Assessment of Passive Stiffness of Medial and Lateral Heads of Gastrocnemius Muscle, Achilles Tendon, and Plantar Fascia at Different Ankle and Knee Positions Using the MyotonPRO

Huang, Jiapeng; Qin, Kun; Tang, Chunzhi; Zhu, Yi; Klein, Cliff S.; Zhang, Zhijie; Liu, Chunlong

doi:10.12659/msm.909550

Cited by 54 publications

(57 citation statements)

References 39 publications

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“…However, the same relationship did not hold when the knee was flexed to 90°. This result is consistent with that of Huang et al 28 , who used MyotonPRO for their assessment. Hirata et al 35 also found that the stiffness of the MG was higher than that of the LG at DF25°.…”

Section: Effects Of Ankle and Knee Angle On The Stiffness Of The Mgsupporting

confidence: 93%

“…The SOL was measured in the distal half of the SOL for visualization of the distal SOL fascicles alone 27 . The PF was assessed at 3 successive levels: between the first and second metatarsal bone, on the anterior edge of the inferior calcaneal border and in the posterior section of the PF 8,28 . The length was measured with a tape measure, and a black pen was used to mark the location of the measurement site.…”

Section: Methodsmentioning

confidence: 99%

“…The stiffness was measured with the SWE transducer positioned on the marks on the skin for the MG, LG, SOL, AT and PF with the ankle joint positioned at 25° of dorsiflexion (DF25°), in a neutral position (0°), or at 50° of plantar flexion (PF50°) and the knee fully extended or flexed to 90°. In addition, to reduce experimental errors, the participants were explicitly asked to keep their lower extremities fully relaxed throughout testing and to refrain from high-intensity exercise for 48 hours before testing 17,28 .…”

Section: Methodsmentioning

confidence: 99%

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Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Liu

Zhou

Sun

et al. 2020

Sci Rep

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Stiffness is a valuable indicator of the functional capabilities of muscle-tendon-fascia. Twenty healthy subjects participated in this study in which the passive elastic properties of the medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus muscles (SOL), Achilles tendon (AT, at 0 cm, 3 cm and 6 cm proximal to the calcaneus tubercle, corresponding to AT0cm, AT3cm and AT6cm, respectively) and plantar fascia (PF) were quantified when their knee was fully extended or flexed to 90° using shear wave elastography at 25° of dorsiflexion (DF25°), 0° (neutral position) of flexion, and 50° of plantar flexion (PF50°) of the ankle joint. The stiffnesses of the AT, MG, LG, SOL and the fascia with the knee fully extended were significantly higher than those with the knee flexed to 90° (p < 0.05), while the stiffness of the PF showed the opposite relationship (p < 0.05). When the knee was fully extended, the stiffness was higher in the LG than in the MG at PF50° and 0° (p < 0.01), and it was higher in the MG than in the LG at DF25° (p = 0.009). Nevertheless, regardless of the knee angle, the stiffness decreased from AT3cm > AT0cm > AT6cm at PF50° and 0° (p < 0.001), while the stiffness decreased from AT0cm > AT3cm > AT6cm at DF25°. Regardless of the knee and ankle angles, the stiffness of the PF increased in a proximal-to-distal direction (p < 0.001). These insights can be used to gain a more intuitive understanding of the relationships between the elastic properties of the muscle-tendon unit and its function. Achilles tendon (AT) injuries and plantar fasciitis can cause chronic pain and impairment 1. In the clinic, the type of treatment administered depends in part on the region and intensity of pain. For example, eccentric exercises are more effective in the treatment of mid-substance tendinopathy than in the treatment of insertional tendinopathy 1. However, because of the complexity of the anatomy and mechanics of the AT and plantar fascia (PF), it can be challenging to identify the region and severity of the damage. In terms of anatomy, the AT, which is the conjoined tendon of the medial gastrocnemius (MG), the lateral gastrocnemius (LG), and the soleus (SOL), is an important bridge for walking, running and jumping in daily life, and each of the contributing muscles exhibit unique structural features 2,3. The twisted structure of the AT is formed by the MG tendons, LG tendons and SOL tendons. These muscle tendons rotate as they descend but do not run parallel to each other 4. In addition, the superficial layer of the AT is formed by the MG tendons, while the deep layer consists of the LG tendons and SOL tendons 5. Furthermore, the LG is shorter and smaller than the MG, so the MG and LG differ in terms of muscle strength and their contribution to the AT 6. In other words, these regional structural features (including those of the MG, LG, SOL, AT and PF) have great inherent variability, which may affect the position and severity of damage in an individual 6. Therefore, it is necessary to further understand the relati...

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Section: Effects Of Ankle and Knee Angle On The Stiffness Of The Mgsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Liu

Zhou

Sun

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Our study supports these findings in both non-weight bearing and weight bearing positions. In addition to this our study utilised eight points of measurement at intervals of 2cm along the Achilles Tendon unlike Huang et al (32) who utilised three points of measurement at 0 cm (Achilles insertion at calcaneum), 3 cm and 6cm along the tendon.…”

Section: Discussionmentioning

confidence: 99%

“…It is likely that this demonstrates strain hardening under loading of the tissues with increase of logarithmic decrement during weight bearing (33). Previous studies utilising the MyotonPRO have evaluated tendon and muscle stiffness unloaded (13,15) and utilising minimal points of measurement (32). In order to simulate loading during posture, gait or other activities, the clinician may benefit from carrying out measurement and assessment of soft tissues when loaded and unloaded.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Weight Bearing and non-weight Bearing Measures of Stiffness in the Achilles Tendon and Gastrocnemius Muscle

Morgan

Martin

Welch

et al. 2020

Muscle Ligaments and Tendons J

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Objectives. To establish quantitative values of stiffness for the Achilles tendon (AT) and Gastrocnemius muscle (GM) in participants weight bearing and non-weight bearing. Methods. Measurements of 25 participants taken bilaterally at 8 points along the AT, and 2 points at the GM included: Natural Oscillation frequency (F), dynamic stiffness (S), mechanical stress relaxation time (R), logarithmic decrement (D) and creep (C) were taken non-weight bearing (NWB) and weight bearing (WB) using the Myoton-PRO. Results. Median WB F scores were significantly higher than NWB F scores. D was significantly (P<0.005) higher NWB than WB for both AT and GM. S decreased from point 1 to point 8. GM S measurements were significantly (P<0.005) higher WB to NWB. C increased along course of tendon in the NWB condition and was significantly (P<0.005) higher at the GM. R was significantly (P<0.005) higher in the NWB condition for the AT and GM. R incrementally increased along the course of the AT in both NWB and WB conditions. Conclusions. There was an overall increased stiffness of the AT and GM during the weight bearing condition compared to the non-weightbearing condition. Further studies are required to develop a robust clinical application of this technology.

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Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation

et al. 2021

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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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Assessment of Passive Stiffness of Medial and Lateral Heads of Gastrocnemius Muscle, Achilles Tendon, and Plantar Fascia at Different Ankle and Knee Positions Using the MyotonPRO

Cited by 54 publications

References 39 publications

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Quantitative Weight Bearing and non-weight Bearing Measures of Stiffness in the Achilles Tendon and Gastrocnemius Muscle

Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation

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