessed through Myotonometry: A Narrative Review. SENSORS 2022; 22:s22072565. [PMID: 35408180 PMCID: PMC9002787 DOI: 10.3390/s22072565] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method to assess several muscles stiffness, as trapezius. This method has been demonstrated fair to moderate correlation with passive stiffness measured by shear wave elastography for several muscles, as well as with level of muscle contraction, pinch and muscle strength, Action Research Arm Test score and muscle or subcutaneous thickness. Myotonometry can detect scapular muscles stiffness differences between pre- and post-intervention in painful conditions and, sometimes, between symptomatic and asymptomatic subjects.
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Affiliation(s)
- Ana S. C. Melo
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal;
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal;
- Center for Interdisciplinary Applied Research in Health, School of Health, Setubal Polytechnic Institute, Campus do IPS Estefanilha, 2914-503 Setubal, Portugal
| | - Eduardo B. Cruz
- Department of Physiotherapy, School of Health, Setubal Polytechnic Institute, Campus do IPS Estefanilha, 2914-503 Setubal, Portugal;
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - João Paulo Vilas-Boas
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal;
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal;
- Correspondence: or
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Yu HK, Liu X, Pan M, Chen JW, Liu C, Wu Y, Li ZB, Wang HY. Performance of Passive Muscle Stiffness in Diagnosis and Assessment of Disease Progression in Duchenne Muscular Dystrophy. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:414-421. [PMID: 34893358 DOI: 10.1016/j.ultrasmedbio.2021.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/07/2021] [Accepted: 09/02/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study was to evaluate the performance of passive muscle stiffness in diagnosing and assessing disease progression in Duchenne muscular dystrophy (DMD). Boys with DMD and age-matched controls were recruited. Shear wave elastography (SWE) videos were collected by performing dynamic stretching of the gastrocnemius medius (GM). At ankle angles from plantar flexion (PF) 30° to dorsiflexion (DF) 20°, the shear modulus of the GM was measured for each 10° of ankle movement. Shear modulus at each ankle angle was compared between the DMD and control group. Correlation between passive muscle stiffness and motor function grading was also analyzed. A total of 26 patients with DMD and 20 healthy boys were enrolled. At multiple stretch levels, passive muscle stiffness of the GM was significantly higher in patients with DMD than in those in the control group (all p values <0.05). The shear modulus of GM at an ankle angle of DF 10° had the largest area under the receiver operating characteristic curve in differentiating DMD patients from normal subjects (AUC = 0.902, 95% confidence interval: 0.814-0.990). Motor function grading was a significant determinant of passive muscle stiffness at an ankle angle of DF 10° (B = 21.409, t = 3.372, p = 0.003). Passive muscle stiffness may potentially serve as a useful non-invasive tool to monitor disease progression in DMD patients.
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Affiliation(s)
- Hong-Kui Yu
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiao Liu
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Fu-tian), Shenzhen, Guangdong, China
| | - Min Pan
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Fu-tian), Shenzhen, Guangdong, China
| | - Jin-Wei Chen
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chen Liu
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu Wu
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhi-Bin Li
- Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong-Ying Wang
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
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27
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Cao J, Xiao Y, Qiu W, Zhang Y, Dou Z, Ren J, Zheng R, Zheng H, Chen Z. Reliability and diagnostic accuracy of corrected slack angle derived from 2D-SWE in quantitating muscle spasticity of stroke patients. J Neuroeng Rehabil 2022; 19:15. [PMID: 35120556 PMCID: PMC8817514 DOI: 10.1186/s12984-022-00995-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/25/2022] [Indexed: 12/21/2022] Open
Abstract
Background To explore the feasibility of corrected slack angle acquired from two-dimensional shear wave elastography (2D-SWE) for quantitating the spasticity of medial gastrocnemius (MG) in stroke patients. Methods Consecutive stroke patients with spastic MG and matched healthy controls were recruited. Intra- and interobserver reliability of 2D-SWE measurement were evaluated, and the correlation between corrected slack angle and modified Ashworth scale (MAS) score was examined. The corrected slack angle before and after botulinum toxin A (BoNT-A) injection was compared and its diagnostic performance in classifying the severity of spasticity were assessed with receiver operating characteristic (ROC) curve analysis. Results The intra- (0.791 95% CI 0.432–0.932) and interobserver (0.751 95% CI 0.382–0.916) reliability of slack angle acquired with 2D-SWE were good. Significant correlation was found between corrected slack angle and MAS score (R = − 0.849, p < 0.001). The corrected slack angle increased after BoNT-A injection. The cutoff value of MAS ≥ 3 had the highest sensitivity (100%) and specificity (93.33%). The positive predictive value (PPV) for classification of MAS ≥ 1+ and the negative predictive value (NPV) for classification of MAS ≥ 3 were greater than 90%. Conclusion 2D-SWE was a reliable method to quantitate the post-stroke spasticity. The corrected slack angle had advantage in classifying the severity of spasticity, especially in early identification of mild spasticity and confirmation of severe spasticity. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-00995-8.
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Affiliation(s)
- Junyan Cao
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Yang Xiao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen, 518055, China
| | - Weihong Qiu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Yanling Zhang
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Jie Ren
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Rongqin Zheng
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen, 518055, China
| | - Zhaocong Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China.
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Kositsky A, Saxby DJ, Lesch KJ, Barrett RS, Kröger H, Lahtinen O, Diamond LE, Korhonen RK, Stenroth L. In vivo assessment of the passive stretching response of the bi-compartmental human semitendinosus muscle using shear wave elastography. J Appl Physiol (1985) 2021; 132:438-447. [PMID: 34941438 PMCID: PMC8799393 DOI: 10.1152/japplphysiol.00473.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The semitendinosus muscle contains distinct proximal and distal compartments arranged anatomically in-series but separated by a tendinous inscription, with each compartment innervated by separate nerve branches. Although extensively investigated in other mammals, compartment-specific mechanical properties within the human semitendinosus have scarcely been assessed in vivo. Experimental data obtained during muscle-tendon unit stretching (e.g., slack angle) can also be used to validate and/or improve musculoskeletal model estimates of semitendinosus muscle force. The purpose of this study was to investigate the passive stretching response of proximal and distal humans semitendinosus compartments to distal joint extension. Using two-dimensional shear wave elastography, we bilaterally obtained shear moduli of both semitendinosus compartments from 14 prone-positioned individuals at ten knee flexion angles (from 90° to 0° [full extension] at 10° intervals). Passive muscle mechanical characteristics (slack angle, slack shear modulus, and the slope of the increase in shear modulus) were determined for each semitendinosus compartment by fitting a piecewise exponential model to the shear modulus-joint angle curves. We found no differences between compartments or legs for slack angle, slack shear modulus, or the slope of the increase in shear modulus. We also found the experimentally determined slack angle occurred at ~15-80° higher knee flexion angles compared to estimates from two commonly used musculoskeletal models, depending on participant and model used. Overall, these findings demonstrate that passive shear modulus-joint angle curves do not differ between proximal and distal human semitendinosus compartments, and provide experimental data to improve semitendinosus force estimates derived from musculoskeletal models.
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Affiliation(s)
- Adam Kositsky
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Kim J Lesch
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Rod S Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Heikki Kröger
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
| | - Olli Lahtinen
- Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, Unit of Radiology, University of Eastern Finland, Kuopio, Finland
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Romano A, Staber D, Grimm A, Kronlage C, Marquetand J. Limitations of Muscle Ultrasound Shear Wave Elastography for Clinical Routine-Positioning and Muscle Selection. SENSORS 2021; 21:s21248490. [PMID: 34960581 PMCID: PMC8706081 DOI: 10.3390/s21248490] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022]
Abstract
Shear wave elastography (SWE) is a clinical ultrasound imaging modality that enables non-invasive estimation of tissue elasticity. However, various methodological factors—such as vendor-specific implementations of SWE, mechanical anisotropy of tissue, varying anatomical position of muscle and changes in elasticity due to passive muscle stretch—can confound muscle SWE measurements and increase their variability. A measurement protocol with a low variability of reference measurements in healthy subjects is desirable to facilitate diagnostic conclusions on an individual-patient level. Here, we present data from 52 healthy volunteers in the areas of: (1) Characterizing different limb and truncal muscles in terms of inter-subject variability of SWE measurements. Superficial muscles with little pennation, such as biceps brachii, exhibit the lowest variability whereas paravertebral muscles show the highest. (2) Comparing two protocols with different limb positioning in a trade-off between examination convenience and SWE measurement variability. Repositioning to achieve low passive extension of each muscle results in the lowest SWE variability. (3) Providing SWE shear wave velocity (SWV) reference values for a specific ultrasound machine/transducer setup (Canon Aplio i800, 18 MHz probe) for a number of muscles and two positioning protocols. We argue that methodological issues limit the current clinical applicability of muscle SWE.
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Affiliation(s)
- Alyssa Romano
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany; (A.R.); (D.S.); (A.G.); (C.K.)
| | - Deborah Staber
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany; (A.R.); (D.S.); (A.G.); (C.K.)
| | - Alexander Grimm
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany; (A.R.); (D.S.); (A.G.); (C.K.)
| | - Cornelius Kronlage
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany; (A.R.); (D.S.); (A.G.); (C.K.)
| | - Justus Marquetand
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany; (A.R.); (D.S.); (A.G.); (C.K.)
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany
- MEG-Center, University of Tübingen, 72074 Tübingen, Germany
- Correspondence: ; Tel.: +49-7071-298-0442
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30
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Yamazaki K, Inoue K, Miyamoto N. Passive and active muscle elasticity of medial gastrocnemius is related to performance in sprinters. Eur J Appl Physiol 2021; 122:447-457. [PMID: 34797438 DOI: 10.1007/s00421-021-04848-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Limited information is available on the association between muscle material properties and sprint performance. We aimed to identify whether and how the elasticity of passive and active muscle of the medial gastrocnemius (MG) is related to sprint performance. METHODS MG shear wave speed was measured under passive and active (20%, 50%, 80% of maximal voluntary contraction [MVC]) conditions, with ultrasound shear wave elastography, in 18 male sprinters. Passive and active ankle joint stiffness was assessed by applying a short-range fast stretch during 0%, 20%, 50%, and 80% MVC of plantar flexion. Additionally, rate of torque development (RTD) during explosive plantar flexion was measured. RESULTS Passive and active MG shear wave speed was negatively correlated with 100-m race time. Passive MG shear wave speed was positively correlated with RTD, and RTD was negatively correlated with 100-m race time. MG shear wave speed at 50% and 80% MVC showed a positive correlation with ankle joint stiffness at the corresponding contraction level, and ankle joint stiffness at 50% and 80% MVC showed negative correlations with 100-m race time. These correlations were significant even after controlling for MVC torque. CONCLUSION Our findings indicate that passive and active muscle elasticity of plantar flexor is important to achieve superior sprint performance. Specifically, high elasticity of passive MG could be related to superior sprint performance through high explosive torque production. In contrast, high elasticity of active MG at moderate-to-high intensity is likely related to high sprint performance through high ankle joint stiffness.
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Affiliation(s)
- Kazuhiko Yamazaki
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Kakeru Inoue
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Naokazu Miyamoto
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.
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Xiao Y, Wang C, Pan M, Chen Z, Ma T, Zhou Y, Liu X. Ultrasonic characterization of localized passive elastic properties of human pennate muscle with a single-probe setup. ULTRASONICS 2021; 116:106512. [PMID: 34274743 DOI: 10.1016/j.ultras.2021.106512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/09/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Quantitative evaluation of passive elastic properties of an individual skeletal muscle in vivo is among the major challenges of biomechanics, and its clinical application is severely limited. By combining shear-wave elastography (SWE) and B-mode imaging techniques, this study develops a novel non-invasive method to measure the local elastic modulus-fascicle strain curve of human pennation muscle during passive stretching using a single probe. Physiologically meaningful parameters are estimated and compared in subjects with different ages or pathological conditions. The in vivo experimental group comprised 12 healthy subjects (four children, four adults, and four seniors) and eight patients (four suffering from pseudohypertrophy, four from atrophy). Their gastrocnemius muscles were passively stretched using an ankle joint motion instrument. Local elastic moduli of the muscle were measured using SWE imaging frames and a built-in 'F-ROI' tool. The corresponding fascicle strains were simultaneously obtained using B-mode imaging frames and a gradient Radon transform. Three parameters (η, μ, G0) were estimated from a normalized elastic modulus-strain curve using the Gauss-Newton method. The measured elastic modulus-strain curves all agreed with models of the estimated parameters (0.910 < R2 < 0.999) and presented different patterns among normal and diseased subjects. η values were lower for pseudohypertrophies (1.93 ± 0.12), but higher for atrophies (63.40 ± 98.89), compared with normal ones (6.02 ± 2.53). In addition, μ values were higher for pseudohypertrophies (22.65 ± 16.40), but lower for atrophies (0.28 ± 0.41), compared with normal ones (1.07 ± 1.22). The proposed method may provide novel insight into the biomechanics of pennate muscle and has the potential to serve for clinical musculoskeletal medical diagnosis, as the single-probe scanning setup is broadly accepted.
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Affiliation(s)
- Yang Xiao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Congzhi Wang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Min Pan
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034, China
| | - Zengtong Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518055, China; Marshall Laboratory of Biomedical Engineering, China
| | - Teng Ma
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518055, China; Marshall Laboratory of Biomedical Engineering, China
| | - Xiao Liu
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034, China
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Yin L, Du L, Li Y, Xiao Y, Zhang S, Ma H, He W. Quantitative Evaluation of Gastrocnemius Medialis Stiffness During Passive Stretching Using Shear Wave Elastography in Patients with Parkinson's Disease: A Prospective Preliminary Study. Korean J Radiol 2021; 22:1841-1849. [PMID: 34431245 PMCID: PMC8546131 DOI: 10.3348/kjr.2020.1338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 01/11/2023] Open
Abstract
Objective To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of −29.13° ± 3.79° and −25.65° ± 3.39°, respectively, vs. −21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = −0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.
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Affiliation(s)
- Lu Yin
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lijuan Du
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanzi Li
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yang Xiao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Shiquan Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Huizi Ma
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Gachon B, Fritel X, Pierre F, Nordez A. Transperineal ultrasound shear-wave elastography is a reliable tool for assessment of the elastic properties of the levator ani muscle in women. Sci Rep 2021; 11:15532. [PMID: 34330975 PMCID: PMC8324884 DOI: 10.1038/s41598-021-95012-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/20/2021] [Indexed: 01/25/2023] Open
Abstract
Our main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties. Secondary objective was to compare reproducibility when considering the mean of three consecutives measurements versus one. In this prospective study involving non-pregnant nulliparous women, two visits were planned, with a measurement of the shear modulus (SM) on the right LAM at rest, during Valsalva maneuver and maximal contraction. Assessments were done with a transperineal approach, using an AIXPLORER device with a linear SL 18–5 (5-18 MHz) probe. For each condition, 3 consecutive measures were performed at each visit. The mean of the three measures, then the first one, were considered for the reproducibility by calculating intraclass correlation coefficient (ICC), and coefficient of variation (CV). Twenty women were included. Reproducibility was excellent when considering the mean of the 3 measures at rest (ICC = 0.90; CV = 15.7%) and Valsalva maneuver (ICC = 0.94; CV = 10.6%), or the first of the three measures at rest (ICC = 0.87; CV = 18.6%) and Valsalva maneuver (ICC = 0.84; CV = 19.9%). Reproducibility was fair for measurement during contraction. Transperineal ultrasound SWE is a reliable tool to investigate LAM elastic properties at rest and during Valsalva maneuver.
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Affiliation(s)
- Bertrand Gachon
- Department of Obstetrics and Gynecology, Poitiers University Hospital, 2, rue de la Miletrie, 86000, Poitiers, France. .,Université de Nantes, Mouvement - Interactions - Performance, MIP, EA4334, 44000, Nantes, France. .,INSERM CIC 1402, Poitiers University, Poitiers University Hospital, Poitiers, France.
| | - Xavier Fritel
- Department of Obstetrics and Gynecology, Poitiers University Hospital, 2, rue de la Miletrie, 86000, Poitiers, France.,INSERM CIC 1402, Poitiers University, Poitiers University Hospital, Poitiers, France
| | - Fabrice Pierre
- Department of Obstetrics and Gynecology, Poitiers University Hospital, 2, rue de la Miletrie, 86000, Poitiers, France
| | - Antoine Nordez
- Université de Nantes, Mouvement - Interactions - Performance, MIP, EA4334, 44000, Nantes, France.,Institut Universitaire de France (IUF), Paris, France
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Muscle elasticity in patients with neonatal brachial plexus palsy using shear-wave ultrasound elastography. Preliminary results. J Pediatr Orthop B 2021; 30:385-392. [PMID: 34031322 DOI: 10.1097/bpb.0000000000000781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ultrasound shear wave elastography (SWE) is a noninvasive, reliable and reproducible method, used for the qualitative and quantitative evaluation of tissues. The aim of this study was to compare muscle elasticity between the healthy and the involved sides in children with neonatal brachial plexus palsy (NBPP) using the elastography tool and to assess whether the difference was correlated with the Mallet grading system. We repeatedly measured the shear modulus coefficient of several muscles around the shoulder in stretched or passively relaxed positions on 14 patients. We evaluated the abductor muscles (supraspinatus and deltoid), the infraspinatus, the pectoralis major and the latissimus dorsi. We found a mean shear modulus significantly higher in most studied muscles in the pathologic side (P < 0.001), especially in the stretched position (P < 0.001). Moreover, the shear modulus increases with the degradation of the Mallet score for the abduction and external rotation tasks. SWE seems to be a reliable and reproducible tool to assess muscle elasticity in NBPP.
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Mechanical properties of ankle joint and gastrocnemius muscle in spastic children with unilateral cerebral palsy measured with shear wave elastography. J Biomech 2021; 124:110502. [PMID: 34126561 DOI: 10.1016/j.jbiomech.2021.110502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 11/22/2022]
Abstract
The aim of this study was to describe passive mechanical and morphological properties of the ankle joint and gastrocnemius medialis (GM) muscle in paretic and contralateral legs in highly functional children with unilateral cerebral palsy (UCP) using shear wave elastography (SWE). SWE measurements on the GM muscle were performed in both paretic and contralateral legs during passive ankle dorsiflexion using a dynamometer in 11 children (mean age: 10 years 6 months) with UCP. Torque-angle and shear modulus-angle relationships were fitted using an exponential model to determine passive ankle joint and GM muscle stiffness respectively. Based on shear-modulus-angle relationship, slack angle and shear modulus of GM muscle were compared between legs. GM and Achilles tendon length were determined at rest using ultrasonography. No significant difference was found between legs for passive ankle joint (p = 0.26; 11.2%; 95 %CI: 31.9, -9.4) and GM muscle passive stiffness (p = 0.62; -4.4%; 95 %CI: 14.7, -23.4). GM shear modulus at a common angle was significantly higher on the paretic leg (p = 0.02; +56.5%; 95 %CI: 100.5, 12.6). GM slack angle on the paretic leg was significantly shifted to a more plantarflexed position (p = 0.04; +25.5%; 95 %CI: 49.7, 1.3) and this was associated with a non-significant lower muscle length compared to the contralateral leg (p = 0.05; -4.5%; 95 %CI: -0.4, -8.7). Increased passive tension on the paretic leg when compared to the contralateral one may be explained in large part by muscle shortening. The role of altered mechanical properties remains unknown.
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Pepper TM, Brismée JM, Sizer PS, Kapila J, Seeber GH, Huggins CA, Hooper TL. The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial. Int J Sports Phys Ther 2021; 16:651-661. [PMID: 34123517 PMCID: PMC8169023 DOI: 10.26603/001c.23606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 10/10/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Iliotibial Band Syndrome (ITBS) is a common clinical condition likely caused by abnormal compressive forces to the iliotibial band (ITB). Stretching interventions are common in ITBS treatment and may predominantly affect tensor fascia latae (TFL). Another ITBS treatment is foam rolling, which may more directly affect the ITB. Shear wave ultrasound elastography (SWUE) measures real-time soft tissue stiffness, allowing tissue changes to be measured and compared. PURPOSE To examine effects of foam rolling and iliotibial complex stretching on ITB stiffness at 0˚ and 10˚ of hip adduction and hip adduction passive range of motion (PROM). STUDY DESIGN Randomized controlled trial. METHODS Data from 11 males (age = 30.5 ± 9.0 years, Body Mass Index (BMI) = 27.8 ± 4.0) and 19 females (age = 23.5 ± 4.9, BMI = 23.2 ± 2.1) were analyzed for this study. Subjects were randomly assigned to one of three groups: control, stretching, and foam rolling. Shear wave ultrasound elastography measurements included ITB Young's modulus at the mid-thigh, the distal femur and the TFL muscle belly. ITB-to-femur depth was measured at mid-thigh level. Hip adduction PROM was measured from digital images taken during the movement. RESULTS No significant interactions or main effects were found for group or time differences in ITB Young's modulus at the three measured locations. The ITB stiffness at the mid-thigh and distal femur increased with 10° adduction, but TFL stiffness did not increase. A main effect for adduction PROM was observed, where PROM increased 0.8˚ post-treatment (p = 0.02). CONCLUSION A single episode of stretching and foam rolling does not affect short-term ITB stiffness. The lack of ITB stiffness changes may be from an inadequate intervention stimulus or indicate that the interventions have no impact on ITB stiffness. LEVELS OF EVIDENCE 1b.
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Affiliation(s)
- Talin M Pepper
- Texas Tech University Health Sciences Center, Lubbock, TX
| | | | | | | | - Gesine H Seeber
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX; University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany; Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christopher A Huggins
- Texas Tech University Health Sciences Center, Lubbock, TX; Lubbock Christian University, Lubbock, TX
| | - Troy L Hooper
- Texas Tech University Health Sciences Center, Lubbock, TX
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Okino K, Aoki M, Yamane M, Kohmura C. Effect of prolonged sitting immobility on shear wave velocity of the lower leg muscles in healthy adults: A proof-of-concept study. PLoS One 2021; 16:e0251532. [PMID: 33970970 PMCID: PMC8109794 DOI: 10.1371/journal.pone.0251532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/27/2021] [Indexed: 01/22/2023] Open
Abstract
Objective The purpose of this study is to investigate the physical changes of the lower leg muscles in the compartment by observing the changes in the shear wave velocity of the gastrocnemius, soleus and tibialis anterior muscles with time in the sitting position for 2 hours and after elevation of the lower leg. Materials and methods The subjects were 24 healthy adult males (average age 26.6 years). Shear wave velocity was measured by Aplio 500 in immobilized leg immediately after the start of sitting, 60 minutes and 120 minutes after the start of sitting. After 120 minutes the subjects raised the lower leg for 3 minutes, then measured again. Results In the lateral and medial gastrocnemius, there was a significant increase in the velocity at 60 (1.58 ± 0.06, 1.70 ± 0.09 m/s) and 120 minutes (1.70 ± 0.10, 1.83 ± 0.11 m/s) after the start of the test (1.52 ± 0.06, 1.66 ± 0.10 m/s), respectively (p<0.01). In the soleus and the tibialis anterior, there was a significant increase in the velocity at 120 minutes (1.89 ± 0.17, 2.30 ± 0.24 m/s) compared to after the start (1.60 ± 0.15, 2.15 ± 0.26 m/s), respectively (p<0.01). In all muscles, there was a significant decrease in the velocity after the raising compared to that of 120 minutes (p<0.01). Conclusions It has been reported that the change of shear wave velocity with time is proportional to the intramuscular pressure in the leg compartment, and it is assumed that the increase of shear wave velocity in the 2-hour seated leg is due to fluid retention in extra-cellular space of the compartment.
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Affiliation(s)
- Kumiko Okino
- Department of Clinical Laboratory Medicine, School of Medical Technology, Health Sciences University of Hokkaido, Kita-ku, Sapporo, Japan
| | - Mitsuhiro Aoki
- Department of Physical Therapy, Graduate School of Rehabilitation Science, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari-gun, Japan
- * E-mail:
| | - Masahiro Yamane
- Department of Physical Therapy, Health Science University Hospital, Kita-ku, Sapporo, Japan
| | - Chikashi Kohmura
- Department of Clinical Laboratory Medicine, School of Medical Technology, Health Sciences University of Hokkaido, Kita-ku, Sapporo, Japan
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Iida N, Taniguchi K, Watanabe K, Miyamoto H, Taniguchi T, Teramoto A, Katayose M. Effective stretching positions for the posterior shoulder capsule as determined by shear wave elastography. J Shoulder Elbow Surg 2021; 30:1186-1195. [PMID: 32919046 DOI: 10.1016/j.jse.2020.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Stretching is often used to prevent and treat posterior shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the posterior shoulder capsule by evaluating the elastic characteristics of posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). METHODS We evaluated 9 fresh-frozen shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All posterior shoulder tissues were preserved intact. Shear moduli of the middle and inferior posterior shoulder capsules and the posterior shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; -30°, 0°, 30°, 60°, respectively). A 4-Nm torque for shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P < .05). In addition, we compared the shear modulus in 2 positions (ie, resting and each stretching) among tissues (ie, capsules and muscles) with repeated measures using 2-way analysis of variance (P < .05). RESULTS Shear modulus values for the middle posterior capsules in "internal rotation at 30° in scapular plane elevation" (28.7 ± 14.3 kPa, P = .01) and in "horizontal adduction at 60° of elevation" (31.1 ± 13.1 kPa, P < .001) were significantly higher than that of the resting position (11.0 ± 7.3 kPa). The shear modulus value for the inferior posterior capsule in "internal rotation at 30° of flexion" was significantly higher than that of the resting position (39.0 ± 17.3 vs. 15.4 ± 13.9 kPa, respectively; P = .004). Additionally, the shear modulus values for the posterior capsules in "internal rotation at 30° in scapular plane elevation and flexion" were significantly higher than that of the posterior shoulder muscles. CONCLUSION Effective middle posterior shoulder capsule stretching positions were shoulder "internal rotation at 30° of scapular plane elevation" and "horizontal adduction at 60° of elevation." Shoulder "internal rotation at 30° of flexion" was the most effective position for the inferior posterior shoulder capsule. Stretching in these positions could relieve posterior shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the shoulder.
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Affiliation(s)
- Naoya Iida
- Department of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan; Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Kota Watanabe
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan; Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroki Miyamoto
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Tatsuya Taniguchi
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Bravo-Sánchez A, Abián P, Sánchez-Infante J, Jimenez F, Abián-Vicén J. Influence of Bias in the Assessment of Patellar Tendon Stiffness: A Systematic Review and Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1151-1162. [PMID: 33589353 DOI: 10.1016/j.ultrasmedbio.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The aim of the present study was to provide a systematic review and meta-analysis of the main biases in practical applications of the different types of elastography in assessment of the stiffness of healthy patellar tendons. A literature search on four databases (Scopus, Web of Science, Pubmed and SportDiscus) was conducted on March 25, 2020. After analysis of 1,052 resultant articles, studies were included if they met two inclusion criteria: (1) studies were observational or randomized controlled trials; (2) studies included outcomes of patellar tendon stiffness. Twenty-one studies met the inclusion criteria and were included in this meta-analysis. Four meta-analyses were performed with respect to assessment procedure and participant characteristics. This meta-analysis found a low effect of examined portion of patellar tendon (standardized mean difference [SMD] = 0.27, 95% confidence interval [CI]: 0.01-0.54, n = 379, Z = 2.01, p = 0.04) and a high effect of knee flexion angle during assessment (SMD = -2.12; 95% CI: -2.67 to -1.58, n = 97, Z = 7.68, p < 0.01) in stiffness outcomes. The risk of bias was generally low, but the heterogenicity of the results downgraded the level of evidence. There is evidence in the elastography assessment of patellar tendon suggesting that the knee position and patellar tendon portion evaluated influence stiffness outcomes for patellar tendon in healthy volunteers.
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Affiliation(s)
- Alfredo Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Pablo Abián
- Faculty of Humanities and Social Sciences, Comillas Pontifical University, Madrid, Spain
| | - Jorge Sánchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Fernando Jimenez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain.
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Kobayashi K, Umehara J, Nakao S, Ichihashi N. Effective stretching position of the coracobrachialis muscle. J Biomech 2021; 120:110390. [PMID: 33794413 DOI: 10.1016/j.jbiomech.2021.110390] [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: 12/02/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
An increase in the stiffness of the coracobrachialis muscle can restrain proper movement of the glenohumeral joint and scapula during arm elevation. Therefore, muscle stiffness should be reduced through stretching. The aim of this study was to determine the effective stretching position of the coracobrachialis muscle using ultrasound shear wave elastography imaging to evaluate the stiffness of individual muscles. Eighteen healthy young men participated in this study. The shear modulus of the coracobrachialis muscle was measured at the following eight shoulder positions: i) 20° abduction (Rest), ii) maximal external rotation at 90° abduction (ER2), iii) maximal internal rotation at 90° abduction (IR2), iv) maximal flexion (Flex), v) maximal extension (Ext), vi) maximal horizontal abduction at 90° abduction (Hab), vii) maximal horizontal abduction and maximal external rotation at 90° abduction (HabER), and viii) maximal horizontal abduction and maximal internal rotation at 90° abduction (HabIR). The shear modulus in each position was compared with that of Rest using the Wilcoxon signed-rank test, and a multiple comparison test was performed among the positions that exhibited significant difference. The shear modulus of all stretching positions was significantly higher than that of Rest, except for Flex. Moreover, the shear moduli of IR2, Ext, Hab, HabER, and HabIR were significantly higher than that of ER2. The shear modulus of Ext was significantly higher than that of HabIR. The coracobrachialis muscle could be stretched effectively at IR2, Ext, Hab, HabER, and HabIR. Among these positions, Ext, Hab, and HabER are recommended for clinical settings.
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Affiliation(s)
- Kotono Kobayashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Jun Umehara
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, Suita, Japan; Research Fellow of Japan Society for the Promotion of Science, Chiyoda-ku, Japan
| | - Sayaka Nakao
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Shear Wave Velocity Estimation Using the Real-Time Curve Tracing Method in Ultrasound Elastography. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The estimation of shear wave velocity is very important in ultrasonic shear wave elasticity imaging (SWEI). Since the stability and accuracy of ultrasonic testing equipment have been greatly improved, in order to further improve the accuracy of shear wave velocity estimation and increase the quality of shear wave elasticity maps, we propose a novel real-time curve tracing (RTCT) technique to accurately reconstruct the motion trace of shear wave fronts. Based on the curve fitting of each frame shear wave, the propagation velocity of two-dimensional shear waves can be estimated. In this paper, shear wave velocity estimation and shear wave image reconstruction are implemented for homogeneous regions and stiff spherical inclusion regions with different elasticity, respectively. The experimental result shows that the proposed shear wave velocity estimation method based on the real-time curve tracing method has advantages in accuracy and anti-noise performance. Moreover, by eliminating artifacts of shear wave videos, the velocity map acquired can restore the shape of inclusions better. The real-time curve tracing method can provide a new idea for the estimation of shear wave velocity and elastic parameters.
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Kodesho T, Taniguchi K, Kato T, Katayose M. Intramuscular differences in shear modulus of the rectus femoris muscle during passive knee flexion. Eur J Appl Physiol 2021; 121:1441-1449. [PMID: 33620546 DOI: 10.1007/s00421-021-04644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 02/14/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to determine (1) intramuscular regional differences in the changes in the shear modulus of the rectus femoris (RF) muscle during passive knee flexion and (2) the relationship between shear modulus and passive knee extension torque. METHOD The shear modulus maps as an index of muscle stiffness and the passive torque were obtained at seven regions during passive knee flexion at 2°/s within a knee joint range of motion of 0°-130° in 16 healthy males. RESULTS The shear modulus of RF increased with the knee angle of flexion. The shear modulus of each longitudinal region was greater in the order of proximal, central, and distal region (p < 0.05). The relationship between the shear modulus and passive torque was highly fitted for all 16 subjects (p < 0.05). The mean coefficient of determination (R2) at second-order polynomial model per subject was 0.96 (± 0.03; range 0.61-0.99), and whole group was 0.58 (± 0.03; range 0.54-0.64) in all regions. CONCLUSIONS The passive stiffness of RF was higher in the proximal region than in the other regions during passive knee flexion. Furthermore, the shear modulus-passive torque was related regardless of the measurement region within a muscle, and the results suggest that the passive knee extension torque reflects passive muscle stiffness of the RF.
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Affiliation(s)
- Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo City, Japan.
| | - Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo City, Japan
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Kodesho T, Taniguchi K, Kato T, Mizoguchi S, Yamakoshi Y, Watanabe K, Fujimiya M, Katayose M. Relationship between shear elastic modulus and passive force of the human rectus femoris at multiple sites: a Thiel soft-embalmed cadaver study. J Med Ultrason (2001) 2021; 48:115-121. [PMID: 33576917 DOI: 10.1007/s10396-020-01076-w] [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: 07/19/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Estimation of muscle passive force from elasticity using shear wave elastography (SWE) has been reported. However, the relationship between the elasticity and passive force of human muscles has not been elucidated. This study investigated the elastic modulus-passive force relationship in human skeletal muscles at multiple sites. METHODS Four rectus femoris (RF) muscles were dissected from a human Thiel-embalmed cadaver. Calibration weights (0-600 g in 60-g increments) were applied to the distal tendon via a pulley system, and the shear elastic modulus as an index of elasticity was measured using SWE. The shear elastic modulus of the RF was measured at the proximal, central, and distal portions. RESULTS The results demonstrated that the relationships between the elasticity in the longitudinal direction of the muscle and the passive force were nearly linear for all tested sites, with coefficients of determination ranging from 0.813 to 0.993. CONCLUSION Shear wave elastography may be used as an indirect method to measure the changing passive force at any site within human muscles.
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Affiliation(s)
- Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan.
| | - Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shougo Mizoguchi
- Second Division of Anatomy, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | | | - Kota Watanabe
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan
| | - Mineko Fujimiya
- Second Division of Anatomy, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan
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Ultrasound shearwave elastography to characterize muscles of healthy and cerebral palsy children. Sci Rep 2021; 11:3577. [PMID: 33574381 PMCID: PMC7878773 DOI: 10.1038/s41598-021-82005-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/07/2021] [Indexed: 11/09/2022] Open
Abstract
Shear wave elastography (SWE) is an ultrasound technique to obtain soft tissue mechanical properties. The aim of this study was to establish the reliability of SWE in young children, define reference data on healthy ones and compare the shear modulus of healthy and spastic muscles from cerebral palsy (CP). The reproducibility is evaluated: at rest, on 7 children without any musculoskeletal pathology by 3 different operators, on 2 muscles: biceps brachii long head and medial gastrocnemius. The comparison study was made, on the same 2 muscles, at rest and under passive stretching, with a control group (29 healthy children), a spastic group (spastic muscles of 16 children from CP) and a non-spastic group (non-spastic muscles of 14 children from CP). The intra-operator reliability and inter-operator reliability, in terms of standard deviation, were 0.6 kPa (11.2% coefficient of variation (CV)) and 0.8 kPa (14.9% CV) for the biceps, respectively, and 0.4 kPa (11.5% CV) and 0.5 kPa (13.8% CV) for the gastrocnemius. At rest, no significant difference was found. Under passive stretching, the non-spastic CP biceps were significantly stiffer than the control ones (p = 0.033). Spastic gastrocnemius had a higher shear modulus than in the control muscles (p = 0.0003) or the non-spastic CP muscles (p = 0.017). CP stretched medial gastrocnemius presented an abnormally high shear moduli for 50% of patients.
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Asayama A, Tateuchi H, Ota M, Motomura Y, Yanase K, Komamura T, Ichihashi N. Differences in shear elastic modulus of the latissimus dorsi muscle during stretching among varied trunk positions. J Biomech 2021; 118:110324. [PMID: 33618168 DOI: 10.1016/j.jbiomech.2021.110324] [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: 06/16/2020] [Revised: 11/25/2020] [Accepted: 01/31/2021] [Indexed: 11/29/2022]
Abstract
The latissimus dorsi (LD) can be divided into the upper, middle, and lower parts, but the effective stretching positions for each part are unknown. In this study, we aimed to investigate effective trunk positions for stretching of the LD. A total of 14 healthy males participated in this study. The following seven trunk positions were chosen as the LD stretching positions; upright of the trunk (Baseline), flexion of the trunk (Flex), contralateral bending of the trunk (LB), contralateral rotation of the trunk (Rot), flexion and contralateral bending of the trunk (Flex + LB), flexion and contralateral rotation of the trunk (Flex + Rot), and contralateral bending and contralateral rotation of the trunk (LB + Rot). Maximal elevation of the upper limb was passively added to all positions. The shear elastic modulus, used as the index of muscle elongation, was measured at the four parts (upper, middle, lower, distal parts) of the LD. The shear elastic moduli showed obviously high values in Rot and LB + Rot at the upper, middle, and distal parts, and also in LB, Rot, and LB + Rot at the lower part. These findings suggest that contralateral trunk rotation, or a combination of contralateral trunk bending and rotation are effective trunk positions for stretching all parts of the LD. Contralateral trunk bending was also effective for stretching the lower part of the LD.
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Affiliation(s)
- Akihiro Asayama
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan.
| | - Hiroshige Tateuchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Megumi Ota
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Yoshiki Motomura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Ko Yanase
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | | | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
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The function of the popliteus muscle: An in vivo ultrasound shear wave elastography study. Hum Mov Sci 2021; 76:102751. [PMID: 33486378 DOI: 10.1016/j.humov.2020.102751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/28/2020] [Accepted: 12/23/2020] [Indexed: 11/23/2022]
Abstract
The function of the popliteus muscle [PM] is crucial to knee function. However, it remained unclear in vivo. Thus, this study aimed to explore the PM function in the non-weight-bearing and the weight-bearing conditions in vivo. Fourteen healthy subjects participated in this study. The muscle stiffness of the PM was measured using shear wave elastography as an index of muscle force. Muscle stiffness was measured at 30° knee flexion as a reference value. Muscle stiffness was also measured at passive 0°knee flexion and passive 20° external rotation and internal rotation at 30° knee flexion, and during isometric knee extension, flexion, external rotation, and internal rotation at 30° knee flexion. Moreover, muscle stiffness was measured during one-leg standing at 0° and 30° of knee flexion. Muscle stiffness was significantly greater at passive 0° knee flexion and 20° external rotation and during isometric knee flexion and internal rotation than the reference value. Two-way analysis of variance revealed significant main effects of weight bearing and knee angle: Muscle stiffness increased with weight bearing and knee extension. Moreover, muscle stiffness was significantly lower at 30° than at 0° knee flexion during one-leg standing. The PM function is knee flexion and internal rotation, and the PM force increases with weight bearing and decreases with knee flexion during one-leg standing.
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Xiao Y, Wang C, Sun Y, Zhang X, Cui L, Yu J, Zheng H. Quantitative Estimation of Passive Elastic Properties of Individual Skeletal Muscle in Vivo Using Normalized Elastic Modulus-Length Curve. IEEE Trans Biomed Eng 2020; 67:3371-3379. [DOI: 10.1109/tbme.2020.2985724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kato T, Taniguchi K, Kikukawa D, Kodesho T, Katayose M. Effect of hip flexion angle on stiffness of the adductor longus muscle during isometric hip flexion. J Electromyogr Kinesiol 2020; 56:102493. [PMID: 33227524 DOI: 10.1016/j.jelekin.2020.102493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 11/19/2022] Open
Abstract
This study examined the effect of hip flexion angle on the stiffness of the adductor longus (AL) muscle during isometric hip flexion. Seventeen men were recruited. Ten participants performed submaximal voluntary contraction at 0%, 25%, 50%, and 75% of maximal voluntary contraction (MVC) during isometric hip flexion after performing MVC at 0°, 40°, and 80° of hip flexion. Seven participants performed submaximal voluntary tasks during isometric hip extension in addition to hip flexion task. The shear modulus of the AL muscle was used as the index of muscle stiffness, and was measured using ultrasound shear-wave elastography during the tasks at each contraction intensity for each hip flexion angle. During hip flexion, the shear modulus of the AL muscle was higher at 0° than at 40° and 80° of hip flexion at each contraction intensity (p < 0.016). Conversely, a significant effect was not found among hip flexion angle during hip extension at 75% of MVC (p = 0.867). These results suggest that mechanical stress of the AL muscle may be higher at 0° of hip flexion during isometric hip flexion.
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Affiliation(s)
- Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Japan; Research Fellow of Japan Society for the Promotion of Science, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Japan.
| | - Daisuke Kikukawa
- Department of Rehabilitation, Yokohama Sports Medical Center, Japan; Graduate School of Nursing and Rehabilitation Sciences, Showa University, Japan
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Japan
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Lindemann I, Coombes BK, Tucker K, Hug F, Dick TJ. Age-related differences in gastrocnemii muscles and Achilles tendon mechanical properties in vivo. J Biomech 2020; 112:110067. [DOI: 10.1016/j.jbiomech.2020.110067] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/30/2020] [Accepted: 09/23/2020] [Indexed: 01/30/2023]
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Chang TT, Feng YN, Zhu Y, Liu CL, Wang XQ, Zhang ZJ. Objective Assessment of Regional Stiffness in Achilles Tendon in Different Ankle Joint Positions Using the MyotonPRO. Med Sci Monit 2020; 26:e926407. [PMID: 33071278 PMCID: PMC7583434 DOI: 10.12659/msm.926407] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Achilles tendinopathy commonly occurs in specific regions of the tendon, and Achilles tendon stiffness can be related to local pathological changes in the tendon. The MyotonPRO is a new handheld device that conveniently assesses stiffness of muscles and tendons. This study aimed to 1) evaluate the intra- and inter-rater reliability of stiffness measurements of the Achilles tendon at different ankle positions, 2) investigate the modulation of stiffness at different ankle joint angles, and 3) examine the differences between 2 regions of Achilles tendon stiffness. MATERIAL AND METHODS Thirty healthy young adults (15 men and 15 women) participated in this study. The regional Achilles tendon stiffness at 0 cm (AT-0) and 6 cm (AT-6) above the tendon insertion were evaluated by the MyotonPRO in the neutral position and 10° dorsiflexion of the ankle joint. Measurements of stiffness were taken by 2 raters on the first day and 5 days later. The stiffness data were compared by repeated measures analysis of variance (ANOVA). RESULTS The intra- and inter-rater reliability of stiffness measurements at AT-0 and AT-6 for each ankle position were good (all intraclass correlation coefficients >0.84). A significant modulation of Achilles tendon stiffness was obtained at different ankle joint angles (P<0.05). Stiffness at AT-0 was higher than at AT-6 (P<0.05) in both positions. CONCLUSIONS These results suggest the MyotonPRO reliably assessed Achilles tendon stiffness and monitors its modulation, and tendon stiffness increased with ankle dorsiflexion. Stiffness was also nonuniform along the length of the tendon.
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Affiliation(s)
- Tian-Tian Chang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Ya-Nan Feng
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, Henan, China (mainland)
| | - Yi Zhu
- Department of Musculoskeletal Pain Rehabilitation, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Chun-Long Liu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China (mainland)
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Zhi-Jie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, Henan, China (mainland)
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