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Kositsky A, Stenroth L, Barrett RS, Korhonen RK, Vertullo CJ, Diamond LE, Saxby DJ. Muscle Morphology Does Not Solely Determine Knee Flexion Weakness After Anterior Cruciate Ligament Reconstruction with a Semitendinosus Tendon Graft: A Combined Experimental and Computational Modeling Study. Ann Biomed Eng 2024; 52:1313-1325. [PMID: 38421479 PMCID: PMC10995045 DOI: 10.1007/s10439-024-03455-7] [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: 06/16/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024]
Abstract
The distal semitendinosus tendon is commonly harvested for anterior cruciate ligament reconstruction, inducing substantial morbidity at the knee. The aim of this study was to probe how morphological changes of the semitendinosus muscle after harvest of its distal tendon for anterior cruciate ligament reconstruction affects knee flexion strength and whether the knee flexor synergists can compensate for the knee flexion weakness. Ten participants 8-18 months after anterior cruciate ligament reconstruction with an ipsilateral distal semitendinosus tendon autograft performed isometric knee flexion strength testing (15°, 45°, 60°, and 90°; 0° = knee extension) positioned prone on an isokinetic dynamometer. Morphological parameters extracted from magnetic resonance images were used to inform a musculoskeletal model. Knee flexion moments estimated by the model were then compared with those measured experimentally at each knee angle position. A statistically significant between-leg difference in experimentally-measured maximal isometric strength was found at 60° and 90°, but not 15° or 45°, of knee flexion. The musculoskeletal model matched the between-leg differences observed in experimental knee flexion moments at 15° and 45° but did not well estimate between-leg differences with a more flexed knee, particularly at 90°. Further, the knee flexor synergists could not physiologically compensate for weakness in deep knee flexion. These results suggest additional factors other than knee flexor muscle morphology play a role in knee flexion weakness following anterior cruciate ligament reconstruction with a distal semitendinosus tendon graft and thus more work at neural and microscopic levels is required for informing treatment and rehabilitation in this demographic.
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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 Technical Physics, University of Eastern Finland, Kuopio, Finland.
| | - Lauri Stenroth
- Department of Technical Physics, 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
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Christopher J Vertullo
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Knee Research Australia, Gold Coast, Queensland, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Jerger S, Centner C, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Specific collagen peptides increase adaptions of patellar tendon morphology following 14-weeks of high-load resistance training: A randomized-controlled trial. Eur J Sport Sci 2023; 23:2329-2339. [PMID: 37424319 DOI: 10.1080/17461391.2023.2232758] [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] [Indexed: 07/11/2023]
Abstract
ABSTRACTThe purpose of this study was to investigate the effect of a supplementation with specific collagen peptides (SCP) combined with resistance training (RT) on changes in structural properties of the patellar tendon. Furthermore, tendon stiffness as well as maximal voluntary knee extension strength and cross-sectional area (CSA) of the rectus femoris muscle were assessed. In a randomized, placebo-controlled study, 50 healthy, moderately active male participants completed a 14-week resistance training program with three weekly sessions (70-85% of 1 repetition maximum [1RM]) for the knee extensors. While the SCP group received 5g of specific collagen peptides daily, the other group received the same amount of a placebo (PLA) supplement. The SCP supplementation led to a significant greater (p < 0.05) increase in patellar tendon CSA compared with the PLA group at 60% and 70% of the patellar tendon length starting from the proximal insertion. Both groups increased tendon stiffness (p < 0.01), muscle CSA (p < 0.05) and muscular strength (p < 0.001) throughout the intervention without significant differences between the groups. The current study shows that in healthy, moderately active men, supplementation of SCP in combination with RT leads to greater increase in patellar tendon CSA than RT alone. Since underlying mechanisms of tendon hypertrophy are currently unknown, further studies should investigate potential mechanisms causing the increased morphology adaptions following SCP supplementation.Trial registration: German Clinical Trials Register identifier: DRKS00029244..
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Key Words
- 1RM, one repetition maximum
- CSA, cross-sectional area
- ECM, extracellular matrix
- FOV, field of view
- MRI, magnetic resonance imaging
- MVC, maximal voluntary contraction
- Magnetic resonance imaging
- PLA, placebo
- RT, resistance training
- SCP, specific collagen peptides
- SEM, standard error of the mean
- cross sectional area
- supplementation
- tendon properties
- ultrasound
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Affiliation(s)
- Simon Jerger
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
| | - Benedikt Lauber
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Olivier Seynnes
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Till Friedrich
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - David Lolli
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Daniel König
- Centre of Sport, Science and University Sports, Department of Sports Science, Division for Nutrition, Exercise and Health, University of Vienna, Wien 1150, Austria
- Faculty of Life Sciences, Department of Nutritional Sciences, Division for Nutrition, Exercise and Health, University of Vienna, Wien 1090, Austria
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Chang TT, Zhu YC, Li Z, Li F, Li YP, Guo JY, Wang XQ, Zhang ZJ. Modulation in the Stiffness of Specific Muscles of the Quadriceps in Patients With Knee Osteoarthritis and Their Relationship With Functional Ability. Front Bioeng Biotechnol 2022; 9:781672. [PMID: 35223811 PMCID: PMC8870124 DOI: 10.3389/fbioe.2021.781672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Deficits in the flexibility of the quadriceps are one of the risk factors for developing knee joint disorders. No studies have investigated the changes in the stiffness of the quadriceps muscle among patients with knee osteoarthritis (OA). Therefore, the purpose of this study was to investigate changes in the stiffness of specific-muscle of the quadriceps in patients with knee OA and their relationship with functional ability. Twenty-five patients with knee OA and 25 healthy, asymptomatic subjects were recruited in this study. The stiffness of the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) in all participants was evaluated using MyotonPRO at 60° and 90° flexion of the knee joint. The results of this study showed a greater VL stiffness in patients with knee OA than in healthy subjects at both 60° and 90° of knee flexion (p < 0.05). Significant differences in VL, VM and RF stiffness were obtained at different knee joint angles in individuals with and without knee OA (p < 0.05). In addition, there was a positive correlation between VL stiffness and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in patients with Knee OA (60° of knee flexion: r = 0.508, p = 0.010; 90° of knee flexion: r = 0.456, p = 0.022). These results indicate that there is an increase in VL stiffness in patients with knee OA compared with healthy, asymptomatic subjects, and the quadriceps stiffness was increased with knee flexion in both healthy subjects and patients with knee OA. VL stiffness is associated with WOMAC scores in patients with knee OA.
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Affiliation(s)
- Tian-Tian Chang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Yuan-Chun Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhe Li
- The First Clinical Medical School, Shaanxi University of Chinese Medicine, Xi’an, China
| | - Feng Li
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Ya-Peng Li
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Jia-Yi Guo
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Zhi-Jie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
- *Correspondence: Zhi-Jie Zhang,
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Barron SM, Ordonez Diaz T, Pozzi F, Vasilopoulos T, Nichols JA. “Linear Relationship Between Electromyography and Shear Wave Elastography Measurements Persists in Deep Muscles of the Upper Extremity”. J Electromyogr Kinesiol 2022; 63:102645. [PMID: 35189570 PMCID: PMC9115669 DOI: 10.1016/j.jelekin.2022.102645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/31/2022] [Accepted: 02/06/2022] [Indexed: 11/26/2022] Open
Abstract
Recent works have demonstrated a linear relationship between muscle activation and shear modulus in various superficial muscles. As such, it may be possible to overcome limitations of traditional electromyography (EMG) methods by assessing activation using shear wave elastography. However, the relationship has not been wholly validated in deep muscles. This study measured the association between squared shear wave velocity, which is related to shear modulus, and activation within superficial and deep muscles. This relationship was also compared between surface and intramuscular EMG electrodes. We simultaneously recorded EMG and shear wave velocity in one deep (brachialis) and one superficial (brachioradialis) muscle in ten healthy individuals during isometric elbow flexion across a wide range of contraction intensities. Muscle activation and squared shear wave velocity demonstrated good reliability (ICC > 0.75) and showed a linear relationship (P < 0.05) for all muscle/EMG electrode type combinations (study conditions) after down-sampling. Study condition was not a significant within-subject factor to the slope or intercept of the relationship (P > 0.05). This work demonstrates that activation of both superficial and deep muscles can be assessed noninvasively using ultrasound shear wave elastography and is a critical step toward demonstrating elastography's utility as an alternative to EMG.
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Centner C, Jerger S, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Low-Load Blood Flow Restriction and High-Load Resistance Training Induce Comparable Changes in Patellar Tendon Properties. Med Sci Sports Exerc 2021; 54:582-589. [PMID: 34772900 DOI: 10.1249/mss.0000000000002824] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Low-load resistance training with blood flow restriction (LL-BFR) has emerged as a viable alternative to conventional high-load (HL) resistance training regimens. Despite increasing evidence confirming comparable muscle adaptations between LL-BFR and HL resistance exercise, only very little is known about tendinous mechanical and morphological adaptations following LL-BFR. Therefore, the aim of the present study was to examine the effects of 14 weeks of LL-BFR and HL training on patellar tendon adaptations. METHODS N = 29 recreationally active male participants were randomly allocated into the following two groups: LL-BFR resistance training (20-35% one repetition maximum/1RM) or HL resistance training (70-85% 1RM). Both groups trained three times per week for 14 weeks. One week before and after the intervention, patellar tendon mechanical and morphological properties were assessed via ultrasound and magnetic resonance imaging (MRI). Additionally, changes in muscle cross-sectional area (CSA) were quantified by MRI and muscle strength via dynamic 1RM measurements. RESULTS The findings demonstrated that both LL-BFR and HL training resulted in comparable changes in patellar tendon stiffness (LL-BFR: + 25.2%, p = 0.003; HL: + 22.5%, p = 0.024) without significant differences between groups. Similar increases in tendon CSA were observed in HL and LL-BFR. Muscle mass and strength also significantly increased in both groups but were not statistically different between HL (+ 38%) and LL-BFR (+ 34%), except for knee extension 1RM where higher changes were seen in LL-BFR. CONCLUSION The present results support the notion that both HL and LL-BFR cause substantial changes in patellar tendon properties and the magnitude of changes are not significantly different between conditions. Further studies are needed which examine the physiological mechanisms underlying the altered tendon properties following LL-BFR training.
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Affiliation(s)
- Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Germany Praxisklinik Rennbahn, Muttenz, Switzerland Department of Neurosciences and Movement Sciences, Université de Fribourg, Switzerland Department of Physical Performance, Norwegian School of Sport Sciences, Norway Department of Sports Science, Institute for Nutrition, Sports and Health, University of Vienna, Vienna, Austria
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Grinspan GA, Cabral HV, de Souza LML, de Oliveira LF, Aguiar S, Blanco E, Benech N. Surface wave elastography is a reliable method to correlate muscle elasticity, torque, and electromyography activity level. Physiol Rep 2021; 9:e14955. [PMID: 34337894 PMCID: PMC8326893 DOI: 10.14814/phy2.14955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
The shear elastic modulus is one of the most important parameters to characterize the mechanical behavior of soft tissues. In biomechanics, ultrasound elastography is the gold standard for measuring and mapping it locally in skeletal muscle in vivo. However, their applications are limited to the laboratory or clinic. Thus, low-frequency elastography methods have recently emerged as a novel alternative to ultrasound elastography. Avoiding the use of high frequencies, these methods allow obtaining a mean value of bulk shear elasticity. However, they are frequently susceptible to diffraction, guided waves, and near field effects, which introduces biases in the estimates. The goal of this work is to test the performance of the non-ultrasound surface wave elastography (NU-SWE), which is portable and is based on new algorithms designed to correct the incidence of such effects. Thus, we show its first application to muscle biomechanics. We performed two experiments to assess the relationships of muscle shear elasticity versus joint torque (experiment 1) and the electromyographic activity level (experiment 2). Our results were comparable regarding previous works using the reference ultrasonic methods. Thus, the NU-SWE showed its potentiality to get wide the biomechanical applications of elastography in many areas of health and sports sciences.
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Affiliation(s)
- Gustavo A. Grinspan
- Sección Biofísica y Biología de SistemasFacultad de CienciasUniversidad de la RepúblicaMontevideoUruguay
- Laboratorio de Acústica UltrasonoraFacultad de CienciasUniversidad de la RepúblicaMontevideoUruguay
| | - Hélio V. Cabral
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine)School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Leonardo M. L. de Souza
- Programa de Engenharia Biomédica (COPPE)Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
| | - Liliam F. de Oliveira
- Programa de Engenharia Biomédica (COPPE)Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
| | - Sofía Aguiar
- Instituto de Ensayo de MaterialesFacultad de IngenieríaUniversidad de la RepúblicaMontevideoUruguay
| | - Ernesto Blanco
- Instituto de FísicaFacultad de CienciasUniversidad de la RepúblicaMontevideoUruguay
| | - Nicolás Benech
- Laboratorio de Acústica UltrasonoraFacultad de CienciasUniversidad de la RepúblicaMontevideoUruguay
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Increased fascicle length but not patellar tendon stiffness after accentuated eccentric-load strength training in already-trained men. Eur J Appl Physiol 2020; 120:2371-2382. [PMID: 32772246 PMCID: PMC7560914 DOI: 10.1007/s00421-020-04462-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/04/2020] [Indexed: 01/28/2023]
Abstract
Purpose This study examined whether additional external load during the eccentric phase of lower limb strength training exercises led to greater adaptations in knee extensor strength, muscle architecture, and patellar tendon properties than traditional concentric–eccentric training in already-trained men. Methods Twenty-eight men accustomed to strength training were randomized to undertake 10 weeks of supervised traditional (TRAD) or accentuated eccentric loading (AEL) or continue their habitual unsupervised (CON) strength training. TRAD and AEL trained 2∙week−1 with a six-repetition maximum (RM) session and a ten-RM session. TRAD used the same external load in both concentric and eccentric phases, while AEL used 40% greater load during the eccentric than concentric phase. Tests were performed at pre- and post-training, including: maximum unilateral isokinetic (30°·s−1) concentric, eccentric and isometric torques by isokinetic dynamometry, unilateral isometric ramp contractions with muscle–tendon ultrasound imaging to measure tendon stiffness and hysteresis, and resting vastus lateralis and medialis fascicle angle and length measured by extended-field-of-view ultrasound. Results After training, both TRAD and AEL significantly increased maximum concentric and isometric torque (p < 0.05), but only AEL increased eccentric torque (AEL: + 10 ± 9%, TRAD: + 4 ± 9%) and vastus lateralis (AEL: + 14 ± 14%, TRAD: + 1 ± 10%) and medialis (AEL: + 19 ± 8%, TRAD: + 5 ± 11%) fascicle length. Conclusion Both TRAD and AEL increased maximum knee extensor strength but only AEL increased VL and VM fascicle length. Neither training program promoted changes in fascicle angle or changes in patellar tendon properties in our already-trained men.
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Taş S, Özkan Ö, Karaçoban L, Dönmez G, Çetin A, Korkusuz F. Knee muscle and tendon stiffness in professional soccer players: a shear-wave elastography study. J Sports Med Phys Fitness 2020; 60:276-281. [DOI: 10.23736/s0022-4707.19.09938-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Peeters T, Vleugels J, Revets H, Saeys W, Beyers K, Truijen S, Verwulgen S. Development and validation of a palpation device for arbitrary muscle stiffness measurements within subjects. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/aafd07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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