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Ghosh S, Rector JA, Saknite I, Smith HB, Walsh KM, Byram BC, Bellan LM, Tkaczyk ER. mTG-Gelatin phantoms as standardized testbeds for skin biomechanical measurements with Myoton. J Mech Behav Biomed Mater 2024; 158:106651. [PMID: 39059120 DOI: 10.1016/j.jmbbm.2024.106651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
Quantitative assessment of skin mechanical properties can play a pivotal role in diagnosing and tracking various dermatological conditions. Myoton is a promising tool that rapidly and noninvasively measures five skin biomechanical parameters. Accurate interpretation of these parameters requires systematic in vitro testing with easy-to-fabricate, cost-effective skin-mimicking phantoms with controllable properties. In this study, we assessed the ability of phantoms made with 5% and 10% gelatin crosslinked with microbial transglutaminase (mTG) to mimic the human skin for Myoton measurements. We discovered that each of the five Myoton parameters displayed moderate to high correlations with shear elastic modulus of the phantoms. Furthermore, Myoton effectively tracked changes in the mechanical properties of these models over time. Additionally, we designed bilayer phantoms incorporating both dermis and subcutaneous tissue-mimicking layers. Myoton successfully distinguished changes in the mechanical properties of the bilayer phantoms due to the introduction of a stiff 2 mm top layer. We also found that 5% mTG-gelatin phantoms mimic Myoton measurements from healthy subjects and 10% phantoms mimic patients with sclerotic chronic graft-versus-host disease (cGVHD). Therefore, multi-layered mTG-gelatin models for skin and soft tissues can serve as standardized testbeds to study different sclerotic skin conditions in a systematic manner.
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Affiliation(s)
- Shramana Ghosh
- Medicine Service and Research Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA; Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John A Rector
- Department of Mechanical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA
| | - Inga Saknite
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hayden B Smith
- Medicine Service and Research Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA; Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kristy M Walsh
- Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA
| | - Brett C Byram
- Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA
| | - Leon M Bellan
- Department of Mechanical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA
| | - Eric R Tkaczyk
- Medicine Service and Research Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA; Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA.
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2
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Obuchowicz R, Obuchowicz B, Nurzynska K, Urbanik A, Pihut M. Population Analysis of Masseter Muscle Tension Using Shear Wave Ultrasonography across Different Disease States. J Clin Med 2024; 13:5259. [PMID: 39274477 PMCID: PMC11396082 DOI: 10.3390/jcm13175259] [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: 08/13/2024] [Revised: 08/29/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
Objective: This study aimed to evaluate the distribution and trends of masseter muscle tension in patients with temporomandibular joint (TMJ) pain, examining gender-specific differences and the impact of various TMJ disorders. Methods: From January 2020 to June 2024, a total of 734 patients presenting with facial pain radiating to the head and neck, localized around and extending from the TMJ, were referred for ultrasonographic examination. After applying exclusion criteria, 535 patients (72.9%) were included in the study. The patient cohort consisted of 343 females (64.1%) and 192 males (35.9%), with muscle tension measured using the Aixplorer ultrasound system equipped with a shear wave device. Data were collected and analyzed across different age groups and TMJ conditions, including "no changes", "exudate", "arthrosis", and "disc displacement". Results: The study found that males exhibited higher muscle tension across all conditions, particularly in the "no changes" (40.4 kPa vs. 32.1 kPa, 25.9% higher) and "exudate" (38.5 kPa vs. 29.7 kPa, 29.6% higher) categories, indicating increased muscle strain and inflammation during middle age. In females, a trend of decreasing muscle tension with age was observed, with a significant reduction from 36.2 kPa in the 20-30 age group to 24.3 kPa in the 60-70 age group (32.9% reduction), suggesting a reduction in muscle mass or strength due to aging. Both genders showed high muscle tension in the presence of exudate, with females peaking in the 40-50 age group at 37.1 kPa and males peaking earlier in the 20-30 age group at 41.2 kPa (10.9% higher in males), highlighting potential gender differences in inflammatory response. In the arthrosis group, males displayed a consistent increase in muscle tension with age, peaking at 37.5 kPa in the 50-60 age group (50.7% increase from the 20-30 age group), while females showed high tension, particularly in the 40-50 age group at 31.0 kPa (82.4% higher compared to the 20-30 age group), indicating the need for targeted joint health interventions in middle-aged women. Conclusions: This study reveals significant gender-specific differences in masseter muscle tension among patients with TMJ pain. Males were found to be more affected by muscle strain and inflammation during middle age, whereas females showed a significant decrease in muscle tension with age. The presence of exudate significantly impacted muscle tension across all age groups for both genders. These findings underscore the importance of tailored clinical interventions and preventive strategies to manage TMJ disorders effectively.
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Affiliation(s)
- Rafal Obuchowicz
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Barbara Obuchowicz
- Department of Conservative Dentistry with Endodontics, Jagiellonian University Collegium Medicum, Montelupich 4, 31-155 Cracow, Poland
| | - Karolina Nurzynska
- Institute of Informatics, Faculty of Automata Control, Electronics, and Computer Science, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Andrzej Urbanik
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Malgorzata Pihut
- Prosthodontic and Orthodontic Department, Dental Institute, Jagiellonian University Medical College, 31-155 Krakow, Poland
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Wei Y, Alzouhayli K, Schilaty ND, Hooke AW, Sellon JL, Bates NA. Viability of shear wave elastography to predict mechanical/ultimate failure in the anterolateral and medial collateral ligaments of the knee. J Biomech 2024; 174:112264. [PMID: 39159586 DOI: 10.1016/j.jbiomech.2024.112264] [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: 01/05/2024] [Revised: 07/01/2024] [Accepted: 08/06/2024] [Indexed: 08/21/2024]
Abstract
The purpose of this study was (1) to determine the utility of shear wave elastography as a predictor for the mechanical failure of superficial knee ligaments and (2) to determine the viability of shear wave elastography to assess injury risk potential. Our hypothesis was that shear wave elastography measurements of the anterolateral ligament and medial collateral ligament would directly correlate with the material properties and the mechanical failure of the ligament, serving as a prognostic measurement for injury risk. 8 cadaveric specimens were acquired, and tissue stiffness for the anterolateral ligament and medial collateral ligament were evaluated with shear wave elastography. The anterolateral ligament and medial collateral ligament were dissected and isolated for unilateral mechanical failure testing. Ultimate failure testing was performed at 100 % strain per second after 50 cycles of 3 % strain viscoelastic conditioning. Each specimen was assessed for load, displacement, and surface strain throughout failure testing. Rate of force, rate of strain development, and Young's modulus were calculated from these variables. Shear wave elastography stiffness for the anterolateral ligament correlated with mean longitudinal anterolateral ligament strain at failure (R2 = 0.853; P<0.05). Medial collateral ligament shear wave elastography calculated modulus was significantly greater than the anterolateral ligament shear wave elastography calculated modulus. Shear wave elastography currently offers limited reliability in the prediction of mechanical performance of superficial knee ligaments. The utility of shear wave elastography assessment for injury risk potential remains undetermined.
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Affiliation(s)
- Yi Wei
- Ohio University Heritage College of Osteopathic Medicine
| | - Kenan Alzouhayli
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nathan D Schilaty
- Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA; Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA
| | - Alexander W Hooke
- Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Jacob L Sellon
- Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Nathanial A Bates
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Kepir E, Demiral F, Akaras E, Paksoy AE, Sevindik Aktas B, Yilmaz Cankaya B, Oztop B, Yagiz G, Owen JA. Hamstring Muscle Stiffness in Athletes with and without Anterior Cruciate Ligament Reconstruction History: A Retrospective Study. J Clin Med 2024; 13:4370. [PMID: 39124637 PMCID: PMC11313014 DOI: 10.3390/jcm13154370] [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: 06/10/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open
Abstract
Introduction: Sports requiring sprinting, jumping, and kicking tasks frequently lead to hamstring strain injuries (HSI). One of the structural risk factors of HSI is the increased passive stiffness of the hamstrings. Anterior cruciate ligament (ACL) injury history is associated with a 70% increase in the incidence of HSI, according to a recent meta-analysis. The same report recommended that future research should concentrate on the relationships between the HSI risk factors. Hence, the present study aimed to retrospectively compare changes in the passive stiffness of the hamstrings in athletes with and without ACL reconstruction history. Methods: Using ultrasound-based shear-wave elastography, the mid-belly passive muscle stiffness values of the biceps femoris long head, semimembranosus, and semitendinosus muscles were assessed and compared amongst athletes with and without a history of ACL reconstruction. Results: There were no significant differences in the biceps femoris long head (injured leg (IL): 26.19 ± 5.28 KPa, uninjured contralateral (UL): 26.16 ± 7.41 KPa, control legs (CL): 27.64 ± 5.58 KPa; IL vs. UL: p = 1; IL vs. CL: p = 1; UL vs. CL: p = 1), semimembranosus (IL: 24.35 ± 5.58 KPa, UL: 24.65 ± 8.35 KPa, CL: 22.83 ± 5.67 KPa; IL vs. UL: p = 1; IL vs. CL: p = 1; UL vs. CL, p = 1), or semitendinosus (IL: 22.45 ± 7 KPa, UL: 25.52 ± 7 KPa, CL: 22.54 ± 4.4 KPa; IL vs. UL: p = 0.487; IL vs. CL: p = 1; UL vs. CL, p = 0.291) muscle stiffness values between groups. Conclusions: The passive mid-muscle belly stiffness values of the biceps femoris long head, semitendinosus, and semimembranosus muscles did not significantly differ between previously injured and uninjured athletes; therefore, further assessment for other muscle regions of hamstrings may be necessary. To collect more comprehensive data related to the structural changes that may occur following ACL reconstructions in athletes, a future study should examine the passive stiffness of wider muscle regions from origin to insertion.
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Affiliation(s)
- Ersagun Kepir
- Institute for Applied Human Physiology, School of Psychology and Sport Sciences, Bangor University, Bangor LL57 2DG, UK;
| | - Furkan Demiral
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Esedullah Akaras
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Erzurum Technical University, 25050 Erzurum, Türkiye
| | - Ahmet Emre Paksoy
- Department of Orthopaedic Surgery, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | | | - Bahar Yilmaz Cankaya
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Bilgehan Oztop
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Gokhan Yagiz
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC 27858, USA
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Amasya University, 05100 Amasya, Türkiye
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - Julian Andrew Owen
- Institute for Applied Human Physiology, School of Psychology and Sport Sciences, Bangor University, Bangor LL57 2DG, UK;
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Russell A, Choi B, Robinson D, Penailillo L, Earp JE. Acute and Chronic Effects of Static Stretching on Intramuscular Hamstring Stiffness. Scand J Med Sci Sports 2024; 34:e14670. [PMID: 38856021 DOI: 10.1111/sms.14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 06/11/2024]
Abstract
Passive hamstring stiffness varies proximo-distally, resulting in inhomogeneous tissue strain during stretching that may affect localized adaptations and risk of muscle injuries. The purpose of the present study was to determine the acute and chronic effects of static stretching (SS) on intramuscular hamstring stiffness. Thirty healthy active participants had acute changes in passive biceps femoris (BF), semimembranosus (SM), and semitendinosus (ST) stiffness measured at 25% (proximal), 50% (middle), and 75% (distal) muscle length, using shear-wave elastography, immediately after SS. Participants then completed 4 weeks of either a SS intervention (n = 15) or no intervention (CON, n = 15) with stiffness measured before and after the interventions. The acute and chronic effects of SS were compared between anatomical regions and between regions on the basis of their relative stiffness pre-intervention. Acutely, SS decreased stiffness throughout the BF and SM (p ≤ 0.05) but not the ST (p = 0.326). However, a regional effect of stretching was observed for SM and ST with greater reduction in stiffness occurring in stiffer muscular regions (p = 0.001-0.013). Chronically, SS increased BF and ST (p < 0.05), but not SM (p = 0.422) stiffness compared with CON, but no regional effect of stretching was observed in any muscle (p = 0.361-0.833). SS resulted in contrasting acute and chronic effects, acutely decreasing stiffness in stiffer regions while chronically increasing stiffness. These results indicate that the acute effects of SS vary along the muscle's length on the basis of the relative stiffness of the muscle and that acute changes in stiffness from SS are unrelated to chronic adaptations.
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Affiliation(s)
- Alexander Russell
- Sports Optimization & Rehabilitation Lab, University of Connecticut, Storrs, Connecticut, USA
| | - Benjamin Choi
- Sports Optimization & Rehabilitation Lab, University of Connecticut, Storrs, Connecticut, USA
| | - Davina Robinson
- Sports Optimization & Rehabilitation Lab, University of Connecticut, Storrs, Connecticut, USA
| | - Luis Penailillo
- School of Physical Therapy, Faculty of Rehabilitation Sciences, Institute of Exercise and Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Jacob E Earp
- Sports Optimization & Rehabilitation Lab, University of Connecticut, Storrs, Connecticut, USA
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Römer C, Czupajllo J, Wolfarth B, Sichting F, Legerlotz K. The Myometric Assessment of Achilles Tendon and Soleus Muscle Stiffness before and after a Standardized Exercise Test in Elite Female Volleyball and Handball Athletes-A Quasi-Experimental Study. J Clin Med 2024; 13:3243. [PMID: 38892954 PMCID: PMC11172482 DOI: 10.3390/jcm13113243] [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: 04/30/2024] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Background: The high prevalence of injuries in female athletes necessitates a course of action that not only enhances research in this field but also incorporates improved prevention programs and regular health monitoring of highly stressed structures such as tendons and muscles. Since myometry is already used by coaches and physiotherapists, it is important to investigate whether tissue stiffness varies in different types of sports, and whether such measures are affected by an acute training session. Methods: Myometric measurements of the Achilles tendon (AT) and soleus muscle (SM) were performed in the longitudinal plane and relaxed tendon position. In total, 38 healthy professional female athletes were examined, applying a quasi-experimental study design, with subgroup analysis performed for different sports. To investigate the stiffness of the AT and SM, 24 female handball and volleyball athletes performed a standardized maximal incremental performance test on a treadmill. In this subgroup, myometric measurements were taken before and after the exercise test. Results: The measurements showed no significant difference between the mean pre- (AT: 661.46 N/m; SM 441.48 N/m) and post-exercise stiffness (AT: 644.71 N/m; SM: 439.07 N/m). Subgroup analysis for different types of sports showed significantly lower AT and SM stiffness in swimming athletes compared to handball (p = 0.002), volleyball (p = 0.000) and hammer throw athletes (p = 0.008). Conclusions: Myometry can be performed on the same day as an acute training session in healthy female professional volleyball and handball athletes. Female swimmers have significantly lower AT and SM stiffness compared to female handball, volleyball and hammer throw athletes. These results show that the stiffness differences in the AT and SM can be assessed by myometry.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité University Medicine Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité University Medicine Berlin, 10115 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité University Medicine Berlin, 10115 Berlin, Germany
| | - Freddy Sichting
- Department of Human Movement Science, Chemnitz University of Technology, 09111 Chemnitz, Germany
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt University Berlin, 10115 Berlin, Germany
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7
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Lettner J, Królikowska A, Ramadanov N, Oleksy Ł, Hakam HT, Becker R, Prill R. Evaluating the Reliability of MyotonPro in Assessing Muscle Properties: A Systematic Review of Diagnostic Test Accuracy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:851. [PMID: 38929468 PMCID: PMC11205912 DOI: 10.3390/medicina60060851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro device offers a non-invasive method to comprehensively assess muscle biomechanical properties. This systematic review evaluates the reliability of MyotonPro across various muscles for diagnostic purposes. Materials and Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in Medline (PubMed), Ovid (Med), Epistemonikos, Embase, Cochrane Library, Clinical trials.gov, and the WHO International Clinical Trials platform. Studies assessing the reliability of MyotonPro across different muscles were included. A methodological quality assessment was performed using established tools, and reviewers independently conducted data extraction. Statistical analysis involved summarizing intra-rater and inter-rater reliability measures across muscles. Results: A total of 48 studies assessing 31 muscles were included in the systematic review. The intra-rater and inter-rater reliability were consistently high for parameters such as frequency and stiffness in muscles of the lower and upper extremities, as well as other muscle groups. Despite methodological heterogeneity and limited data on specific parameters, MyotonPro demonstrated promising reliability for diagnostic purposes across diverse patient populations. Conclusions: The findings suggest the potential of MyotonPro in clinical assessments for accurate diagnosis, treatment planning, and monitoring of muscle properties. Further research is needed to address limitations and enhance the applicability of MyotonPro in clinical practice. Reliable muscle assessments are crucial for optimizing treatment outcomes and improving patient care in various healthcare settings.
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Affiliation(s)
- Jonathan Lettner
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Tytusa Chalubinskiego 3, 50-368 Wroclaw, Poland;
| | - Nikolai Ramadanov
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Łukasz Oleksy
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland
- Department of Orthopaedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
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8
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Vatovec R, Grandovec A, Kozinc Ž, Voglar M. Effects of foam rolling on hamstrings stiffness in damaged and non-damaged muscle states. Front Physiol 2024; 15:1396361. [PMID: 38651043 PMCID: PMC11033509 DOI: 10.3389/fphys.2024.1396361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction: The aim of this study was to examine the effects of foam rolling (FR) on hamstring muscles stiffness in both non-damaged and exercise-induced muscle damage (EIMD) states, using shear wave ultrasound elastography to measure changes in shear modulus. Methods: Fourteen healthy adults (25.5 ± 4.7 years) participated in a within-participant repeated measures design, with a 2-minute FR intervention applied on one leg and contralateral leg serving as a control. The damaging protocol encompassed maximal eccentric knee extensions performed on an isokinetic dynamometer and the Nordic hamstring exercise, consisting of 3 sets of 10 and 6 repetitions, respectively. Measurement were taken at baseline and then 1 h, 24 h and 48 h after the damaging protocol. Results: The results indicated no significant time × leg interaction for shear modulus in biceps femoris, semimembranosus, and semitendinosus muscles in both non-damaged and damaged states. Notably, there was a significant increase in biceps femoris (p = 0.001; η2 = 0.36) and semitendinosus (p < 0.001; η2 = 0.44) shear modulus after EIMD, but no significant differences were found between the FR and control leg, which was also the case for muscle soreness, range of motion, and passive resistive torque (p = 0.239-0.999 for interactions). Discussion: The absence of significant changes post-FR intervention suggests a limited role of short-duration FR in altering muscle stiffness during recovery from EIMD. These findings contribute to the understanding of FR's role in muscle recovery. Although this was not directly investigated, our results suggest a predominance of central mechanisms rather than direct mechanical modifications in muscle properties. This research highlights the necessity for additional investigations to explore how FR interventions influence muscles in different states and to elucidate the mechanisms underlying these influences.
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Affiliation(s)
| | | | - Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
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9
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Day JM, Merriman H. Upper extremity soft tissue stiffness measured with shear wave elastography: A between-day reliability study. Shoulder Elbow 2024; 16:159-168. [PMID: 38655409 PMCID: PMC11034466 DOI: 10.1177/17585732231179115] [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: 12/19/2022] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 04/26/2024]
Abstract
Background Imbalances in soft tissue stiffness (STS) of the pectoralis and common wrist extensors (CWEs) can adversely alter upper extremity function. Shear wave elastography (SWE) has the capacity to provide precise, repeatable, objective data on STS. The purpose of this study was to determine the between-day intrarater reliability for the pectoralis and CWE tendon stiffness as measured by SWE. Methods STS measured by the shear wave modulus (kilopascals (kPa)) was captured bilaterally on the pectoralis major, pectoralis minor, and CWE tendon using 2D SWE ultrasound imaging (GE Logiq S8, 9 L transducer) on two separate days. Within examiner intraclass correlation coefficients (ICC (3, 3)) with 95% confidence intervals, standard error of the measure, and minimal detectable changes were calculated. Results The investigators recruited 10 healthy participants (mean age = 23.50 ± 1.43). Between day intrarater reliability values were obtained for the dominant pectoralis major ICC = 0.70 (-0.15, -0.93), nondominant pectoralis major ICC = 0.63 (-0.30, -0.91), dominant pectoralis minor ICC = 0 .72(-0.04, -0.93), nondominant pectoralis minor ICC = 0.75(0.08, -0.94), dominant CWE tendon ICC = 0.75(-0.08, -0.94), and nondominant CWE tendon ICC = 0.75(-0.12, -0.94). Discussion Our data demonstrate acceptable reliability but future studies should include methods that control for variables known to effect STS.
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Affiliation(s)
- Joseph M Day
- Department of Physical Therapy, University of Dayton, Ohio, USA
| | - Harold Merriman
- Department of Physical Therapy, University of Dayton, Ohio, USA
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10
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Melo AS, Montóia B, Cruz EB, Vilas-Boas JP, Sousa AS. Scapular muscle dynamic stiffness of asymptomatic subjects and subjects with chronic shoulder pain, at rest and isometric contraction conditions. Proc Inst Mech Eng H 2024; 238:288-300. [PMID: 38403635 DOI: 10.1177/09544119241228082] [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: 02/27/2024]
Abstract
Muscle stiffness had a crucial role in joint stability, particularly, at the shoulder complex. Although changes in upper trapezius muscle stiffness have been described for shoulder pain, contradictory findings have been obtained. Also, existing data regarding scapular muscles are, majorly, about trapezius. Myotonometry is a method used to assess stiffness; however, the reliability values of scapular muscle stiffness through this method have not been assessed in shoulder pain conditions. The present study aims to compare scapular muscles' stiffness (trapezius, serratus anterior, and levator scapulae) between subjects with and without chronic shoulder pain and to evaluate the related test-retest reliability. Twenty-two symptomatic and twenty-two asymptomatic subjects participated in a cross-sectional study. The dynamic muscular stiffness of scapular muscles, at rest and during an isometric contraction, was measured bilaterally with myotonometry, in two moments. The differences in bilateral averaged values between symptomatic and asymptomatic subjects and the effect of the group (group presenting pain in the dominant or non-dominant side, and asymptomatic group) and of the limb (unilateral painful or asymptomatic limb, and bilateral asymptomatic limbs) were investigated. Test-retest intra-rater reliability was determined. An effect of the group was observed at rest, for middle trapezius stiffness, and during contraction, for middle and lower trapezius stiffness. For middle trapezius, increased values were observed in the group presenting pain in non-dominant side comparing to both groups or to group presenting pain in dominant side. The intraclass correlation coefficient, majorly, ranged between 0.775 and 0.989. Participants with pain in the non-dominant side presented an increased middle trapezius' stiffness. Globally, high reliability was observed for scapular muscles dynamic stiffness.
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Affiliation(s)
- Ana Sc Melo
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Bárbara Montóia
- Escola Superior de Saúde, Politécnico do Porto, Porto, Portugal
| | - Eduardo B Cruz
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
- Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - J Paulo Vilas-Boas
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Andreia Sp Sousa
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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11
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Schoenrock B, Muckelt PE, Hastermann M, Albracht K, MacGregor R, Martin D, Gunga HC, Salanova M, Stokes MJ, Warner MB, Blottner D. Muscle stiffness indicating mission crew health in space. Sci Rep 2024; 14:4196. [PMID: 38378866 PMCID: PMC10879143 DOI: 10.1038/s41598-024-54759-6] [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: 11/07/2023] [Accepted: 02/16/2024] [Indexed: 02/22/2024] Open
Abstract
Muscle function is compromised by gravitational unloading in space affecting overall musculoskeletal health. Astronauts perform daily exercise programmes to mitigate these effects but knowing which muscles to target would optimise effectiveness. Accurate inflight assessment to inform exercise programmes is critical due to lack of technologies suitable for spaceflight. Changes in mechanical properties indicate muscle health status and can be measured rapidly and non-invasively using novel technology. A hand-held MyotonPRO device enabled monitoring of muscle health for the first time in spaceflight (> 180 days). Greater/maintained stiffness indicated countermeasures were effective. Tissue stiffness was preserved in the majority of muscles (neck, shoulder, back, thigh) but Tibialis Anterior (foot lever muscle) stiffness decreased inflight vs. preflight (p < 0.0001; mean difference 149 N/m) in all 12 crewmembers. The calf muscles showed opposing effects, Gastrocnemius increasing in stiffness Soleus decreasing. Selective stiffness decrements indicate lack of preservation despite daily inflight countermeasures. This calls for more targeted exercises for lower leg muscles with vital roles as ankle joint stabilizers and in gait. Muscle stiffness is a digital biomarker for risk monitoring during future planetary explorations (Moon, Mars), for healthcare management in challenging environments or clinical disorders in people on Earth, to enable effective tailored exercise programmes.
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Affiliation(s)
- Britt Schoenrock
- NeuroMuscular System & Signaling Group, Berlin Center of Space Medicine and Extreme Environments, 10115 Berlin, Germany, Institute of Integrative Neuroanatomy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany, 10115, Berlin, Germany
| | - Paul E Muckelt
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Maria Hastermann
- Experimental and Clinical Research Center (ECRC) and NeuroCure Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | - Hans-Christian Gunga
- Institute of Physiology, Berlin Center of Space Medicine and Extreme Environments, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany, Berlin, Germany
| | - Michele Salanova
- NeuroMuscular System & Signaling Group, Berlin Center of Space Medicine and Extreme Environments, 10115 Berlin, Germany, Institute of Integrative Neuroanatomy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany, 10115, Berlin, Germany
| | - Maria J Stokes
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Martin B Warner
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Dieter Blottner
- NeuroMuscular System & Signaling Group, Berlin Center of Space Medicine and Extreme Environments, 10115 Berlin, Germany, Institute of Integrative Neuroanatomy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany, 10115, Berlin, Germany.
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12
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Chang CH, Ho CS, Li F, Chen CY, Yeh HC, Ho CA. Acute effects of muscle mechanical properties after 2000-m rowing in young male rowers. PeerJ 2024; 12:e16737. [PMID: 38188161 PMCID: PMC10771759 DOI: 10.7717/peerj.16737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background The mechanical properties of muscles, such as changes in muscle tone and stiffness, are related to sports performance and injuries. Rowers are at increased risk of muscle fatigue and injury during high-repetition and heavy-load cyclic muscle actions. In view of this, the aim of the present study was to investigate the acute effect on muscle tone and stiffness, as well as bilateral muscle asymmetry, in high school rowers after a 2000-meter rowing ergometer test. Methods Twelve young male rowers (age = 17.1 ± 0.9 years, body weight = 73.5 ± 9.7 kg) were included in the study. The data of muscle tone (frequency) and stiffness of the posterior deltoids (PD), latissimus dorsi (LD), and rectus femoris (RF) (dominant and non-dominant side) before and after a 2000-m rowing ergometer test were collected using a handheld MyotonPRO device. Results After the rowing ergometer test, the muscle tone of dominant side PD, LD, and RF were significantly increased (p < 0.05). On the other hand, the muscle stiffness of the non-dominant side LD and RF, as well as the dominant side PD, LD, and RF were significantly increased after the rowing ergometer test (p < 0.05). The muscle tone and stiffness results showed that the dominant side PD, LD, and RF were all significantly higher than the non-dominant side after the rowing ergometer test (p < 0.05), where bilateral PD and RF exhibits moderate asymmetry (5% < symmetry index < 10%). Conclusions After a high-intensity and high-load 2000-m rowing ergometer test, PD, LD, and RF showed increases in muscle tone and stiffness, as well as changes in the symmetry of bilateral muscle mechanical properties.
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Affiliation(s)
- Chun-Hao Chang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Fang Li
- School of Physical Education, Central China Normal University, Wuhan City, Hubei Province, China
| | - Chao-Yuan Chen
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
- Sport Office, National Taipei University of Business, Taipei City, Taiwan
| | - Hung-Chih Yeh
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chia-An Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
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13
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Shan X, Umemoto K, Ishikawa T, Fukushige K, Takeuchi T, Naito M. Biomechanical assessment of gastrocnemii and Achilles tendon using MyotonPRO: in vivo measurements, and preliminary in situ measurements using formalin-fixed tissues. Connect Tissue Res 2024; 65:16-25. [PMID: 37830341 DOI: 10.1080/03008207.2023.2267682] [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: 05/16/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE This study aims to evaluate the reliability and validity of using MyotonPRO to quantify the mechanical properties of the muscle-tendon unit through in vivo measurements and preliminary in situ measurements using formalin-fixed tissues. MATERIALS AND METHODS The mechanical properties of gastrocnemii and the Achilles tendon of 12 healthy adults (six males and six females, 34.9 ± 5.8 years) were examined for in vivo test twice within a day and once post-24 hours using MyotonPRO, while nine human cadavers (formalin-fixed, 3 males and 6 females, 89.9 ± 5.1 years) were assessed for preliminary in situ test with identical time schedule to evaluate the within-day and inter-day reliability and validity. RESULTS In vivo tests had very high within-day (ICC: 0.96-0.99) and inter-day reliability (ICC: 0.83-0.96), while in situ tests (formalin-fixed tissues) showed high within-day (ICC: 0.87-0.99) and inter-day reliability (ICC: 0.76-0.98) for the results of tone and stiffness. There was no significant difference in the stiffness of the free part of the Achilles tendon between in vivo and in situ conditions. The stiffness of the lateral gastrocnemius (r = 0.55, p = 0.018), proximal part of the Achilles tendon (r = 0.56, p = 0.015), and free part of the Achilles tendon (r = 0.47, p = 0.048) before removing the skin was significantly correlated with that after removing the skin condition. CONCLUSIONS The findings of the current study suggest that MyotonPRO is reliable and valid for evaluating tendon stiffness both in vivo and in situ (formalin-fixed tissues).
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Affiliation(s)
- Xiyao Shan
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kanae Umemoto
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Takuro Ishikawa
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kaori Fukushige
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Takao Takeuchi
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Munekazu Naito
- Department of Anatomy, School of Medicine, Aichi Medical University, Nagakute, Japan
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14
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Suwankanit K, Shimizu M, Suzuki K, Kaneda M. Usefulness of Ultrasound Shear Wave Elastography for Detection of Quadriceps Contracture in Immobilized Rats. Animals (Basel) 2023; 14:76. [PMID: 38200807 PMCID: PMC10778017 DOI: 10.3390/ani14010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Quadriceps contracture is an abnormal pathological shortening of the muscle-tendon unit. To improve the prognosis of quadriceps contracture, improvement of its diagnostic method is needed. In this study, we evaluated the diagnostic utility of ultrasound shear wave elastography in a rat model of quadriceps contracture induced by immobilization. Fifty Wistar rats were randomly divided into control and immobilization groups. During up to 4 weeks of joint immobilization, the quadriceps elastic modulus, muscle hardness, creatinine phosphokinase levels, joint range of motion, histopathologic parameters, and levels of fibrosis-associated mRNA expression were measured every week in the immobilization and control groups and compared. In the immobilization group, the elastic modulus gradually but significantly increased (p < 0.05) throughout the immobilization period. However, muscle hardness and serum creatinine phosphokinase levels only increased at 1 and 2 weeks after the start of immobilization, respectively. Muscle atrophy and shortening progressed throughout the immobilization group. Collagen type I and III, α-SMA protein, and mRNA expression of IL-1β and TGF-β1 significantly increased (p < 0.05) throughout in the immobilization group. Ultrasound shear wave elastography is the most useful method for clinical assessment of muscle contracture.
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Affiliation(s)
- Kanokwan Suwankanit
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Miki Shimizu
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
| | - Kazuhiko Suzuki
- Laboratory of Veterinary Toxicology, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-0054, Japan;
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Tokyo 183-8509, Japan;
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15
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Götschi T, Snedeker JG, Fitze DP, Sarto F, Spörri J, Franchi MV. Three-dimensional mapping of ultrasound-derived skeletal muscle shear wave velocity. Front Bioeng Biotechnol 2023; 11:1330301. [PMID: 38179131 PMCID: PMC10764491 DOI: 10.3389/fbioe.2023.1330301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction: The mechanical properties of skeletal muscle are indicative of its capacity to perform physical work, state of disease, or risk of injury. Ultrasound shear wave elastography conducts a quantitative analysis of a tissue's shear stiffness, but current implementations only provide two-dimensional measurements with limited spatial extent. We propose and assess a framework to overcome this inherent limitation by acquiring numerous and contiguous measurements while tracking the probe position to create a volumetric scan of the muscle. This volume reconstruction is then mapped into a parameterized representation in reference to geometric and anatomical properties of the muscle. Such an approach allows to quantify regional differences in muscle stiffness to be identified across the entire muscle volume assessed, which could be linked to functional implications. Methods: We performed shear wave elastography measurements on the vastus lateralis (VL) and the biceps femoris long head (BFlh) muscle of 16 healthy volunteers. We assessed test-retest reliability, explored the potential of the proposed framework in aggregating measurements of multiple subjects, and studied the acute effects of muscular contraction on the regional shear wave velocity post-measured at rest. Results: The proposed approach yielded moderate to good reliability (ICC between 0.578 and 0.801). Aggregation of multiple subject measurements revealed considerable but consistent regional variations in shear wave velocity. As a result of muscle contraction, the shear wave velocity was elevated in various regions of the muscle; showing pre-to-post regional differences for the radial assessement of VL and longitudinally for BFlh. Post-contraction shear wave velocity was associated with maximum eccentric hamstring strength produced during six Nordic hamstring exercise repetitions. Discussion and Conclusion: The presented approach provides reliable, spatially resolved representations of skeletal muscle shear wave velocity and is capable of detecting changes in three-dimensional shear wave velocity patterns, such as those induced by muscle contraction. The observed systematic inter-subject variations in shear wave velocity throughout skeletal muscle additionally underline the necessity of accurate spatial referencing of measurements. Short high-effort exercise bouts increase muscle shear wave velocity. Further studies should investigate the potential of shear wave elastography in predicting the muscle's capacity to perform work.
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Affiliation(s)
- Tobias Götschi
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G. Snedeker
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Daniel P. Fitze
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Fabio Sarto
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
| | - Jörg Spörri
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Martino V. Franchi
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
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16
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Xu W, Zheng Y, Jiang Y, Zhang Z, Ma S, Cao Y. Shear wave imaging the active constitutive parameters of living muscles. Acta Biomater 2023; 166:400-408. [PMID: 37230437 DOI: 10.1016/j.actbio.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Shear wave elastography (SWE) of human skeletal muscles allows for measurement of muscle elastic properties in vivo and has important applications in sports medicine and for the diagnosis and treatment of muscle-related diseases. Existing methods of SWE for skeletal muscles rely on the passive constitutive theory and have so far been unable to provide constitutive parameters describing muscle active behavior. In the present paper, we overcome this limitation by proposing a SWE method for quantitative inference of active constitutive parameters of skeletal muscles in vivo. To this end, we investigate the wave motion in a skeletal muscle described by a constitutive model in which muscle active behavior has been defined by an active parameter. An analytical solution relating shear wave velocities to both passive and active material parameters of muscles is derived, based upon which an inverse approach has been developed to evaluate these parameters. To demonstrate the usefulness of the reported method, in vivo experiments were carried out on 10 volunteers to obtain constitutive parameters, particularly those describing active deformation behaviors of living muscles. The results reveal that the active material parameter of skeletal muscles varies with warm-up, fatigue and rest. STATEMENT OF SIGNIFICANCE: Existing shear wave elastography methods are limited to imaging the passive parameters of muscles. This limitation is addressed in the present paper by developing a method to image the active constitutive parameter of living muscles using shear waves. We derived an analytical solution demonstrating the relationship between constitutive parameters of living muscles and shear waves. Relying on the analytical solution, we proposed an inverse method to infer active parameter of skeletal muscles. We performed in vivo experiments to demonstrate the usefulness of the theory and method; the quantitative variation of the active parameter with muscle states such as warm-up, fatigue and rest has been reported for the first time.
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Affiliation(s)
- Weiqiang Xu
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yang Zheng
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yuxuan Jiang
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Zhaoyi Zhang
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Shiyu Ma
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yanping Cao
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China.
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17
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Konrad A, Tilp M, Mehmeti L, Mahnič N, Seiberl W, Paternoster FK. The Relationship Between Lower Limb Passive Muscle and Tendon Compression Stiffness and Oxygen Cost During Running. J Sports Sci Med 2023; 22:28-35. [PMID: 36876188 PMCID: PMC9982528 DOI: 10.52082/jssm.2023.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023]
Abstract
Studies have reported that a stiff triceps surae muscle and tendon-aponeurosis and also a more compliant quadriceps muscle and tendon-aponeurosis, are related to lower oxygen cost during running. However, to date, no study has investigated in a single experiment how oxygen cost during running is related to the stiffness of the free tendons (Achilles tendon, patellar tendon) and all the superficial muscles of two major muscle groups for running (i.e., quadriceps, triceps surae). Thus, 17 male trained runners/triathletes participated in this study and visited the laboratory on three occasions. On the first day, the participants were familiarized with the tests. On the second day, the passive compression stiffness of the triceps surae muscle (i.e., gastrocnemii), Achilles tendon, quadriceps muscle (i.e., vastii, rectus femoris), and patellar tendon was non-invasively measured using a digital palpation device (MyotonPRO). In addition, an incremental test was applied to test the VO2max of the participants. Thereafter, in the third visit, after at least 48-h of rest, participants performed a 15-min run on the treadmill with a speed reflecting a velocity of 70% VO2max, to assess oxygen costs during running. The Spearman correlation showed a significant negative correlation between passive Achilles tendon compression stiffness and running oxygen consumption, with a large effect size (rρ = -0.52; CI (95%) -0.81 to -0.33; P = 0.03). Moreover, no further significant relationship between oxygen cost during running and the passive compression stiffness of the quadriceps muscle and patellar tendon, as well as the triceps surae muscle, was detected. The significant correlation indicates that a stiffer passive Achilles tendon can lead to a lower oxygen cost during running. Future studies will have to test the causality of this relationship with training methods such as strength training that are able to increase the Achilles tendon stiffness.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
- Associate Professorship of Biomechanics in Sports, Technical University of Munich, Munich, Germany
| | - Markus Tilp
- Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
| | - Leutrim Mehmeti
- Associate Professorship of Biomechanics in Sports, Technical University of Munich, Munich, Germany
| | - Nik Mahnič
- Associate Professorship of Biomechanics in Sports, Technical University of Munich, Munich, Germany
| | - Wolfgang Seiberl
- Department of Human Sciences, Institute of Sport Science, Universität der Bundeswehr München, Neubiberg, Germany
| | - Florian K Paternoster
- Associate Professorship of Biomechanics in Sports, Technical University of Munich, Munich, Germany
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18
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Roth C, Schwiete C, Happ K, Rettenmaier L, Schoenfeld BJ, Behringer M. Resistance training volume does not influence lean mass preservation during energy restriction in trained males. Scand J Med Sci Sports 2023; 33:20-35. [PMID: 36114738 DOI: 10.1111/sms.14237] [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: 05/17/2022] [Revised: 08/04/2022] [Accepted: 09/12/2022] [Indexed: 12/24/2022]
Abstract
This study investigated the effects of a relatively high- versus moderate-volume resistance training program on changes in lean mass during caloric restriction. Thirty-eight resistance-trained males were randomized to perform either a high-volume (HVG; 5 sets/exercise) or a moderate-volume (MVG; 3 sets/exercise) resistance training program. Both groups were supervised during lower body training. Participants consumed 30 kcal/kg for 6 weeks after 1 week of weight maintenance (45 kcal/kg), with protein intake fixed at 2.8 g/kg fat-free mass. Muscle thickness of the m. rectus femoris, body composition, contractile properties, stiffness, mood, and sleep status were assessed at pre-, mid-, and post-study. No significant group × time interaction was observed for muscle thickness of the m. rectus femoris at 50% (∆ [post-pre] 0.36 ± 0.93 mm vs. ∆ -0.01 ± 1.59 mm; p = 0.226) and 75% length (∆ -0.32 ± 1.12 mm vs. ∆ 0.08 ± 1.14 mm; p = 0.151), contractility, sleep, and mood in the HVG and MVG, respectively. Body mass (HVG: ∆ -1.69 ± 1.12 kg vs. MVG: ∆ -1.76 ± 1.76 kg) and lean mass (∆ -0.51 ± 2.30 kg vs. ∆ -0.92 ± 1.59 kg) decreased significantly in both groups (p = 0.022), with no between-group difference detected (p = 0.966). High-volume resistance training appears to have neither an advantage nor disadvantage over moderate-volume resistance training in terms of maintaining lean mass or muscle thickness. Given that both groups increased volume load and maintained muscle contractility, sleep quality, and mood, either moderate or higher training volumes conceivably can be employed by resistance-trained individuals to preserve muscle during periods of moderate caloric restriction.
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Affiliation(s)
- Christian Roth
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Carsten Schwiete
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Kevin Happ
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Lukas Rettenmaier
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Brad J Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, New York, USA
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
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19
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Çevik Saldıran T, Kara İ, Kutlutürk Yıkılmaz S. Quantification of the forearm muscles mechanical properties using Myotonometer: Intra- and Inter-Examiner reliability and its relation with hand grip strength. J Electromyogr Kinesiol 2022; 67:102718. [PMID: 36334405 DOI: 10.1016/j.jelekin.2022.102718] [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: 07/23/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022] Open
Abstract
The primary objective of this study was to investigate the reliability of the myotonometer in the mechanical properties of the forearm muscles [m. extensor carpi radialis brevis (ECRB), and m. flexor carpi ulnaris (FCU)] in healthy individuals. The secondary objective was to investigate the relationship between the handgrip strength and mechanical properties of these forearm muscles. The mechanical properties (muscle tone, stiffness, and elasticity) of the ECRB and FCU were measured using the MyotonPRO device. Examiner 1 performed two sets of measurements with a time interval of 30 min to determine intra-examiner reliability. Examiner 2 performed measurements during the interval between the two sets of examiner 1. The intra- and inter-examiner reliabilities were excellent (ICC˃0.82) for muscle tone, stiffness, and elasticity of the FCU. Both intra- and inter-examiner reliability in the evaluation of ECRB muscle tone, elasticity, and stiffness was moderate to excellent (ICCs = 0.56-0.98). The muscle tone and stiffness properties of the FCU were positively correlated with the handgrip strength (p <.05). The study findings indicate that the MyotonPRO device is a reliable tool to quantify ECRB, and FCU muscles mechanical properties in healthy individuals.
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Affiliation(s)
- Tülay Çevik Saldıran
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bitlis Eren University, Bitlis, Turkey.
| | - İlke Kara
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bitlis Eren University, Bitlis, Turkey; Department of Physical Therapy and Rehabilitation, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Seval Kutlutürk Yıkılmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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20
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Bravo-Sánchez A, Abián P, Sánchez-Infante J, Ramírez-delaCruz M, Esteban-García P, Jiménez F, Abián-Vicén J. Five-Compressions Protocol as a Valid Myotonometric Method to Assess the Stiffness of the Lower Limbs: A Brief Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14425. [PMID: 36361308 PMCID: PMC9654301 DOI: 10.3390/ijerph192114425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The objective of this study was to evaluate the validity of a short assessment MyotonPRO protocol to measure the stiffness of the superficial muscles and tendons of the lower limbs. The stiffness of the dominant lower limb vastus lateralis (VL), rectus femoris (RF) and patellar tendon (PT) was evaluated in 52 healthy participants (26.9 ± 3.4 years) with two MyotonPRO protocols: the standard protocol (10 mechanical taps) and the short protocol (five mechanical taps). The myotonometry was performed at the midpoint of the length from the upper pole of the patella to the greater trochanter for the VL, and to the anterior superior iliac spine for the RF. The PT was evaluated 1 cm caudal from the inferior pole of the patella. Pearson's correlation coefficients were calculated to determine the relationships between protocols. The validity of the short protocol was evaluated with Student's t-test. High positive correlations were observed between the short and standard protocols in the stiffness of the VL (r = 0.959; p < 0.001), the RF (r = 0.967; p < 0.001) and the PT (r = 0.953; p < 0.001) and no differences were found between both protocols in the stiffness assessment of the VL, RF and PT (p > 0.05). Therefore, the five-compressions protocol is a valid protocol for the assessment of lower limb mechanical properties.
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Affiliation(s)
- Alfredo Bravo-Sánchez
- Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Pablo Abián
- Faculty of Humanities and Social Sciences, Comillas Pontifical University, C. Alberto Aguilera 23, 28049 Madrid, Spain
| | | | - María Ramírez-delaCruz
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Paula Esteban-García
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Fernando Jiménez
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
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Lall PS, Alsubiheen AM, Aldaihan MM, Lee H. Differences in Medial and Lateral Gastrocnemius Stiffness after Exercise-Induced Muscle Fatigue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113891. [PMID: 36360770 PMCID: PMC9656849 DOI: 10.3390/ijerph192113891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 06/10/2023]
Abstract
Muscles are affected at the cellular level by exercised-induced fatigue, inducing changes in their stiffness. Examining muscle stiffness can improve the knowledge of various pathologic conditions, such as pain and injury. The objective of this study was to examine the stiffness of the medial gastrocnemius (MG) muscle and the lateral gastrocnemius (LG) muscle to determine the changes in stiffness, and to assess the differences in the stiffness between the MG and the LG, as affected by muscle fatigue measured using shear wave elastography (SWE) and a MyotonPRO after inducing muscle fatigue. A total of 35 healthy young adults participated in the study. The stiffness of the MG and the LG were assessed before and after a muscle fatigue protocol (MFP), which included three sets of 50 eccentric contractions of the calf muscles of the dominant leg, at rest, and at maximum voluntary contraction (MVC). The measurements were taken with SWE and the MyotonPRO simultaneously. Compared to baseline, the resting stiffness of the MG and the LG significantly increased immediately, 24 h, and 48 h after muscle fatigue (p < 0.05); however, during MVC, the stiffness of the MG decreased (p < 0.05) and that of the LG showed no change (p > 0.05). When the stiffness of the MG and the LG were compared before and after the MFP, changes in the stiffness of the MG were significantly greater than those in the LG (p < 0.05). This signifies that the MG was more affected by the exercise-induced muscle fatigue than was the LG. The assessment of musculoskeletal tissue and its characteristics, before and after eccentric exercise, is crucial in the prevention of overuse injuries associated with repeated exposure to both low and high levels of force.
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Affiliation(s)
- Prarthana Sanya Lall
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
| | - Abdulrahman M. Alsubiheen
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mishal M. Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Hanuel Lee
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
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Römer C, Czupajllo J, Zessin E, Fischer T, Wolfarth B, Lerchbaumer MH. Muscle and Tendon Stiffness of the Lower Limb of Professional Adolescent Soccer Athletes Measured Using Shear Wave Elastography. Diagnostics (Basel) 2022; 12:diagnostics12102453. [PMID: 36292143 PMCID: PMC9601169 DOI: 10.3390/diagnostics12102453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/14/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While adolescents have specific risk factors for acute and chronic injury, there is a lack of preventive medicine algorithms for this vulnerable group. Shear wave elastography (SWE) is currently mainly used for assessing muscle and tendon stiffness in adult athletes and can diagnose tissue pathologies such as tendinopathy. The aim was to investigate differences in quadriceps tendon and muscle stiffness between adolescent and adult professional soccer players using SWE and identify lateral imbalances in order to improve the knowledge of preventive medicine algorithms for professional adolescent athletes. METHODS Standardized SWE examinations of both lower limb tendons and muscles (the quadriceps tendon (QT) and the vastus medialis (VM) muscle) in the longitudinal plane and relaxed tendon position were performed in 13 healthy adolescent soccer athletes (13-17 years), and a control group of 19 healthy adult professional soccer athletes (18-29 years). RESULTS Adolescent soccer players had lower stiffness values for both the quadriceps tendon (3.11 m/s vs. 3.25 m/s) and the vastus medialis muscle (1.67 m/s vs. 1.71 m/s) than adult athletes. Moreover, QT stiffness in adolescent soccer players was significantly lower on the right side (QT: adult 3.50 m/s (2.73-4.56) vs. adolescent 2.90 m/s (2.61-3.12); p = 0.031). Analysis of the lateral differences revealed softer QT and VM tissue on the right side in over two-thirds of adolescent soccer athletes. Over two-thirds of adults had stiffer QT and VM tissue on the right side. CONCLUSION In adolescent soccer players, the stiffness of the QT and VM muscle measured by SWE is lower in the right leg. SWE of the musculoskeletal system may thus become a relevant diagnostic tool to detect early lateral imbalances as a main risk factor for injury and may thus contribute to the prevention of acute and chronic injury prevention in adolescent athletes.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Markus Herbert Lerchbaumer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450657084
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Römer C, Czupajllo J, Wolfarth B, Lerchbaumer MH, Legerlotz K. Effects of orally administered hormonal contraceptives on the musculoskeletal system of healthy premenopausal women-A systematic review. Health Sci Rep 2022; 5:e776. [PMID: 35957969 PMCID: PMC9364327 DOI: 10.1002/hsr2.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/12/2022] [Accepted: 07/17/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction The musculoskeletal system (MSK) is one of the extragonadal target tissues of sex hormones: osteoblasts and osteocytes express estrogen receptors, while in fibroblasts of the anterior cruciate ligament (ACL) and myocytes of the vastus lateralis muscle (MVL), estrogen and progesterone receptors can be detected by immunoassay. Indeed, upon binding of sex hormones to the extragonadal receptors, the MSK seems to respond to varying levels of sex hormones with structural adaptation. Hormonal contraceptives can affect the musculoskeletal system; however, there is a lack of high-quality studies, and no recommendation for female athletes exists. Material and Methods This is a systematic review of publications on the effects of oral hormonal contraceptives on the biomechanical properties of tendons, muscles and ligaments, muscle strength, and soft tissue regeneration. A systematic database search was performed using MESH keywords and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology in Pubmed and Cochrane to identify studies investigating the influence of oral hormonal contraceptives on muscles, tendons, and ligaments of healthy, adult, premenopausal women. The risk of bias in the studies included was assessed by two independent researchers using the ROBINS-I Tool. Results Nine comparative studies were identified that met the inclusion criteria. Endpoints were muscle strength and biomechanical tissue properties. No significant influence of oral hormonal contraceptives on muscle strength was found, although general muscle growth and Type I fiber growth were found to be significantly increased in a dose-dependent manner. There was a negative effect on regeneration of muscle strength after exercise. The stiffness of tendons remained unchanged, while their size adaptation to load increased. Conclusion The anabolic effect could be beneficial for specific sports, whereas reduced muscle regeneration could be disadvantageous for women exercising with high-performance demands. The different effects on tendons and ligaments and the functional consequences of altered ligament and muscle stiffness, especially with regard to synthetic hormones, should be further investigated.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité—University Medicine BerlinHumboldt‐University of BerlinBerlinGermany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité—University Medicine BerlinHumboldt‐University of BerlinBerlinGermany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité—University Medicine BerlinHumboldt‐University of BerlinBerlinGermany
| | - Markus H. Lerchbaumer
- Department of RadiologyCharité—University Medicine Berlin, Humboldt‐University of BerlinBerlinGermany
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport SciencesHumboldt‐University of BerlinBerlinGermany
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Cruz-Montecinos C, Besomi M, Acevedo-Valenzuela N, Cares-Marambio K, Bustamante A, Guzmán-González B, Tapia-Malebrán C, Sanzana-Cuche R, Calatayud J, Méndez-Rebolledo G. Soleus muscle and Achilles tendon compressive stiffness is related to knee and ankle positioning. J Electromyogr Kinesiol 2022; 66:102698. [PMID: 36007467 DOI: 10.1016/j.jelekin.2022.102698] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/15/2022] Open
Abstract
Changes in fascicle length and tension of the soleus (SOL) muscle have been observed in humans using B-mode ultrasound to examine the knee from different angles. An alternative technique of assessing muscle and tendon stiffness is myometry, which is non-invasive, accessible, and easy to use. This study aimed to estimate the compressive stiffness of the distal SOL and Achilles tendon (AT) using myometry in various knee and ankle joint positions. Twenty-six healthy young males were recruited. The Myoton-PRO device was used to measure the compressive stiffness of the distal SOL and AT in the dominant leg. The knee was measured in two positions (90° of flexion and 0° of flexion) and the ankle joint in three positions (10° of dorsiflexion, neutral position, and 30° of plantar flexion) in random order. A three-way repeated-measures ANOVA test was performed. Significant interactions were found for structure × ankle position, structure × knee position, and structure × ankle position × knee position (p < 0.05). The AT and SOL showed significant increases in compressive stiffness with knee extension over knee flexion for all tested ankle positions (p < 0.05). Changes in stiffness relating to knee positioning were larger in the SOL than in the AT (p < 0.05). These results indicate that knee extension increases the compressive stiffness of the distal SOL and AT under various ankle joint positions, with a greater degree of change observed for the SOL. This study highlights the relevance of knee position in passive stiffness of the SOL and AT.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile; Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Northern Metropolitan Health Service, Santiago, Chile.
| | - Manuela Besomi
- Carrera de Kinesiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Chile; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Nicolás Acevedo-Valenzuela
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Kevin Cares-Marambio
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Alejandro Bustamante
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Benjamín Guzmán-González
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Claudio Tapia-Malebrán
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rodolfo Sanzana-Cuche
- Department of Anatomy and Legal Medicine Faculty of Medicine, University of Chile, Chile; Facultad de Medicina y Ciencia, Universidad San Sebastián, Sede Los Leones, Chile
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain
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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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Saldiran TÇ, Yazgan P, Akgöl AC, Mutluay FK. Radial shock-wave therapy for frozen shoulder patients with type 2 diabetes mellitus: a pilot trial comparing two different energy levels. Eur J Phys Rehabil Med 2022; 58:412-422. [PMID: 35191654 PMCID: PMC9980541 DOI: 10.23736/s1973-9087.22.07087-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Extracorporeal shock-wave therapy (ESWT) is highly recommended for the management of orthopedic shoulder pathologies. Yet, the clinical relevance of the dose difference effect of radial ESWT approaches in the management of frozen shoulder patients with type 2 diabetes mellitus remains uncertain. AIM The aim was to examine the short-term effects of medium-and high-energy levels of radial ESWT (rESWT) in the treatment of frozen shoulder patients with type 2 diabetes mellitus. DESIGN Prospective clinical pilot study. SETTING This study was conducted in an outpatient clinic. POPULATION Thirty-nine patients who had frozen shoulder untreated for at least 3 months, diagnosed with type 2 diabetes mellitus for ≥3 years were included. METHODS The patients were randomly allocated to receive either high-energy rESWT (hrESWT), or medium-energy rESWT (mrESWT) or placebo at 8 Hz twice a week for six weeks. The primary outcome measure was pain, evaluated by the Visual Analog Scale (VAS) Score. Secondary outcome measures were function evaluated by the Shoulder Pain and Disability Index (SPADI) Score, and shoulder active range of motion (AROM). The mechanical properties of the deltoid and trapezius muscles were assessed using the MyotonPRO (Myoton AS, Tallinn, Estonia). RESULTS The mrESWT resulted in statistically significant reductions in night pain at 6 weeks (η<inf>p</inf>2=0.27, P=0.003). Significantly improved function (SPADI scores: -35.42±21.29 vs.-29.59±22.60; η<inf>p</inf>2=0.39, P˂0.001) was found in both hrESWT and mrESWT group by 6 weeks. Significantly higher mean shoulder AROM values were recorded for external rotation (η<inf>p</inf>2=0.53, P<0.001), and internal rotation (η<inf>p</inf>2=0.21, P=0.020), in the hrESWT group at the 6th week. A significantly improved resting tone (η<inf>p</inf>2=0.58) and stiffness of deltoid muscle (η<inf>p</inf>2=0.62) were found in the mrESWT group (P<0.001). The trapezius muscle resting tone reduced with hrESWT (η<inf>p</inf>2=0.17, P=0.033). CONCLUSIONS Regardless of the energy levels, rESWT appears to be an effective therapeutic intervention for frozen shoulder patients with type 2 diabetes mellitus in the short-term results. CLINICAL REHABILITATION IMPACT Our results suggest that this rESWT can be a useful strategy for the rehabilitation of frozen shoulder patients with type 2 diabetes mellitus. This is the first study on dose difference effectiveness in terms of the clinical significance of rESWT which is key to transfer research evidence into practice.
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Affiliation(s)
- Tülay Ç Saldiran
- School of Health Sciences, Department of Physiotherapy and Rehabilitation, Bitlis Eren University, Bitlis, Turkey -
| | - Pelin Yazgan
- Department of Physical Therapy and Medicine, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey
| | - Ahmet C Akgöl
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Okan University, Istanbul, Turkey
| | - Fatma K Mutluay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Khowailed IA, Lee Y, Lee H. Assessing the differences in muscle stiffness measured with shear wave elastography and myotonometer during the menstrual cycle in young women. Clin Physiol Funct Imaging 2022; 42:320-326. [PMID: 35596621 DOI: 10.1111/cpf.12763] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/15/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022]
Abstract
This study assessed the differences in muscle stiffness of the medial gastrocnemius (MG) and tibialis anterior (TA) muscles at rest and contraction during ovulation and follicular phase (menstruation) in women with regular menstrual cycle. Thirty-four young healthy women (mean age 21.3 ± 1.3 years) with regular menstrual cycles participated in this study. Stiffness of the TA and MG muscles at rest and voluntary contraction during ovulation and follicular phase in young women were measured using shear-wave elastography (SWE) and the handheld myotonometer MyotonPRO. The absolute stiffness difference between resting and contraction was expressed as the stiffness increase rate (SIR). The stiffness of the MG and TA at the resting position was not significantly different between the two phases of the menstrual cycle (p > .05). A significantly greater stiffness of both muscles measured using MyotonPRO in the follicular phase than during ovulation was found (p < .05), while stiffness measured by SWE showed a difference only in the TA muscle during contraction (p < .05). In addition, there were no significant differences in the SIR of both muscles between the two phases (p > .05). The results of our study showed a significantly greater stiffness of the MG and TA muscles at the follicular phase than at ovulation during contraction only. As muscle stiffness affects the risk of injury owing to reduced stability during sports activities, these changes in mechanical properties during the menstrual cycle should be noted, and training strategies should be used in female athletes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Iman Akef Khowailed
- Doctor of Physical Therapy Program, College of Rehabilitative Sciences, University of St Augustine for Health Sciences, San Marcos, CA, USA
| | - Youngjin Lee
- Department of Radiological Science, Gachon University, Incheon, Korea
| | - Haneul Lee
- Department of Physical Therapy, Gachon University, Incheon, Korea
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Kim N, Park J, Shin H, Bae Y. Gastrocnemius Medial Head Stiffness Is Associated with Potential Fall Risk in Community-Dwelling Older Adults. Healthcare (Basel) 2022; 10:healthcare10050785. [PMID: 35627922 PMCID: PMC9141566 DOI: 10.3390/healthcare10050785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to compare the muscle strength, balance ability, thickness, and stiffness of the tibialis anterior and gastrocnemius muscle in the elderly, with (fallers) and without (non-fallers) fall experience, and confirmed the correlation between the variables mentioned above and muscle stiffness in the faller. We selected 122 elderly participants, comprising 40 fallers and 82 non-fallers, and measured the muscle strength of the tibialis anterior (TA) and the gastrocnemius (GA). Balance ability was measured by the functional reach test (FRT), timed up and go test (TUG), short physical performance battery (SPPB), and gait speed (GS). We used shear wave elastography (SWE) to determine the thickness of the TA and the medial (GAmed) and lateral head (GAlat) of the gastrocnemius and the stiffness during relaxation and contraction. Balance ability, except muscle strength, was significantly lower in fallers compared with non-fallers. The GAmed and GAlat thickness were significantly lower in fallers than that in non-fallers. In fallers, the thickness, rest, and contractive stiffness of GAmed were correlated with the FRT, GS, SPPB. Low rest and GAmed contractive stiffness were related to lower balance ability in fallers. The muscle stiffness measurement using SWE was a novel method to assess potential fall risk.
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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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Dieterich AV, Haueise A, Gizzi L. [Feeling stiff…but what does it mean objectively? : Can you measure muscle tension?]. Schmerz 2022; 36:242-247. [PMID: 35301591 PMCID: PMC9300510 DOI: 10.1007/s00482-022-00636-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 10/27/2022]
Abstract
Almost everyone is familiar with "tense muscles", but what is muscle tension physiologically behind? Are tense muscles more active; do they have problems relaxing? Are they harder or stiffer than asymptomatic muscles? In this work, current evidence regarding the activity and stiffness of tense neck muscles is presented. Further, measurement methods and their limitations are explained. These limitations reveal the shortcomings of the current knowledge and the need for further research. Finally, a recently funded research project on the measurement of tense muscles is presented.
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Affiliation(s)
- A V Dieterich
- Studiengang Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, Konrad-Goldmann-Str. 7, 79100, Freiburg i.B., Deutschland.
| | - A Haueise
- Studiengang Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, Konrad-Goldmann-Str. 7, 79100, Freiburg i.B., Deutschland
| | - L Gizzi
- Institute for Modelling and Simulation of Biomechanical Systems, Universität Stuttgart, Pfaffenwaldring 4f, 70569, Stuttgart, Deutschland
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31
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No Association between Jump Parameters and Tissue Stiffness in the Quadriceps and Triceps Surae Muscles in Recreationally Active Young Adult Males. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While the main contributor for drop jump (DJ) performance is the calf muscle–tendon unit (MTU), for countermovement jump (CMJ) performance, it is the quadriceps MTU. However, to date, it is not clear if the muscle and/or tendon stiffness of the respective MTUs can be related to DJ or CMJ performance. Therefore, the purpose of this study was to investigate the relationships between DJ and CMJ performance parameters and tissue stiffness (i.e., muscle stiffness, tendon stiffness) of the calf MTU and quadriceps MTU, respectively. Consequently, with 16 healthy volunteers, the tissue stiffness of the gastrocnemius medialis (GM), gastrocnemius lateralis (GL) Achilles tendon (AT), vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), and patellar tendon (PT) were recorded with a Myoton device. Moreover, DJ and CMJ performances were assessed with a force plate. The alpha level was set to 0.05. Pearson correlation coefficients revealed no significant association between DJ performance and GM, GL, or AT stiffness (−0.07 to 0.24; p > 0.05). Similarly, no association was found between CMJ performance parameters and VM, VL, RF, or PT stiffness (−0.13–0.36; p > 0.05). According to our results, other variables, such as jump technique, body weight, or strength, were likely play a more important role in DJ and CMJ performance.
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32
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Lee MT, Wu CY, Chen CW, Cheng HL, Chen CC, Hsieh YW. Age and sex differences in the biomechanical and viscoelastic properties of upper limb muscles in middle-aged and older adults: A pilot study. J Biomech 2022; 134:111002. [DOI: 10.1016/j.jbiomech.2022.111002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/24/2021] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
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Do Y, Lall PS, Lee H. Assessing the Effects of Aging on Muscle Stiffness Using Shear Wave Elastography and Myotonometer. Healthcare (Basel) 2021; 9:healthcare9121733. [PMID: 34946459 PMCID: PMC8700831 DOI: 10.3390/healthcare9121733] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/05/2022] Open
Abstract
The current study investigated the differences in muscle stiffness between older and young adults at rest and during contraction. We also evaluated the differences in muscle stiffness assessments using a myotonometer (MyotonPRO) and shear wave elastography (SWE). Twenty-two older adults (mean age, 66.6 ± 1.6 years) and 23 young adults (mean age, 66.6 ± 1.6 years) participated in this study. Muscle stiffness of the tibialis anterior (TA) and medial gastrocnemius (MG) muscles at rest and during contraction were measured using SWE and the MyotonPRO. The stiffness increase rate (SIR) was also calculated to determine the absolute stiffness difference. The mean muscle stiffness of the TA and MG muscles was significantly lower in older adults than in young adults at rest and during contraction (p < 0.05). Similarly, the SIR values of the TA and MG were significantly lower in older adults than in young adults (p < 0.05). Our results indicate that both instruments could be used to quantify muscle stiffness changes and serve as a cornerstone for assessing aging-related losses in muscle function. Stiffness measures may help exercise professionals to develop an in-depth understanding of muscle impairment at the tissue level.
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Affiliation(s)
| | | | - Haneul Lee
- Correspondence: ; Tel.: +(82)-32-820-4335; Fax: +(82)-32-820-4420
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Bramley JL, Worsley PR, Bader DL, Everitt C, Darekar A, King L, Dickinson AS. Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation. Ann Biomed Eng 2021; 49:3176-3188. [PMID: 34580782 PMCID: PMC8671271 DOI: 10.1007/s10439-021-02858-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/20/2021] [Indexed: 12/03/2022]
Abstract
Despite the potential for biomechanical conditioning with prosthetic use, the soft tissues of residual limbs following lower-limb amputation are vulnerable to damage. Imaging studies revealing morphological changes in these soft tissues have not distinguished between superficial and intramuscular adipose distribution, despite the recognition that intramuscular fat levels indicate reduced tolerance to mechanical loading. Furthermore, it is unclear how these changes may alter tissue tone and stiffness, which are key features in prosthetic socket design. This study was designed to compare the morphology and biomechanical response of limb tissues to mechanical loading in individuals with and without transtibial amputation, using magnetic resonance imaging in combination with tissue structural stiffness. The results revealed higher adipose infiltrating muscle in residual limbs than in intact limbs (residual: median 2.5% (range 0.2-8.9%); contralateral: 1.7% (0.1-5.1%); control: 0.9% (0.4-1.3%)), indicating muscle atrophy and adaptation post-amputation. The intramuscular adipose content correlated negatively with daily socket use, although there was no association with time post-amputation. Residual limbs were significantly stiffer than intact limbs at the patellar tendon site, which plays a key role in load transfer across the limb-prosthesis interface. The tissue changes following amputation have relevance in the clinical understanding of prosthetic socket design variables and soft tissue damage risk in this vulnerable group.
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Affiliation(s)
- J L Bramley
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Mailpoint M7, University Road, Southampton, SO17 1BJ, UK
| | - P R Worsley
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - D L Bader
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - C Everitt
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Darekar
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - L King
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A S Dickinson
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Mailpoint M7, University Road, Southampton, SO17 1BJ, UK.
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The Relation of Body Mass Index to Muscular Viscoelastic Properties in Normal and Overweight Individuals. ACTA ACUST UNITED AC 2021; 57:medicina57101022. [PMID: 34684059 PMCID: PMC8537384 DOI: 10.3390/medicina57101022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023]
Abstract
Background: The body mass index (BMI) is closely related to fat tissue, which may have direct or indirect effects on muscle function. Previous studies have evaluated BMI and muscle viscoelastic properties in vivo in older people or individual sexes; however, the relationship between BMI and muscular viscoelastic properties is still unknown. Aims: The purpose of this study was to determine the correlation of BMI with muscular viscoelastic properties, and to compare these properties in a young sedentary population with normal and overweight individuals. Methods: A total of 172 healthy sedentary individuals (mean age, 26.00 ± 5.45 years) were categorized by sex (male and female) and BMI classification (normal (BMI, 18.50-24.99 kg/m2), overweight (BMI = 25.00-29.99 kg/m2)). Body weight was evaluated using an electronic scale, while height was measured using a standard stadiometer. BMI was calculated by dividing the weight in kilograms by the square of height in meters. The viscoelastic properties (tone, stiffness, and elasticity) of the biceps brachii (BB) and biceps femoris (BF) muscles were measured bilaterally using the MyotonPRO device at rest. Results: The bilateral BF tone and stiffness, right BB stiffness, and elasticity showed weak correlations with BMI in all participants. Furthermore, the bilateral BF tone and stiffness, right BB stiffness and elasticity, and left BB stiffness were weakly positively correlated with male sex. Only the right BB elasticity was weakly positively correlated with BMI in females (p < 0.05). No correlation with BMI was determined for other viscoelastic properties (p > 0.05). The overweight group showed increased bilateral BF stiffness and tone, right BB stiffness, and reduced bilateral BB elasticity compared to the normal-weight group (p < 0.05), while other viscoelastic properties were similar (p > 0.05). Greater bilateral BB tone, BF tone and stiffness, and lower BF elasticity were observed in males than in females (p < 0.05), but other viscoelastic properties were not significantly different (p < 0.05). No effect of BMI-sex interactions was found on viscoelastic properties (p > 0.05). Conclusions: The BB and BF viscoelastic properties were weakly correlated with BMI. Males showed greater muscle tone and stiffness, and lower elasticity. The overweight individuals showed increased stiffness and tone, particularly in lower extremities, and reduced elasticity in upper extremities. The effect of BMI-sex interactions on the viscoelastic properties was not clear. Higher BMI (increased mechanical load) might cause the human body to develop different muscular viscoelastic adaptations in the extremities.
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Hodgkinson D, Prasad S, Antoun JS, Mei L, Farella M. Biomechanical properties of the lips in a pre-orthodontic sample of adolescents and young adults. Eur J Orthod 2021; 44:232-239. [PMID: 34401897 DOI: 10.1093/ejo/cjab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To assess biomechanical properties of the lip muscles and to investigate their relationship with sex, age, body mass index (BMI), and cephalometric variables. MATERIALS AND METHODS Demographic information and BMI were collected from 83 study participants seeking orthodontic treatment at the University of Otago. Tone, stiffness, and elasticity of the lip muscles were measured thrice at four different anatomical sites using a digital palpation device. To estimate method error, a duplicate set of measurements in a subsample of 20 participants was taken a week later. Sagittal and vertical cephalometric classifications were based on ANB and FMPA angles, respectively. Data were analysed using mixed models. RESULTS Biomechanical properties of lip muscles were remarkably consistent both within and between different recording sessions. The lower lip had higher tone and stiffness than the upper lip. Both the upper and lower lip stiffness and tone were higher in females than in males, whereas upper lip elasticity was higher in males. Thinner upper lips had higher tone and were stiffer than thicker upper lips, whereas thinner lower lips were less elastic than thicker lower lips. Muscle tone and stiffness of both the upper and lower lips were lower in Class III than in Class I and Class II individuals. The upper lip of hyperdivergent individuals was less elastic than that of normodivergent and hypodivergent individuals, and stiffer than that of hypodivergent individuals. CONCLUSIONS The biomechanical properties of perioral soft tissues can be reliably measured and vary with anatomical site, sex, and cephalometric measurements.
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Affiliation(s)
- Danielle Hodgkinson
- Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sabarinath Prasad
- Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Joseph S Antoun
- Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Li Mei
- Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.,Department of Surgical Science, University of Cagliari, Italy
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Preliminary Assessment of Muscle Activity and Muscle Characteristics during Training with Powered Robotic Exoskeleton: A Repeated-Measures Study. Healthcare (Basel) 2021; 9:healthcare9081003. [PMID: 34442139 PMCID: PMC8392199 DOI: 10.3390/healthcare9081003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
A variety of robotic exoskeletons have been developed for patients with spinal cord injuries. However, the optimal training method and period for using a robotic exoskeleton have been uncertain until now. The purpose of this study is to determine the minimum training period for using a robotic exoskeleton with minimal muscle activity by investigating the changes in muscle activity and muscle characteristics of healthy adults during robotic exoskeleton training. A total of 16 people participated in the study. The robotic exoskeleton locomotion training consisted of three 50-min sessions a week for 7 weeks. The assessment consisted of sitting, standing, wide standing, sit-to-stand, and stand-to-sit where muscle activity and muscle characteristics were measured during each motion. All measurements were performed in the first session and every five sessions. Participants showed decreased muscle activity up to 10 sessions of training in the standing position, and 15 sessions in sit-to-stand and stand-to-sit motions. Upper extremity muscles showed decreased muscle activity, tone, stiffness, and logarithmic decrement up to the 15th session. The study results show that at least 15 training sessions are required to use the robotic exoskeleton with minimal load on the musculoskeletal system, and longer training is required for patients with spinal cord injury.
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38
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Wang L, Guo X, Tan L, Chen Q. Quantitative assessment of normal middle deltoid muscle elasticity at various arm abduction using ultrasound shear wave elastography. Sci Rep 2021; 11:12479. [PMID: 34127765 PMCID: PMC8203697 DOI: 10.1038/s41598-021-92074-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 06/03/2021] [Indexed: 12/25/2022] Open
Abstract
The objective of this study is to assess the change in the normal MD elasticity using shear wave elastography (SWE) through measuring the middle deltoid (MD) elasticity in healthy participants at various arm abduction (with bilateral arms at 0 degrees abduction and 90 degrees active abduction) and analyzing the factors affecting normal MD elasticity. Mean shear wave velocity (SWV) of the MD in healthy right-handed participants were evaluated using SWE at different arm abduction, and potential factors (gender, MD thickness, age, body mass index) affecting MD elasticity were analyzed. Different arm abduction positions of each participant were as follows: (i) 0° abduction of bilateral arm (L0° and R0°), (ii) 90° active abduction of bilateral arm (L90° and R90°). Mean SWV was significantly higher at L90° than L0°, higher at R90° than R0°, higher at R0° than L0°, and higher at R90° than L90° (all P < 0.0001). SWV was significantly higher in males at both L0° (P < 0.05) and R0° (P < 0.01) than in females. Neither MD thickness, age nor body mass index influenced MD elasticity. Reference ranges of normal MD elasticity were 2.4–3.1 m/s in males and 2.2–2.9 m/s in females at L0° and 2.5–3.3 m/s in males and 2.4–3.2 m/s in females at R0°, and were 4.9–6.7 m/s at L90°, 5.2–7.1 m/s at R90° for both males and females. SWE is a feasible technique to assess normal MD elasticity at various arm abduction. Our results suggest that normal MD elasticity at L0°, R0°, L90°, and R90° with SWE are different. Moreover, these reference ranges may serve as quantitative baseline measurements for assessment of normal MD elasticity in the future.
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Affiliation(s)
- Lei Wang
- Department of Medical Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No.32, West 2nd section, Yihuan road, Chengdu, 610072, Sichuan, China.,Department of Medical Ultrasound, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Xuanyan Guo
- Department of Medical Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No.32, West 2nd section, Yihuan road, Chengdu, 610072, Sichuan, China.,Department of Medical Ultrasound, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Li Tan
- Department of Medical Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No.32, West 2nd section, Yihuan road, Chengdu, 610072, Sichuan, China.,Department of Medical Ultrasound, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Qin Chen
- Department of Medical Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No.32, West 2nd section, Yihuan road, Chengdu, 610072, Sichuan, China. .,Department of Medical Ultrasound, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
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