Achilles Tendon Stiffness : Influence of Measurement Methodology
Khair, R. M., Sukanen, M., & Finni, T. (2024). Achilles Tendon Stiffness : Influence of Measurement Methodology. Ultrasound in Medicine and Biology, 50(10), 1522-1529. https://doi.org/10.1016/j.ultrasmedbio.2024.06.005
Published in
Ultrasound in Medicine and BiologyDate
2024Copyright
© 2024 The Author(s). Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology
Objective
Mechanical stiffness derived from force-elongation curves is fundamentally different from shear wave (SW) elastography-based tissue properties. We compared these techniques, with a total of five methods of assessing Achilles tendon (AT) stiffness.
Methods
Seventeen participants (12 male and 5 female) with unilateral AT rupture performed submaximal contractions at 30% and 10% maximal isometric contraction torque of the un-injured limb. SW velocity was acquired at rest. Force-elongation curves were assessed from the free AT and the medial gastrocnemius (MG) tendon. Mechanical stiffness was determined near the end of the linear region of the force-elongation curve and from the toe region. Bivariate correlations between mechanical stiffness and SW velocity, as well as pairwise t-tests between limbs, were computed.
Results
In the injured limb, SW velocity correlated with MG tendon and free AT toe-region stiffness during 10% (r = 0.59, p = 0.020 and r = 0.60, p = 0.011, respectively) and 30% of submaximal contractions (r = 0.56, p = 0.018 and r = 0.67, p = 0.004, respectively). The un-injured limb showed no associations. In both limbs pooled together, SW velocity correlated with MG tendon toe-region stiffness in 30% of submaximal contractions (r = 0.43, p = 0.012). Free tendon mechanical stiffness was lower in the injured limb, with a mean difference of 148.5 Nmm⁻¹ (95% CI: 35.6–261.3, p = 0.013), while SW velocity was higher in the injured limb (1.67 m × s⁻¹, 95% CI; -2.4 to -0.9, p < 0.001).
Conclusion
SW elastography may reflect AT viscoelastic properties at the initial slope of the force-length curve with strains <1% but cannot offer insight into AT mechanics at higher loads. Extended toe regions in the injured limb could have caused the association between mechanical stiffness and SW-based stiffness.
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0301-5629Keywords
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https://converis.jyu.fi/converis/portal/detail/Publication/233269804
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- Liikuntatieteiden tiedekunta [3120]
Related funder(s)
Research Council of FinlandFunding program(s)
Academy Project, AoFAdditional information about funding
This work was supported by Academy of Finland-funded research projects UNderstanding REStoration of AchillesTendon function after rupture (UNRESAT; grant #323168/Taija Finni) and Development of novel methods for creation of a new subject-specific view of Achilles tendon structure and loading in health and disease (ACHILLES; grant #355678/Taija Finni).License
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