Age-Related Changes in Achilles Tendon Stiffness and Impact on Functional Activities: A Systematic Review and Meta-Analysis

Delabastita, Tijs; Bogaerts, Stijn; Vanwanseele, Benedicte

doi:10.1123/japa.2017-0359

Cited by 46 publications

(42 citation statements)

References 60 publications

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“…Couppe et al [28] suggested hypoactivity resulting from retirement to be the main protagonist to ageing-associated lower tendon mechanical properties. This observation at face value opposes what is reported elsewhere within the literature [8,29,30]. It should be noted that the Couppe data arise from patellar tendon data of highly trained participants.…”

Section: Introductioncontrasting

confidence: 62%

The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men

et al. 2021

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Purpose We investigated the combined impact of ageing and obesity on Achilles tendon (AT) properties in vivo in men, utilizing three classification methods of obesity. Method Forty healthy, untrained men were categorised by age (young (18–49 years); older (50–80 years)), body mass index (BMI; normal weight (≥18.5–<25); overweight (≥25–<30); obese (≥30)), body fat% (normal adipose (<28%); high adiposity (≥28%)) and fat mass index (FMI; normal (3–6); excess fat (>6–9); high fat (>9). Assessment of body composition used dual-energy X-ray absorptiometry, gastrocnemius medialis (GM)/AT properties used dynamometry and ultrasonography and endocrine profiling used multiplex luminometry. Results Older men had lower total range of motion (ROM; −11%; P = 0.020), GM AT force (−29%; P < 0.001), stiffness (−18%; P = 0.041), Young’s modulus (−22%; P = 0.011) and AT stress (−28%; P < 0.001). All three methods of classifying obesity revealed obesity to be associated with lower total ROM (P = 0.014–0.039). AT cross sectional area (CSA) was larger with higher BMI (P = 0.030). However, after controlling for age, higher BMI only tended to be associated with greater tendon stiffness (P = 0.074). Interestingly, both AT CSA and stiffness were positively correlated with body mass (r = 0.644 and r = 0.520) and BMI (r = 0.541 and r = 0.493) in the young but not older adults. Finally, negative relationships were observed between AT CSA and pro-inflammatory cytokines TNF-α, IL-6 and IL-1β. Conclusions This is the first study to provide evidence of positive adaptations in tendon stiffness and size in vivo resulting from increased mass and BMI in young but not older men, irrespective of obesity classification.

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Section: Introductioncontrasting

confidence: 62%

The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men

et al. 2021

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“…Interestingly, both Achilles tendon stiffness (Delabastita et al, 2020) and the walking pattern (Boyer et al, 2017) are found to differ in young and older adults. Although their influence to the energy cost of walking is related (Delabastita et al, 2020), most studies only evaluated either the influence of Achilles tendon stiffness or the influence of specific walking patterns on the energy cost of walking. Therefore, the relative contributions of alterations in Achilles tendon stiffness versus alterations in walking patterns are not well understood.…”

Section: Introductionmentioning

confidence: 99%

Achilles tendon stiffness minimizes the energy cost in simulations of walking in older but not in young adults

Delabastita

Groote

Vanwanseele

2020

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Both Achilles tendon stiffness and walking patterns influence the energy cost of walking, but their relative contributions remain unclear. These independent contributions can only be investigated using simulations. We created models for 16 young (24±2 years) and 15 older (75±4 years) subjects, with individualized (using optimal parameter estimations) and generic triceps surae muscle-tendon parameters. We varied Achilles tendon stiffness and calculated the energy cost of walking. Both in young and older adults, Achilles tendon stiffness independently contributed to the energy cost of walking. However, overall, a 25% increase in Achilles tendon stiffness increased the triceps surae and whole-body energy cost of walking with approximately 7% and 1.5%, respectively. Therefore, the influence of Achilles tendon stiffness is rather limited. Walking patterns also independently contributed to the energy cost of walking because the plantarflexor (including, but not limited to the triceps surae) energy cost of walking was lower in older than in young adults. Hence, training interventions should probably rather target specific walking patterns than Achilles tendon stiffness to decrease the energy cost of walking. However, based on the results of previous experimental studies, we expected that the calculated hip extensor and whole-body energy cost of walking would be higher in older than in young adults. This was not confirmed in our results. Future research might therefore assess the contribution of the walking pattern to the energy cost of walking by individualizing maximal isometric muscle force and by using three-dimensional models of muscle contraction.Summary statementAchilles tendon stiffness and walking patterns independently contribute to the energy cost in simulations of walking in young and older adults. The influence of Achilles tendon stiffness is rather small.

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“…The objective of the current cross-sectional study was to compare Achilles tendon transverse stiffness ( k TR ) in a group of recreational runners with Achilles tendinopathy, in comparison to an asymptomatic group of runners with equivalent training history. We also aimed to determine the between-week intra-individual reliability of k TR in the same participants.We hypothesized that stiffness would be lower in the tendinopathy group,[4] and would be negatively correlated with age and waist circumference [9] [10] and positively correlated withVISA-A (Victoria Institute of Sports Assessment—Achilles)[11].…”

Section: Introductionmentioning

confidence: 99%

Transverse tendon stiffness is reduced in people with Achilles tendinopathy: A cross-sectional study

et al. 2019

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Objectives The objective of the current cross-sectional study was to examine Achilles tendon transverse stiffness in a group of recreational runners with Achilles tendinopathy, in comparison to an asymptomatic group of runners with similar training history. We also aimed to determine the between-week intra-individual reliability of this measurement technique. Design Cross-sectional cohort study. Methods A hand-held dynamometer was used to assess the transverse stiffness of the Achilles tendon (AT) in twenty-five recreational runners. In ten people with midportion Achilles tendinopathy (5 men, 5 women), measurements were taken directly over the most symptomatic location. In 15 people who were free of AT symptoms (7 men, 8 women), measurements were taken at an equivalent location on the tendon. Participants returned after one week to determine measurement reliability (intra-class correlation coefficient/ICC and minimum detectable change/MDC95). We also collected information about people’s tendon loading activities, tendon thickness (ultrasound mesaurement), and symptoms (Victorian Institute of Sports Assessment–Achilles / VISA-A score). Results The AT transverse stiffness was lower in people with Achilles tendinopathy (777 N/m ± 86) compared to those who were asymptomatic (873 N/m ± 72) (p < 0.05). AT transverse stiffness was negatively correlated with age and tendon thickness, and positively correlated with VISA-A score and waist circumference. Reliability was good, with ICC of 0.81 in people with tendinopathy and 0.80 in healthy controls, and an MDC95 of 118 and 87N/m in these two respective groups. Conclusions Transverse Achilles tendon stiffness can be reliably measured in people with midportion Achilles tendinopathy, and appears to be lower in people who are older, more symptomatic, and with more extensive tendon thickening. The potential clinical utility of monitoring tendon stiffness in the management of tendon injuries merits further study.

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Age-Related Changes in Achilles Tendon Stiffness and Impact on Functional Activities: A Systematic Review and Meta-Analysis

Cited by 46 publications

References 60 publications

The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men

The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men

Achilles tendon stiffness minimizes the energy cost in simulations of walking in older but not in young adults

Transverse tendon stiffness is reduced in people with Achilles tendinopathy: A cross-sectional study

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