Characterizing Musculoskeletal Tissue Mechanics Based on Shear Wave Propagation: A Systematic Review of Current Methods and Reported Measurements

Blank, Jonathon; Blomquist, Matthew B; Arant, Lesley R.; Cone, Stephanie G.; Roth, Joshua D.

doi:10.1007/s10439-022-02935-y

Cited by 25 publications

(13 citation statements)

References 538 publications

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“…Briefly, SWE is based on the generation of an acoustic shear wave and subsequent tracking of its propagation velocity, where the velocity is higher in stiffer tissue. Then, the shear modulus is calculated as an index of muscle stiffness [ 10 , 12 , 13 ]. The reliability of SWE to assess muscle stiffness has been confirmed, including for trunk muscles [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

Vatovec

Kozinc

Voglar

2022

Sensors

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Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (−8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006–0.022; Cohen’s d = 0.40–46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697–0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29–0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain.

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Section: Introductionmentioning

confidence: 99%

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

Vatovec

Kozinc

Voglar

2022

Sensors

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“…From this, it appears that the pathological tension state of our research target is underrepresented in SWE, suggesting a lower-than-expected tension level. Indeed, the average shear-wave elastic modulus of skeletal muscles ranges from 0.6 to 240.0 kPa, [34] further indicating that our participants had low baseline elasticity values. This is understandable as our participants were mostly elderly, and multiple studies show a negative correlation between muscle elasticity and age.…”

Section: Discussionmentioning

confidence: 99%

Understanding tightened muscle in knee osteoarthritis and the impacts of Fu’s subcutaneous needling: A pilot trial with shear-wave elastography and near-infrared spectroscopy

Yang,

Wang,

Sun

2024

Medicine

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Background: Given the scarce reports on the interplay between Fu’s subcutaneous needling (FSN), tightened muscle, and therapeutic effects, we developed a clinical research protocol to synchronously collect data on clinical efficacy and muscle characteristics in patients with knee osteoarthritis, exploring the mechanism of FSN action. The primary aim was to assess the feasibility and safety of this protocol, guiding future trials and their sample size calculations. Methods: In this prospective, single-blind, self-controlled study, 19 patients with early to mid-stage unilateral knee osteoarthritis underwent FSN therapy on both knees over 1 week (4 sessions, every other day). We measured local elastic modulus, muscle thickness, blood flow volume, and oxygen consumption rate of bilateral vastus lateralis muscles using shear-wave elastography and near-infrared spectroscopy (NIRS) before and after the first and fourth treatments. Additionally, real-time NIRS indicators (oxygenated hemoglobin [O2Hb], deoxyhemoglobin [HHb], total hemoglobin [THb], and tissue saturation index [TSI]) were recorded during these treatments. Pain intensity (visual analogue scale [VAS]), functional status (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and active range of motion were evaluated before these treatments. Results: All 19 participants completed the trial without serious adverse events. After 3 FSN treatments, significant changes were observed in VAS and WOMAC scores (VAS: P < .001; WOMAC: P < .001), and knee flexion (P < .001) and external rotation (P = .02), except for internal rotation. No meaningful significant differences were observed in muscle characteristics at baseline or between pre- and post-treatment periods. NIRS results during treatments indicated significant increases in local O2Hb and THb post-FSN therapy (First treatment: O2Hb: P = .005; THb: P = .006. Fourth treatment: O2Hb: P = .002; THb: P = .004); however, no significant increases were observed for HHb (First treatment: P = .06; Fourth treatment: P = .28). No linear correlation was found between therapeutic effects and changes in tightened muscle indices. Conclusion: FSN reduces pain and improves joint function in knee osteoarthritis, while also enhancing blood flow and oxygenation in the vastus lateralis muscle of the affected side. Further revisions of this protocol are warranted based on our insights.

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“…TAUT is grounded in the theoretical SWV changes resulting from applied tensile forces (not solely the inherent elasticity) [47][48][49] . The underlying technology has been established in other tissues including tendons; in this context, it is often called shear wave tensiometry 47,50,51 . We use the term Tensography to minimize confusion with the classical implications of tensiometry (i.e., interfacial or surface tension).…”

Section: Introductionmentioning

confidence: 99%

Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

Kerensky

Paul²,

Routkevitch³

et al. 2023

Preprint

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Background Tension in the spinal cord is a trademark of tethered cord syndrome. Unfortunately, existing tests cannot quantify tension across the bulk of the cord, making the diagnostic evaluation of stretch ambiguous. A potential non-destructive metric for spinal cord tension is ultrasound-derived shear wave velocity (SWV). The velocity is sensitive to tissue elasticity and boundary conditions including strain. We use the term Ultrasound Tensography to describe the acoustic evaluation of tension with SWV. Methods Our solution “Tethered cord Assessment with Ultrasound Tensography (TAUT)” was utilized in three sub-studies: finite element simulations, a cadaveric benchtop validation, and a neurosurgical case series. The simulation computed SWV for given tensile forces. The induced tension cadaveric model validated the SWV-tension relationship. Lastly, SWV was measured intraoperatively in patients diagnosed with tethered cord who underwent surgical treatment (spinal column shortening). The surgery alleviates tension by decreasing the vertebral column length. Results Here we observe a strong linear relationship between tension and squared SWV across the preclinical sub-studies. Higher tension induces faster shear waves in the simulation (R2 = 0.984) and cadaveric (R2 = 0.951) models. The SWV decreases in all neurosurgical procedures (p<0.001). Moreover, TAUT has a c-statistic of 0.962 (0.92-1.00), detecting all tethered cords. Conclusions This study presents the first clinical metric of spinal cord tension. Strong agreement among computational, cadaveric, and clinical studies demonstrates the utility of ultrasound-induced SWV for quantitative intraoperative feedback. This technology is positioned to enhance tethered cord diagnosis, treatment, and post-operative monitoring as it differentiates stretched from healthy cords.

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Characterizing Musculoskeletal Tissue Mechanics Based on Shear Wave Propagation: A Systematic Review of Current Methods and Reported Measurements

Cited by 25 publications

References 538 publications

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

Understanding tightened muscle in knee osteoarthritis and the impacts of Fu’s subcutaneous needling: A pilot trial with shear-wave elastography and near-infrared spectroscopy

Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

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