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Adam NC, Smith CR, Herzog W, Amis AA, Arampatzis A, Taylor WR. In Vivo Strain Patterns in the Achilles Tendon During Dynamic Activities: A Comprehensive Survey of the Literature. SPORTS MEDICINE - OPEN 2023; 9:60. [PMID: 37466866 DOI: 10.1186/s40798-023-00604-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
Achilles' tendon (AT) injuries such as ruptures and tendinopathies have experienced a dramatic rise in the mid- to older-aged population. Given that the AT plays a key role at all stages of locomotion, unsuccessful rehabilitation after injury often leads to long-term, deleterious health consequences. Understanding healthy in vivo strains as well as the complex muscle-tendon unit interactions will improve access to the underlying aetiology of injuries and how their functionality can be effectively restored post-injury. The goals of this survey of the literature with a systematic search were to provide a benchmark of healthy AT strains measured in vivo during functional activities and identify the sources of variability observed in the results. Two databases were searched, and all articles that provided measured in vivo peak strains or the change in strain with respect to time were included. In total, 107 articles that reported subjects over the age of 18 years with no prior AT injury and measured while performing functional activities such as voluntary contractions, walking, running, jumping, or jump landing were included in this review. In general, unclear anatomical definitions of the sub-tendon and aponeurosis structures have led to considerable confusion in the literature. MRI, ultrasound, and motion capture were the predominant approaches, sometimes coupled with modelling. The measured peak strains increased from 4% to over 10% from contractions, to walking, running, and jumping, in that order. Importantly, measured AT strains were heavily dependent on measurement location, measurement method, measurement protocol, individual AT geometry, and mechanical properties, as well as instantaneous kinematics and kinetics of the studied activity. Through a comprehensive review of approaches and results, this survey of the literature therefore converges to a united terminology of the structures and their common underlying characteristics and presents the state-of-knowledge on their functional strain patterns.
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Affiliation(s)
- Naomi C Adam
- Institute for Biomechanics, ETH Zürich, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland
| | - Colin R Smith
- Institute for Biomechanics, ETH Zürich, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, The University of Calgary, Calgary, Canada
| | - Andrew A Amis
- Department of Mechanical Engineering, Imperial College London, London, UK
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, and Berlin School of Movement Science, Berlin, Germany
| | - William R Taylor
- Institute for Biomechanics, ETH Zürich, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland.
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Kharazi M, Theodorakis C, Mersmann F, Arampatzis A, Bohm S. A Simplified Method for Considering Achilles Tendon Curvature in the Assessment of Tendon Elongation. SENSORS 2021; 21:s21217387. [PMID: 34770691 PMCID: PMC8588279 DOI: 10.3390/s21217387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/23/2021] [Accepted: 11/02/2021] [Indexed: 01/29/2023]
Abstract
The consideration of the Achilles tendon (AT) curvature is crucial for the precise determination of AT length and strain. We previously established an ultrasound-kinematic-based method to quantify the curvature, using a line of reflective foil skin markers covering the AT from origin to insertion. The current study aimed to simplify the method by reducing the number of markers while maintaining high accuracy. Eleven participants walked (1.4 m/s) and ran (2.5, 3.5 m/s) on a treadmill, and the AT curvature was quantified using reflective foil markers aligned with the AT between the origin on the gastrocnemius myotendinous-junction (tracked by ultrasound) and a marker on the calcaneal insertion. Foil markers were then systematically removed, and the introduced error on the assessment of AT length and strain was calculated. We found a significant main effect of marker number on the measurement error of AT length and strain (p<0.001). Using more than 30% of the full marker-set for walking and 50% for running, the R2 of the AT length error saturated, corresponding to average errors of <0.1 mm and <0.15% strain. Therefore, a substantially reduced marker-set, associated with a marginal error, can be recommended for considering the AT curvature in the determination of AT length and strain.
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Affiliation(s)
- Mohamadreza Kharazi
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (M.K.); (C.T.); (F.M.); (A.A.)
- Berlin School of Movement Science, 10115 Berlin, Germany
| | - Christos Theodorakis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (M.K.); (C.T.); (F.M.); (A.A.)
- Berlin School of Movement Science, 10115 Berlin, Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (M.K.); (C.T.); (F.M.); (A.A.)
- Berlin School of Movement Science, 10115 Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (M.K.); (C.T.); (F.M.); (A.A.)
- Berlin School of Movement Science, 10115 Berlin, Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (M.K.); (C.T.); (F.M.); (A.A.)
- Berlin School of Movement Science, 10115 Berlin, Germany
- Correspondence: ; Tel.: +49-30-2093-46010
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Krikelis G, Pain MTG, Furlong LAM. Sources of Error When Measuring Achilles Tendon Mechanics During the Stance Phase of Running. J Biomech Eng 2021; 143:094505. [PMID: 34008851 DOI: 10.1115/1.4051221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 11/08/2022]
Abstract
In recent years, the use of methods to investigate muscle-tendon unit function that combine motion capture with ultrasound (MoCapUS) has increased. Although several limitations and individual errors of these methods have been reported, the total error from all the potential sources together has not been estimated. The aim of this study was to establish the total error in the Achilles tendon (AT) measurements, specifically its length (ATL), strain (ATS), and moment arm (ATMA) acquired with MoCapUS during running. The total error from digitizing, marker movement, ultrasound calibration, and probe rotation errors caused mean ATL error of 4.2 ± 0.6 mm, mean ATMA error of 0.1 ± 0.1 mm, and could potentially alter measured ATS by a mean 2.9 ± 0.2%. Correcting both the calcaneus insertion position (CIP) and properly synchronizing ultrasound and motion capture data caused changes of up to 5.4 ± 1.7 mm in ATL and 11.6 ± 1.3 mm in ATMA. CIP correction and synchronization caused a similar amount of change in ATL, as well as ATS. However, the ATMA change was almost exclusively due to the CIP correction. Finally, if all sources of error were combined, the total ATL error could reach 13.1 mm, the total ATMA error could reach 14.4 mm, and ATS differences could reach up to ± 6.7%. The magnitude of such errors emphasizes the fact that MoCapUS-based AT measurements must be interpreted within the scope of their corresponding errors.
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Affiliation(s)
- Giorgos Krikelis
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Matthew T G Pain
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Laura-Anne M Furlong
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
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Sung HR, Oh SJ, Ryu JN, Cha YJ. Muscle activities of lower extremity and erector spinae muscles according to ankle joint position during squat exercise. J Back Musculoskelet Rehabil 2021; 34:671-676. [PMID: 33843662 DOI: 10.3233/bmr-191807] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the most effective ankle joint position for squat exercise by comparing muscle activities of lower extremity and erector spinae muscles in different ankle joint positions. METHODS Thirty-seven normal healthy adults in their 20s participated in this study. Muscle activities of dominant vastus medialis oblique, vastus lateralis, biceps femoris, and erect spinae were measured in three ankle joint positions; dorsiflexion, neutral, and plantar flexion. RESULTS Muscle activities of the vastus medialis oblique, vastus lateralis, and erector spinae muscles were statistically different in the three ankle joint positions during squat exercise (p< 0.05). Vastus medialis oblique muscles showed higher muscle activity in ankle plantar flexion than in the dorsiflexion or neutral positions (plantar flexion > neutral position, +3.3% of maximal voluntary isometric contraction (MVIC); plantar flexion > dorsiflexion, +12.2% of MVIC, respectively). Vastus lateralis muscles showed 7.1% of MVIC greater muscle activity in the neutral position than in dorsiflexion, and erector spinae muscles showed higher muscle activity in dorsiflexion than in plantar flexion or in the neutral position (dorsiflexion > neutral position, +4.3% of MVIC; dorsiflexion > plantar flexion, +7.1% of MVIC, respectively). CONCLUSION In squat exercises designed to strengthen the vastus medialis oblique, ankle joint plantar flexion is probably the most effective ankle training position, and the dorsiflexion position might be the most effective exercise for strengthening the erector spinae muscle.
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Affiliation(s)
- Ha-Rim Sung
- Department of Physical Therapy, Graduate School, Daejeon University, Dong-Gu, Daejeon, Korea
| | - Se-Jung Oh
- Department of Physical Therapy, Graduate School, Daejeon University, Dong-Gu, Daejeon, Korea
| | - Jun-Nam Ryu
- Department of Physical Therapy, Yeoju University, Yeoju City, Korea
| | - Yong-Jun Cha
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Dong-Gu, Daejeon, Korea
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Pan W, Zhou J, Lin Y, Zhang Z, Wang Y. Elasticity of the Achilles Tendon in Individuals With and Without Plantar Fasciitis: A Shear Wave Elastography Study. Front Physiol 2021; 12:686631. [PMID: 34234693 PMCID: PMC8257043 DOI: 10.3389/fphys.2021.686631] [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: 03/27/2021] [Accepted: 05/31/2021] [Indexed: 12/03/2022] Open
Abstract
The elastic properties of the Achilles tendon (AT) are altered in local injury or other diseases and in response to changes in mechanical load. Recently, elastography has been used to evaluate variations in tendon elastic properties, mainly among healthy individuals or athletes. Therefore, this study evaluated the biomechanical changes in ATs in individuals with and without plantar fasciitis (PF). The purposes were as follows: (1) to evaluate the passive stiffness of three regions of the AT which defined as 0 (AT0 cm), 3 (AT3 cm), and 6 cm (AT6 cm) above the calcaneal tuberosity in participants with and without PF, (2) to investigate the interplay between the passive stiffness in patients with PF and pain, (3) to detect optimal cut-off points of stiffness of the AT in assessing individuals with chronic PF, and (4) to determine the correlation between the plantar fascia thickness (PFT) and pain. This cross-sectional study included 40 participants (mean age = 51 ± 13 years). When the ankle was in a relaxed position, patients with PF experienced increased passive stiffness in AT0 cm (p = 0.006) and AT3 cm (P = 0.003), but not in the neutral position. Significant correlations were observed between pain and stiffness of AT (AT0 cm r = 0.489, P = 0.029; AT3 cm r = 487, P = 0.030; AT6 cm r = 0.471, P = 0.036), but not in the PFT (P = 0.557). Optimal cut-off stiffness was AT (452 kPa) in the relaxed ankle position. The plantar fascia of patients with PF was significantly thicker than that of the controls (P < 0.001). Findings from the present study demonstrate that tendon stiffness is a good indicator of the clinical situation of patients with PF. Monitoring passive tendon stiffness may provide additional information to assess severity of the condition and guide therapeutic. The treatment programs for PF should also be tailored to the distal AT, as conventional therapy might not be targeted to tight tendons.
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Affiliation(s)
- Weiyi Pan
- Shenzhen Dapeng New District Nan'ao People's Hospital, Branch of the First Affiliate of Shenzhen University, Shenzhen, China
| | - Jiping Zhou
- Shenzhen Dapeng New District Nan'ao People's Hospital, Branch of the First Affiliate of Shenzhen University, Shenzhen, China
| | - Yuyi Lin
- Shenzhen Dapeng New District Nan'ao People's Hospital, Branch of the First Affiliate of Shenzhen University, Shenzhen, China
| | - Zhijie Zhang
- Luoyang Orthopedics Hospital of Henan Province, Luoyang, China
| | - Yulong Wang
- ShenZhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Rosa LG, Zia JS, Inan OT, Sawicki GS. Machine learning to extract muscle fascicle length changes from dynamic ultrasound images in real-time. PLoS One 2021; 16:e0246611. [PMID: 34038426 PMCID: PMC8153491 DOI: 10.1371/journal.pone.0246611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Dynamic muscle fascicle length measurements through B-mode ultrasound have become popular for the non-invasive physiological insights they provide regarding musculoskeletal structure-function. However, current practices typically require time consuming post-processing to track muscle length changes from B-mode images. A real-time measurement tool would not only save processing time but would also help pave the way toward closed-loop applications based on feedback signals driven by in vivo muscle length change patterns. In this paper, we benchmark an approach that combines traditional machine learning (ML) models with B-mode ultrasound recordings to obtain muscle fascicle length changes in real-time. To gauge the utility of this framework for 'in-the-loop' applications, we evaluate accuracy of the extracted muscle length change signals against time-series' derived from a standard, post-hoc automated tracking algorithm. METHODS We collected B-mode ultrasound data from the soleus muscle of six participants performing five defined ankle motion tasks: (a) seated, constrained ankle plantarflexion, (b) seated, free ankle dorsi/plantarflexion, (c) weight-bearing, calf raises (d) walking, and then a (e) mix. We trained machine learning (ML) models by pairing muscle fascicle lengths obtained from standardized automated tracking software (UltraTrack) with the respective B-mode ultrasound image input to the tracker, frame-by-frame. Then we conducted hyperparameter optimizations for five different ML models using a grid search to find the best performing parameters for a combination of high correlation and low RMSE between ML and UltraTrack processed muscle fascicle length trajectories. Finally, using the global best model/hyperparameter settings, we comprehensively evaluated training-testing outcomes within subject (i.e., train and test on same subject), cross subject (i.e., train on one subject, test on another) and within/direct cross task (i.e., train and test on same subject, but different task). RESULTS Support vector machine (SVM) was the best performing model with an average r = 0.70 ±0.34 and average RMSE = 2.86 ±2.55 mm across all direct training conditions and average r = 0.65 ±0.35 and average RMSE = 3.28 ±2.64 mm when optimized for all cross-participant conditions. Comparisons between ML vs. UltraTrack (i.e., ground truth) tracked muscle fascicle length versus time data indicated that ML tracked images reliably capture the salient qualitative features in ground truth length change data, even when correlation values are on the lower end. Furthermore, in the direct training, calf raises condition, which is most comparable to previous studies validating automated tracking performance during isolated contractions on a dynamometer, our ML approach yielded 0.90 average correlation, in line with other accepted tracking methods in the field. CONCLUSIONS By combining B-mode ultrasound and classical ML models, we demonstrate it is possible to achieve real-time tracking of human soleus muscle fascicles across a number of functionally relevant contractile conditions. This novel sensing modality paves the way for muscle physiology in-the-loop applications that could be used to modify gait via biofeedback or unlock novel wearable device control techniques that could enable restored or augmented locomotion performance.
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Affiliation(s)
- Luis G. Rosa
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Jonathan S. Zia
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Gregory S. Sawicki
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, United States of America
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Increasing the midsole bending stiffness of shoes alters gastrocnemius medialis muscle function during running. Sci Rep 2021; 11:749. [PMID: 33436965 PMCID: PMC7804138 DOI: 10.1038/s41598-020-80791-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/28/2020] [Indexed: 01/30/2023] Open
Abstract
In recent years, increasing the midsole bending stiffness (MBS) of running shoes by embedding carbon fibre plates in the midsole resulted in many world records set during long-distance running competitions. Although several theories were introduced to unravel the mechanisms behind these performance benefits, no definitive explanation was provided so far. This study aimed to investigate how the function of the gastrocnemius medialis (GM) muscle and Achilles tendon is altered when running in shoes with increased MBS. Here, we provide the first direct evidence that the amount and velocity of GM muscle fascicle shortening is reduced when running with increased MBS. Compared to control, running in the stiffest condition at 90% of speed at lactate threshold resulted in less muscle fascicle shortening (p = 0.006, d = 0.87), slower average shortening velocity (p = 0.002, d = 0.93) and greater estimated Achilles tendon energy return (p ≤ 0.001, d = 0.96), without a significant change in GM fascicle work (p = 0.335, d = 0.40) or GM energy cost (p = 0.569, d = 0.30). The findings of this study suggest that running in stiff shoes allows the ankle plantarflexor muscle-tendon unit to continue to operate on a more favourable position of the muscle's force-length-velocity relationship by lowering muscle shortening velocity and increasing tendon energy return.
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Hollville E, Rabita G, Guilhem G, Lecompte J, Nordez A. Effects of Surface Properties on Gastrocnemius Medialis and Vastus Lateralis Fascicle Mechanics During Maximal Countermovement Jumping. Front Physiol 2020; 11:917. [PMID: 32982767 PMCID: PMC7488207 DOI: 10.3389/fphys.2020.00917] [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: 12/06/2019] [Accepted: 07/09/2020] [Indexed: 11/14/2022] Open
Abstract
Interactions between human movement and surfaces have previously been studied to understand the influence of surface properties on the mechanics and energetics of jumping. However, little is known about the muscle-tendon unit (MTU) mechanics associated with muscle activity and leg adjustments induced by different surfaces during this movement. This study aimed to examine the effects of three surfaces with different properties (artificial turf, hybrid turf, and athletic track) on the muscle mechanics and muscle excitation of the gastrocnemius medialis (GM) and vastus lateralis (VL) during maximal countermovement jumping (CMJ). Twelve participants performed maximal CMJs on the three sport surfaces. GM and VL muscle fascicles were simultaneously imaged using two ultrafast ultrasound systems (500 Hz). MTUs lengths were determined based on anthropometric models and two-dimensional joint kinematics. Surface electromyography (EMG) was used to record GM and VL muscle activity. Surface mechanical testing revealed systematic differences in surface mechanical properties (P = 0.006, η2: 0.26–0.32, large). Specifically, the highest force reduction and vertical deformation values have been observed on artificial turf (65 ± 2% and 9.0 ± 0.3 mm, respectively), while athletic track exhibited the lowest force reduction and vertical deformation values (28 ± 1% and 2.1 ± 0.1 mm, respectively) and the highest energy restitution (65 ± 1%). We observed no significant difference in CMJ performance between the three surfaces (∼35–36 cm, P = 0.66). GM and VL fascicle shortening (P = 0.90 and P = 0.94, respectively) and shortening velocity (P = 0.13 and P = 0.65, respectively) were also unaffected by the type of surface. However, when jumping from greater deformable surface, both GM muscle activity (P = 0.022, η2 = 0.18, large) and peak shortening velocity of GM MTU (P = 0.042, η2 = 0.10, medium) increased during the push-off phase. This resulted in a greater peak plantar flexion velocity late in the jump (P = 0.027, η2 = 0.13, medium). Our findings suggest that maximal vertical jumping tasks in humans is not affected by common sport surfaces with different mechanical properties. However, internal regulatory mechanisms exist to compensate for differences in surface properties.
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Affiliation(s)
- Enzo Hollville
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France.,NG Lab, Natural Grass, Paris, France.,Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Giuseppe Rabita
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Gaël Guilhem
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Jennyfer Lecompte
- NG Lab, Natural Grass, Paris, France.,Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - Antoine Nordez
- Movement - Interactions - Performance, MIP, EA 4334, Université de Nantes, Nantes, France.,Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Hollville E, Nordez A, Guilhem G, Lecompte J, Rabita G. Surface properties affect the interplay between fascicles and tendinous tissues during landing. Eur J Appl Physiol 2019; 120:203-217. [PMID: 31776693 DOI: 10.1007/s00421-019-04265-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Muscle-tendon units are forcefully stretched during rapid deceleration events such as landing. Consequently, tendons act as shock absorbers by buffering the negative work produced by muscle fascicles likely to prevent muscle damage. Landing surface properties can also modulate the amount of energy dissipated by the body, potentially effecting injury risk. This study aimed to evaluate the influence of three different surfaces on the muscle-tendon interactions of gastrocnemius medialis (GM), and vastus lateralis (VL) during single- and double-leg landings from 50 cm. METHODS Ultrasound images, muscle activity and joint kinematics were collected for 12 participants. Surface testing was also performed, revealing large differences in mechanical behavior. RESULTS During single-leg landing, stiffer surfaces increased VL fascicle lengthening and velocity, and muscle activity independent of joint kinematics while GM length changes showed no difference between surfaces. Double-leg landing resulted in similar fascicle and tendon behavior despite greater knee flexion angles on stiffer surfaces. CONCLUSION This demonstrates that VL fascicle lengthening is greater when the surface stiffness increases, when performing single-leg landing. This is due to the combination of limited knee joint flexion and lower surface absorption ability which resulted in greater mechanical demand mainly withstood by fascicles. GM muscle-tendon interactions remain similar between landing surfaces and types. Together, this suggests that surface damping properties primarily affect the VL muscle-tendon unit with a potentially higher risk of injury as a result of increased surface stiffness when performing single-leg landing tasks.
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Affiliation(s)
- Enzo Hollville
- Research Department, Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France.,NG Lab, Natural Grass, Paris, France
| | - Antoine Nordez
- Laboratory 'Movement, Interactions, Performance' (EA 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France.,Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Gaël Guilhem
- Research Department, Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France
| | - Jennyfer Lecompte
- NG Lab, Natural Grass, Paris, France.,LBM-Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Giuseppe Rabita
- Research Department, Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France.
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Regional Elastic Properties of the Achilles Tendon Is Heterogeneously Influenced by Individual Muscle of the Gastrocnemius. Appl Bionics Biomech 2019; 2019:8452717. [PMID: 31781292 PMCID: PMC6874961 DOI: 10.1155/2019/8452717] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/02/2019] [Accepted: 09/19/2019] [Indexed: 11/17/2022] Open
Abstract
Background Anatomical studies and the mechanical property studies showed that there is a strong correlation between Achilles tendon (AT) elasticity and individual gastrocnemius muscle (the medial head of gastrocnemius (MG) and the lateral head of gastrocnemius (LG)) elasticity. Limited ankle dorsiflexion range of motion has been correlated with decreased flexibility of the MG/LG/AT complex. However, no studies have been conducted to examine the exact correlation between the Achilles tendon and the individual muscle of the gastrocnemius. Purposes The purposes of the present study were (1) to evaluate intra- and interoperator reliabilities of elastic property measurements in the gastrocnemius muscle-Achilles tendon complex by using the shear wave elastography (SWE) and (2) to examine the correlation between the regional elastic properties of the AT and the individual muscle of the gastrocnemius. Methods Twenty healthy subjects (mean age: 22.50 (3.02) years) were recruited in this study. The elastic properties of the AT and the individual muscle of the gastrocnemius were quantified using the SWE. Findings The SWE has comparatively high reliability in quantifying the elastic properties of the muscle-tendon range from good to excellent. The intraoperator ICC of the gastrocnemius muscle-Achilles tendon complex was 0.77 to 0.95, while the interoperator ICC was 0.76 to 0.94. The minimal detectable change (MDC) of the muscle was 1.72 kPa, while the AT was 32.90 kPa. A significant correlation was found between the elastic modulus of AT and the elastic modulus of the MG (r = 0.668 and p = 0.001 at the relaxing position and r = 0.481 and p = 0.032 at the neutral position). Conclusions The SWE has the potential to assess localized changes in muscle-tendon elastic properties, provide more intuitive relations between elastic properties of the muscle tendon and function, and evaluate the therapeutic effect of the muscle tendon. A significant correlation between the AT and the MG was found, and it may provide a new treatment idea (targeted to the tight muscle heads) for the clinical setting to treat subjects with AT disorders.
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Werkhausen A, Cronin NJ, Albracht K, Bojsen-Møller J, Seynnes OR. Distinct muscle-tendon interaction during running at different speeds and in different loading conditions. J Appl Physiol (1985) 2019; 127:246-253. [PMID: 31070955 DOI: 10.1152/japplphysiol.00710.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The interaction between the Achilles tendon and the triceps surae muscles seems to be modulated differently with various task configurations. Here we tested the hypothesis that the increased forces and ankle joint work during running under contrasting conditions (altered speed or load) would be met by different, time-dependent adjustments at the muscle-tendon level. Ultrasonography, electromyography, kinematics, and ground reaction force measurements were used to examine Achilles tendon, gastrocnemius, and soleus muscle mechanics in 16 runners in four different running conditions, consisting of a combination of two different speeds (preferred and +20% of preferred speed) and two loading conditions (unloaded and +20% of body mass). Positive ankle joint work increased similarly (+13%) with speed and load. Gastrocnemius and soleus muscle fascicle length and peak velocity were not altered by either condition, suggesting that contractile conditions are mostly preserved despite the constraints imposed in this experimental design. However, at higher running speed, tendon length changes were unaltered but mean muscle electromyographic activity increased in gastrocnemius (+10%, P < 0.01) and soleus (+14%, P < 0.01). Conversely, when loading was increased, mean muscle activity remained similar to unloaded conditions but the mean velocity of gastrocnemius fascicles was reduced and tendon recoil increased (+29%, P < 0.01). Collectively, these results suggest that the neuromuscular system meets increased mechanical demands by favoring economical force production when enough time is available. NEW & NOTEWORTHY We demonstrate that muscle-tendon mechanics are adjusted differently when running under constraints imposed by speed or load, despite comparable increases in work. The neuromuscular system likely modulates the way force is produced as a function of availability of time and potential energy.
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Affiliation(s)
- Amelie Werkhausen
- Department of Physical Performance, Norwegian School of Sport Sciences , Oslo , Norway
| | - Neil J Cronin
- Neuromuscular Research Centre, Faculty of Sport and Health Sciences, University of Jyväskylä , Jyväskylä , Finland
| | - Kirsten Albracht
- Institute of Biomechanics and Orthopedics, German Sport University Cologne , Cologne , Germany.,Department of Medical Engineering and Technomathematics, Aachen University of Applied Sciences , Aachen , Germany
| | - Jens Bojsen-Møller
- Department of Physical Performance, Norwegian School of Sport Sciences , Oslo , Norway
| | - Olivier R Seynnes
- Department of Physical Performance, Norwegian School of Sport Sciences , Oslo , Norway
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Matijevich ES, Branscombe LM, Scott LR, Zelik KE. Ground reaction force metrics are not strongly correlated with tibial bone load when running across speeds and slopes: Implications for science, sport and wearable tech. PLoS One 2019; 14:e0210000. [PMID: 30653510 PMCID: PMC6336327 DOI: 10.1371/journal.pone.0210000] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/15/2018] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Tibial stress fractures are a common overuse injury resulting from the accumulation of bone microdamage due to repeated loading. Researchers and wearable device developers have sought to understand or predict stress fracture risks, and other injury risks, by monitoring the ground reaction force (GRF, the force between the foot and ground), or GRF correlates (e.g., tibial shock) captured via wearable sensors. Increases in GRF metrics are typically assumed to reflect increases in loading on internal biological structures (e.g., bones). The purpose of this study was to evaluate this assumption for running by testing if increases in GRF metrics were strongly correlated with increases in tibial compression force over a range of speeds and slopes. METHODS Ten healthy individuals performed running trials while we collected GRFs and kinematics. We assessed if commonly-used vertical GRF metrics (impact peak, loading rate, active peak, impulse) were strongly correlated with tibial load metrics (peak force, impulse). RESULTS On average, increases in GRF metrics were not strongly correlated with increases in tibial load metrics. For instance, correlating GRF impact peak and loading rate with peak tibial load resulted in r = -0.29±0.37 and r = -0.20±0.35 (inter-subject mean and standard deviation), respectively. We observed high inter-subject variability in correlations, though most coefficients were negligible, weak or moderate. Seventy-six of the 80 subject-specific correlation coefficients computed indicated that higher GRF metrics were not strongly correlated with higher tibial forces. CONCLUSIONS These results demonstrate that commonly-used GRF metrics can mislead our understanding of loading on internal structures, such as the tibia. Increases in GRF metrics should not be assumed to be an indicator of increases in tibial bone load or overuse injury risk during running. This has important implications for sports, wearable devices, and research on running-related injuries, affecting >50 scientific publications per year from 2015-2017.
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Affiliation(s)
- Emily S. Matijevich
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States of America
| | - Lauren M. Branscombe
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States of America
| | - Leon R. Scott
- Department of Orthopaedics, Vanderbilt University, Nashville, TN, United States of America
| | - Karl E. Zelik
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States of America
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States of America
- Department of Physical Medicine & Rehabilitation, Vanderbilt University, Nashville, TN, United States of America
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Clark WH, Franz JR. Do triceps surae muscle dynamics govern non-uniform Achilles tendon deformations? PeerJ 2018; 6:e5182. [PMID: 30013844 PMCID: PMC6046199 DOI: 10.7717/peerj.5182] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/14/2018] [Indexed: 01/03/2023] Open
Abstract
The human Achilles tendon (AT) consists of sub-tendons arising from the gastrocnemius and soleus muscles that exhibit non-uniform tissue displacements thought to facilitate some independent actuation. However, the mechanisms governing non-uniform displacement patterns within the AT, and their relevance to triceps surae muscle contractile dynamics, have remained elusive. We used a dual-probe ultrasound imaging approach to investigate triceps surae muscle dynamics (i.e., medial gastrocnemius-GAS, soleus-SOL) as a determinant of non-uniform tendon tissue displacements in the human AT. We hypothesized that superficial versus deep differences in AT tissue displacements would be accompanied by and correlate with anatomically consistent differences in GAS versus SOL muscle shortening. Nine subjects performed ramped maximum voluntary isometric contractions at each of five ankle joint angles spanning 10° dorsiflexion to 30° plantarflexion. For all conditions, SOL shortened by an average of 78% more than GAS during moment generation. This was accompanied by, on average, 51% more displacement in the deep versus superficial region of the AT. The magnitude of GAS and SOL muscle shortening positively correlated with displacement in their associated sub-tendons within the AT. Moreover, and as hypothesized, superficial versus deep differences in sub-tendon tissue displacements positively correlated with anatomically consistent differences in GAS versus SOL muscle shortening. We present the first in vivo evidence that triceps surae muscle dynamics may precipitate non-uniform displacement patterns in the architecturally complex AT.
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Affiliation(s)
- William H Clark
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, United States of America
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, United States of America
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