Ultrasound imaging of patellar tendon thickness in elite sprint track cyclists and elite soccer players: An intra-rater and inter-rater reliability study

Abstract

The goal of our study was to investigate the relative and absolute intra-rater and inter-rater reliability of ultrasound assessment of patellar tendon (PT) thickness assessed over four locations, in track cyclists and soccer players. Fifteen male elite track cyclists and 15 male elite soccer players participated. Tendon thickness was measured over 4 locations placed at 5-10-15-20 mm inferior to the apex of the patella by two experienced examiners. Each examiner took two US images for the test measurements with a 10-min rest period. After a 30-min period, the subjects underwent a retest measurements that were also repeated 1-week after. A two-way analysis of variance revealed a significant group x location interaction on PT thickness for Examiner 1 (p = .001, η2 = .81) and Examiner 2 (p = 0.001, η2 = 0.78). Intra-rater reliability ranged from good to excellent (ICC2,k ≥ 0.75), whereas inter-rater reliability was good (ICC2,k ≥ 0.75) in both groups. Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT (corresponding to 15 and 20 mm) can be considered the most reliable spot to measure PT thickness. The PT thickness was larger among track cyclists than soccer players, with larger differences over the distal location (15 mm). Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT corresponding to 15 mm and 20 mm can be considered the most reliable area to measure PT thickness.

Fatigue-induced Alterations of the Patellar Tendon in Elite Sprint Track Cyclists

“…Alterations in morphological properties were evaluated using ultrasonography imaging, while the mechanical property was assessed using myotonometry at the same six locations on PT. Our previous studies have demonstrated good to excellent intra-and inter-reliability for this measurement procedure using ultrasound [8] and similar changes in PT thickness after 200 m flying start competition in elite sprint track cyclists [4].…”

“…The settings of the ultrasound system were standardized for all participants and kept identical for all measures. The scan depth was set to 1.8 mm, according to [4,8]. The axial resolution of ultrasound images was found to be 0.068 mm per pixel.…”

“…However, multiple locations have also been analyzed [4,[14][15][16]. Holm et al [14] and Toprak et al [15] measured PT thickness at 6 mm and 10 mm proximal to the patellar pole and ti bial tuberosity, while Klich et al [4,8] evaluated PT thickness at 5-10-15-20 mm inferior to the apex of the patella. Castro et al [16] adjusted the measurement to the length of PT (at 25 %, 50 %, and 75 %).…”

“…The morphological properties of PT might be investigated using ultrasonographic imaging [4,8]. A normal PT is characterized as an echoic fibrillar structure.…”

Measurement properties of the short version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for individuals with knee osteoarthritis

“…For this, two applications of the SV-WOMAC were performed with an interval of 1 week between applications. This interval was long enough to avoid memory bias and short enough to ensure no changes were found in the measured construct [14,16,17]. In addition to validating the construct, the following instruments were applied: the numeric rating scale (NRPS), International Knee Documentation Committee (IKDC), Short Form Health Survey (SF 36), and WOMAC.…”