To describe changes in the VL and BF muscle tendon unit using US after a long-term stretching program to identify which structures are responsible for ROM increase.

This review aimed to describe the state of the art in muscle-tendon unit (MTU) assessment by supersonic shear wave imaging (SSI) elastography in states of muscle contraction and stretching, during aging, and in response to injury and therapeutic interventions. A consensus exists that MTU elasticity increases during passive stretching or contraction, and decreases after static stretching, electrostimulation, massage, and dry needling. There is currently no agreement regarding changes in the MTU due to aging and injury. Currently, the application of SSI for the purpose of diagnosis, rehabilitation, and physical training remains limited by a number of issues, including the lack of normative value ranges, the lack of consensus regarding the appropriate terminology, and an inadequate understanding of the main technical limitations of this novel technology.

The skeletal muscle system can adapt to an external stimulus from either physiological or pathological conditions. This plasticity is measured by imaging techniques such as magnetic resonance imaging or ultrasound. The anatomical cross-sectional area of a muscle is one of the muscle architecture parameters that relates to the maximum muscle strength. The aim of this study was to determine the reliability of anatomical cross-sectional area rectus femoris measurements, obtained by ultrasound, with two different protocols. Acquisition of four anatomical cross-sectional area images of the right rectus femoris in two distinct regions (15 cm above the patella and 50% of the thigh length) was performed in 2 days, from a group of 15 young healthy subjects. The cross-sectional area of each image was measured five times. The reliability of the anatomical cross-sectional area measures was determined by the coefficient of variation (CV), intraclass correlation coefficient (ICC) and typical error of measurement (TEM). In each protocol, there were no significant differences between the means of anatomical cross-sectional area in measurements, images and days (P>0·05). The CVs were 8·53% and 8·9%, the ICCs 0·88 and 0·87 and the TEMs 65·59 and 94·25 between the 2 days in the regions of 15 cm and 50% of the thigh length, respectively. The average values of the cross-sectional area at 50% of the thigh length were significantly higher than those for at 15 cm above the patella (P<0·001). The measurement of rectus femoris anatomical cross-sectional area by ultrasound proved reliable.

SummaryBackground: Supersonic Shear Imaging (SSI) is a technique which analyses quantitatively the tissue properties in real time. The relation between joint torque and Young's modulus (E) of the agonist muscles is important for obtaining stratification values and ranges of normality. The aim of this study was to evaluate the intra and intersessions reliability of the E values of the Achilles tendon and medial gastrocnemius muscle, bilaterally, during rest, and correlate them with the isometric plantarflexion peak torque.