Achilles tendon morphology, plantar flexors torque and passive ankle stiffness in spastic hemiparetic stroke survivors

Freire, Bruno; Dias, Caroline Pietá; Goulart, Natália Batista Albuquerque; Castro, Camila Dias de; Becker, Jéfferson; Gomes, Irênio; Vaz, Marco Aurélio

doi:10.1016/j.clinbiomech.2016.12.004

Cited by 23 publications

(33 citation statements)

References 29 publications

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“…The portions of AT measured in the present study were the muscle‐tendon junction of each muscle (ie, SOL, GL, and GM). These muscle‐tendon junctions can be measured using ultrasonography . In the clinical setting, ultrasonography is widely used because of its noninvasive nature, low cost, and high portability.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Achilles tendon length and running performance in well‐trained male endurance runners

Ueno

Suga

Takao

et al. 2017

Scandinavian Med Sci Sports

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This study aimed to determine the relationship between Achilles tendon (AT) length and running performance, including running economy, in well-trained endurance runners. We also examined the reasonable portion of the AT related to running performance among AT lengths measured in three different portions. The AT lengths at three portions and cross-sectional area (CSA) of 30 endurance runners were measured using magnetic resonance imaging. Each AT length was calculated as the distance from the calcaneal tuberosity to the muscle-tendon junction of the soleus, gastrocnemius medialis (GM ), and gastrocnemius lateralis, respectively. These AT lengths were normalized with shank length. The AT CSA was calculated as the average of 10, 20, and 30 mm above the distal insertion of the AT and normalized with body mass. Running economy was evaluated by measuring energy cost during three 4-minutes submaximal treadmill running trials at 14, 16, and 18 km/h, respectively. Among three AT lengths, only a GM correlated significantly with personal best 5000-m race time (r=-.376, P=.046). Furthermore, GM correlated significantly with energy cost during submaximal treadmill running trials at 14 km/h and 18 km/h (r=-.446 and -.429, respectively, P<.05 for both), and a trend toward such significance was observed at 16 km/h (r=-.360, P=.050). In contrast, there was no correlation between AT CSA and running performance. These findings suggest that longer AT, especially GM , may be advantageous to achieve superior running performance, with better running economy, in endurance runners.

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Section: Discussionmentioning

confidence: 99%

Relationship between Achilles tendon length and running performance in well‐trained male endurance runners

Ueno

Suga

Takao

et al. 2017

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

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“…According to Jiang et al [28], patients after stroke are characterized by reduced dynamics of coactivation of paretic foot flexors and extensors, especially during the extension which leads to balance disturbances during the support phase of gait. In the literature, we found only a few studies assessing the decrease in strength of the paretic foot flexor and its effects on the patient’s mobility [1, 5, 29]. The results of our research (Table 3) indicate that in patients in the early poststroke period occur not only significant weakening of the paretic foot flexor but also of the nonparetic foot, compared to healthy feet of controlled group; the phenomenon which up to this point has not been reported in the publications.…”

Section: Discussionmentioning

confidence: 99%

“…Ankle joint efficiency of a healthy limb is determined by several factors including range of motion, dependent primarily on tendo-muscular unit elasticity [3], the intactness of the proprioceptive pathway, responsible for "deep sensation” within the ankle joint [4] the strength of individual muscles as well as relationships between forces generated by antagonistic muscle groups [5, 6]. To date, the relationship between these determinants (of ankle joint efficiency) has not been clearly defined [7, 8]. The method for measuring strength becomes an issue when one takes into account the strength of the muscles controlling the movement of the ankle [9].…”

Section: Introductionmentioning

confidence: 99%

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

et al. 2019

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Background Ankle joint function in a paretic limb has a fundamental impact on mobility. Return of joint function is a measure of early poststroke physical rehabilitation. This study aims to assess the suitability of using the isometric protocol for objective evaluation of flexor and extensor muscle strength in the paretic limb of poststroke patients. Methods 34 patients (F: 9, M: 25) aged 51–79 years with hemiparesis following an acute ischemic stroke and 34 healthy controls were examined using the isometric protocol measured on the Biodex System ® . The following parameters were analyzed: peak torque [PT], average torque [AVGT], average torque/body weight [AVGT/BW] for flexors and extensors, and AVGT flexor/AVGT extensor [agonist/antagonist ratio] of the paretic foot, the nonparetic foot and foot of healthy controls using three foot–shank positions (15°, 0°, and − 15°) prior to rehabilitation commencement and at its completion 16 weeks later. Results Prior to rehabilitation commencement, nonparetic foot differed significantly ( p < 0.05) from healthy foot controls in all parameters and all positions for flexors and in all positions for foot–shank positions of 0° and − 15° for extensors. At rehabilitation program completion the following parameters increased significantly for the paretic foot: PT, AVGT, and AVGT/BW for foot extensors in all tested positions, and PT for foot flexors in foot–shank position of − 15°. The nonparetic foot however, showed no significant difference following rehabilitation regardless parameter or foot position tested for flexors and extensors alike. Prior to rehabilitation agonist/antagonist ratio in the paretic foot differed significantly from corresponding parameter in the control group for the foot–shank positions of 15° and 0°, whereas at rehabilitation completion, the two groups showed significant difference only in foot–shank position of 0°. Conclusions In the early period following stroke, there is a significant strengthening of the paretic limb, but no improvement in the strength of nonparetic limb.

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“…23 There is also a method using isokinetic muscle strength. 16 Eccentric torques measured by the isokinetic muscle strength were a clinical indicator of spasticity and significantly correlated with the modified Ashworth scale, which is an index reflecting the degree of spasticity. 16 The This study had certain limitations.…”

Section: J Kptmentioning

confidence: 94%

“…16 Eccentric torques measured by the isokinetic muscle strength were a clinical indicator of spasticity and significantly correlated with the modified Ashworth scale, which is an index reflecting the degree of spasticity. 16 The This study had certain limitations. The number of subjects was small, and there was a marked difference in functional levels among the subjects, which is selecting the subjects, considered only the duration of the disease and the degree of spasticity.…”

Section: J Kptmentioning

confidence: 94%

The Effect of Lower Extremity Strengthening Exercise Using Sliding Stander on Balance and Spasticity in Chronic Stroke: A Randomized Clinical Trial

2019

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Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p< 0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

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Achilles tendon morphology, plantar flexors torque and passive ankle stiffness in spastic hemiparetic stroke survivors

Cited by 23 publications

References 29 publications

Relationship between Achilles tendon length and running performance in well‐trained male endurance runners

Relationship between Achilles tendon length and running performance in well‐trained male endurance runners

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

The Effect of Lower Extremity Strengthening Exercise Using Sliding Stander on Balance and Spasticity in Chronic Stroke: A Randomized Clinical Trial

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