Objective: Regulating the impedance of our joints is essential for the effective control of posture and movement. The impedance of a joint is governed mainly by the mechanical properties of the muscle-tendon units spanning it. Many studies have quantified the net impedance of joints but not the specific contributions from the muscles and tendons. The inability to quantify both muscle and tendon impedance limits the ability to determine the causes underlying altered movement control associated with aging, neuromuscular injury, and other conditions that have different effects on muscle and tendon properties. Therefore, we developed a technique to quantify joint, muscle, and tendon impedance simultaneously and evaluated this technique at the human ankle. Methods: We used a single degree of freedom actuator to deliver pseudorandom rotations to the ankle while measuring the corresponding torques. We simultaneously measured the displacement of the medial gastrocnemius muscletendon junction with B-mode ultrasound. From these experimental measurements, we were able to estimate ankle, muscle, and tendon impedance using non-parametric system identification. Results: We validated our estimates by comparing them to previously reported muscle and tendon stiffness, the position-dependent component of impedance, to demonstrate that our technique generates reliable estimates of these properties. Conclusion: Our approach can be used to clarify the respective contributions from the muscle and tendon to the net mechanics of a joint. Significance: This is a critical step forward in the ultimate goal of understanding how muscles and tendons govern ankle impedance during posture and movement.
Background Following a stroke, intrinsic muscle properties such as stiffness may be altered, which is accompanied by increased spasticity and contractures. Previously, quantification of muscle stiffness has been based off of indirect measurements. Using shear wave ultrasound elastography, direct measurements of muscle material properties can be made. Methods Our aim was to evaluate material properties, specifically passive stiffness, using shear wave ultrasound elastography across a range of muscle lengths, in the medial gastrocnemius and the tibialis anterior in chronic stroke survivors. Findings Our main results show significant increases of 27.7% and 26.9 % in shear wave velocity of stroke-impaired medial gastrocnemius compared to the unimpaired contralateral side at 90° ankle angle (P=0.033) and 15° plantarflexion (P=0.001), respectively. However, no significant difference was found in the tibialis anterior between the two sides. Relatively weak correlations were found between SW velocity in the medial gastrocnemius and joint stiffness for both the non-paretic (ρ=0.384, P=0.001), and paretic side (ρ=0.363, P=0.002). Additionally, muscle stiffness estimates of stroke-impaired tibialis anterior from joint torque and angle measurements were significantly greater by 23.1% (P=0.033) than the unimpaired contralateral side. However, no significant difference was found in the medial gastrocnemius. Interpretation These results indicate that there are non-uniform changes in passive stiffness of stroke-impaired muscle. Therefore, muscles need to be evaluated individually to access alterations. Additionally, interpretation of joint-based calculations of muscle stiffness should be made cautiously. Having the ability to non-invasively assess muscle stiffness adaptations in vivo would aid in prognosis, evaluation, and treatment following a stroke.
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