Stiffness mapping of lower leg muscles during passive dorsiflexion

Sant, Guillaume Le; Nordez, Antoine; Andrade, Ricardo J.; Hug, François; Freitas, Sandro R.; Gross, Raphaël

doi:10.1111/joa.12589

Cited by 84 publications

(85 citation statements)

References 59 publications

(138 reference statements)

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“…SWE has very good reliability for measuring shear modulus of superficial and deep muscles, especially during stretching (15,43,51). A previous study showed good interday reliability for shear wave measurements at all the locations used in this study (43).…”

Section: Instrumentationsupporting

confidence: 52%

“…An isokinetic dynamometer (Biodex 3 Medical, Shirley, New York) was used to passively rotate the ankle of participants, with the knee fully extended (hip at 0°, experiment 1) and the knee flexed at 90°[hip at 90°, experiment 2) [see Fig. 1 of Le Sant et al (43)]. The ergometer axis was aligned with the estimated ankle center of rotation (8).…”

Section: Instrumentationmentioning

confidence: 99%

“…These regions were chosen on the basis of anatomical guidelines used for botulinum toxin injections to treat muscle over activity in neurological conditions (55,63). SWE has very good reliability for measuring shear modulus of superficial and deep muscles, especially during stretching (15,43,51). A previous study showed good interday reliability for shear wave measurements at all the locations used in this study (43).…”

Section: Instrumentationmentioning

confidence: 99%

See 2 more Smart Citations

Effects of stroke injury on the shear modulus of the lower leg muscle during passive dorsiflexion

Sant

Nordez

Hug

et al. 2019

Journal of Applied Physiology

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Le Sant G, Nordez A, Hug F, Andrade R, Lecharte T, McNairPJ, Gross R. Effects of stroke injury on the shear modulus of the lower leg muscle during passive dorsiflexion. Contractures are common complications of a stroke. The spatial location of the increased stiffness among plantar flexors and its variability among survivors remain unknown. This study assessed the mechanical properties of the lower leg muscles in stroke survivors during passive dorsiflexions. Stiffness was estimated through the measurement of the shear modulus. Two experiments were independently conducted, in which participants lay supine: with the knee extended (experiment 1, n ϭ 13 stroke survivors and n ϭ 13 controls), or with the knee flexed at 90°(experiment 2, n ϭ 14 stroke survivors and n ϭ 14 controls). The shear modulus of plantar flexors [gastrocnemius medialis (three locations), gastrocnemius lateralis (three locations), soleus (two locations), flexor digitorum longus, flexor hallucis longus), peroneus longus] and dorsiflexors (tibialis anterior and extensor digitorum longus) was measured using ultrasound shear wave elastography during passive dorsiflexions (2°/s). At the same ankle angle, stroke survivors displayed higher shear modulus than controls for gastrocnemius medialis and gastrocnemius lateralis (knee extended) and soleus (knee flexed). Very low shear modulus was found for the other muscles. The adjustment for muscle slack angle suggested that the increased shear modulus was arising from consequences of contractures. The stiffness distribution between muscles was consistent across participants with the highest shear modulus reported for the most distal regions of gastrocnemius medialis (knee extended) and soleus (knee flexed). These results provide a better appreciation of stiffness locations among plantar flexors of stroke survivors and can provide evidence for the implementation of clinical trials to evaluate targeted interventions applied on these specific muscle regions. NEW & NOTEWORTHYThe shear modulus of 13 muscle regions was assessed in stroke patients using elastography. When compared with controls, shear modulus was increased in the gastrocnemius muscle (GM) when the knee was extended and in the soleus (SOL) when the knee was flexed. The distal regions of GM and SOL were the most affected. These changes were consistent in all the stroke patients, suggesting that the regions are a potential source of the increase in joint stiffness.

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Section: Instrumentationsupporting

confidence: 52%

Section: Instrumentationmentioning

confidence: 99%

Section: Instrumentationmentioning

confidence: 99%

See 1 more Smart Citation

Effects of stroke injury on the shear modulus of the lower leg muscle during passive dorsiflexion

Sant

Nordez

Hug

et al. 2019

Journal of Applied Physiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…This junction is an atypical region made of sarcolemmal invaginations interspersed with bundles of collagen fibers appearing as finger-like processes. Previous authors have shown that stiffness is greater this region within a few centimeters of the myoaponeurotic junction (Yoshitake et al, 2014;Knudsen et al, 2015;Le Sant et al, 2017). Moreover, it has been proposed that the thoracolumbar fascia acts as a retinaculum covering the LPM and pressing it down gently, in particular the outer aspect of the erector spinae (Bogduk and Macintosh, 1984).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance elastography of the lumbar back muscles: A preliminary study

et al. 2018

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Back pain is associated with increased lumbar paraspinal muscle (LPM) stiffness identified by manual palpation and strain elastography. Recently, magnetic resonance elastography (MRE) has allowed the stiffness of muscle to be characterized noninvasively in vivo, providing quantitative 3D stiffness maps (elastograms). The aim of this study was to characterize the stiffness (shear modulus, SM) of the LPM (multifidus and erector spinae) using MRE. MRE of the lumbar region was performed on seven adults in supine position. MRE was acquired in three muscular states: relaxed with outstretched legs, stretched with passive pelvis flexion, and contracted with outstretched legs and tightened trunk muscles. The mean SM was measured within a region of interest manually defined in the multifidus, erector spinae, and the entire paraspinal compartment. The intermuscular difference and the effects of stretching and contraction were assessed by ANOVA and t-tests. At rest, the mean SM of the paraspinal compartment was 1.6 ± 0.2 kPa. It increased significantly with stretching to 1.65 ± 0.3 kPa, and with contraction to 2.0 ± 0.7 kPa. Irrespective of muscular state, the erector spinae was significantly stiffer than the multifidus. The multifidus underwent proportionally higher stiffness changes from rest to contraction and stretching. MRE can be used to measure the stiffness of the LPM in different muscular states. We hypothesize that, irrespective of posture, the erector spinae behaves as semi-rigid beam, and ensures permanent stiffness of the spine. The multifidus behaves as an adaptable muscle that provides segmental flexibility to the spine and tunes the spine stiffness. Clin. Anat. 31:514-520, 2018. © 2018 Wiley Periodicals, Inc.

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“…Previous authors showed that limb motions transmit tensile force to different segment according to the location on their attachment on the TLF (Barker et al, ). Given the anatomical variations at each segmental level (orientation of collagen fiber in the pTLF, muscle bellies size, intermuscular spaces) and the stiffness differences between parts of a muscle, we could expect different muscle‐fascia behaviors at other lumbar levels (Le Sant et al, ).…”

Section: Discussionmentioning

confidence: 99%