Mechanical Effects of Immobilization on the Achilles’ Tendon

Fujio, Mizue; Trudel, Guy; Uhthoff, Hans K.; Bäckman, David

doi:10.1016/s0003-9993(02)04834-7

Cited by 53 publications

(60 citation statements)

References 21 publications

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“…Immobilization is also known to cause decreased stiffness of tendon tissue, but only in weight-bearing tendons (16,39). If physical inactivity has a systemic effect on tendon tissue, the decreased modulus observed in the obese mice in our study may be explained by a decreased physical activity level.…”

Section: Diet Age Contentmentioning

confidence: 57%

Systemic stiffening of mouse tail tendon is related to dietary advanced glycation end products but not high-fat diet or cholesterol

Eriksen

Svensson

Scheijen

et al. 2014

Journal of Applied Physiology

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Tendon pathology is related to metabolic disease and mechanical overloading, but the effect of metabolic disease on tendon mechanics is unknown. This study investigated the effect of diet and apolipoprotein E deficiency (ApoE(-/-)) on mechanical properties and advanced glycation end product (AGE) cross-linking of non-weight-bearing mouse tail tendons. Twenty ApoE(-/-) male mice were used as a model for hypercholesterolemia along with 26 wild-type (WT) mice. One-half of the mice from each group was fed a normal diet (ND) and the other half was fed a high-fat diet (HFD) to induce obesity. All were killed at 40 wk, and tail tendon fascicles were mechanically tested to failure and analyzed for AGEs. Diets were also analyzed for AGEs. ApoE(-/-) mice displayed a 14% increase in plateau modulus compared with WT mice (P < 0.05), whereas HFD mice displayed a 13% decrease in plateau modulus (P < 0.05) and a 12% decrease in total modulus (P < 0.05) compared with ND mice. Tail tendons of HFD mice had significantly lower concentrations of AGEs [carboxymethyllysine (CML): 26%, P < 0.0001; methylglyoxal-derived hydroimidazolone 1 (MG-H1): 15%, P < 0.005; pentosidine: 13%, P < 0.0005]. The HFD had ∼44-fold lower content of CML (P < 0.01), ∼29-fold lower content of carboxyethyllysine (P < 0.005), and ∼16-fold lower content of MG-H1 (P < 0.05) compared with ND. ApoE(-/-) increased, whereas HFD decreased mouse tail tendon stiffness. Dietary AGE content may be a crucial determinant for accumulation of AGE cross-links in tendons and for tissue compliance. The results demonstrate how systemic metabolic factors may influence tendon health.

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Section: Diet Age Contentmentioning

confidence: 57%

Systemic stiffening of mouse tail tendon is related to dietary advanced glycation end products but not high-fat diet or cholesterol

Eriksen

Svensson

Scheijen

et al. 2014

Journal of Applied Physiology

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“…11 Achilles tendons immobilized for 4 or 8 weeks were larger but mechanically weaker. 16 Finally, Galatz et al 6 transected rat SSP tendons and found inferior mechanical properties in the group undergoing repair after a 3-week delay. Therefore, even though healthy tendons are transected in animal models, the status at delayed repair is of degeneration.…”

Section: Discussionmentioning

confidence: 99%

Improved strength of early versus late supraspinatus tendon repair: a study in the rabbit

Trudel

Ramachandran

Ryan

et al. 2012

Journal of Shoulder and Elbow Surgery

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“…14 Reduced tension states, such as immobilization, promote weakening of the mechanical properties of connective tissues and result in joint contracture. 12,[18][19][20] Immobilization increases synthesis and degradation of collagen, an increase in the concentration of reducible collagen cross-links, and newly synthesized collagen which is presumably immature and less capable of resisting the tensile stresses. 2,3,5,7 Prolonged passive stretching is widely prescribed for treatment of joint contracture.…”

mentioning

confidence: 99%

“…6 The duration and magnitude of the stretching force applied is only guided by subjective clinical impressions based on local skin temperature and a patient's subjective feedback. 3,12,14,24 The periarticular tissues after immobilization have less ability to resist tensile stresses and can easily be damaged when subjected to excessive load. 3,12,14,22 We hypothesized a reduced tension state associated with immobilization would result in weakening of the tissue with increased phase lag (corresponds to the viscosity of the joint tissues) and joint deformation and decreased maximum knee extension angle, dynamic stiffness, stiffness, and maximum load after 40 days of joint immobilization.…”

mentioning

confidence: 99%

“…3,12,14,24 The periarticular tissues after immobilization have less ability to resist tensile stresses and can easily be damaged when subjected to excessive load. 3,12,14,22 We hypothesized a reduced tension state associated with immobilization would result in weakening of the tissue with increased phase lag (corresponds to the viscosity of the joint tissues) and joint deformation and decreased maximum knee extension angle, dynamic stiffness, stiffness, and maximum load after 40 days of joint immobilization. We also hypothesized low-torque and longduration repeated stretching of the resulting moderately developed flexion contractures would result in a decreased phase lag and deformation, and increased maximum knee ROM, dynamic stiffness, stiffness, and maximum load, relative to high torque and/or short duration repeated stretch treatments.…”

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confidence: 99%

See 1 more Smart Citation

Experimental Joint Contracture Correction with Low Torque-Long Duration Repeated Stretching

Usuba

Akai²,

Shirasaki³

et al. 2007

Clinical Orthopaedics &Amp; Related Research

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Tension is necessary to maintain and restore the mechanical properties of soft connective tissues. Conversely, reduced tension states such as produced by immobilization weaken mechanical properties and facilitate joint contracture. We assessed the effect of low torque-long duration stretching to increase the range of motion (ROM) and to restore the mechanical properties of contracted joints in 66 rat knees immobilized for 40 days. After remobilization, we randomly divided the contracted knees into four treatment groups treated with repeated stretches of diverse torques and duration: stretching with low-torque and long-duration, high-torque and short-duration, high-torque and long-duration, low-torque and short duration. We included control and natural recovery groups. Phase lag in all treatment groups recovered to the same range as in the normal controls. Dynamic stiffness, which was not altered by joint immobilization, increased in all treatment groups. Deformation and load to failure improved substantially only in the low-torque and long-duration stretching group. Low-torque and long-duration repeated stretching leads to a greater restoration of ROM with more normal mechanical properties compared to high-torque and short duration stretching.

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Mechanical Effects of Immobilization on the Achilles’ Tendon

Cited by 53 publications

References 21 publications

Systemic stiffening of mouse tail tendon is related to dietary advanced glycation end products but not high-fat diet or cholesterol

Systemic stiffening of mouse tail tendon is related to dietary advanced glycation end products but not high-fat diet or cholesterol

Improved strength of early versus late supraspinatus tendon repair: a study in the rabbit

Experimental Joint Contracture Correction with Low Torque-Long Duration Repeated Stretching

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