The association of muscle and tendon elasticity with passive joint stiffness: In vivo measurements using ultrasound shear wave elastography

Chino, Kentaro; Takahashi, Hideyuki

doi:10.1016/j.clinbiomech.2015.07.014

Cited by 44 publications

(33 citation statements)

References 21 publications

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“…While we found that the SW velocity in the MG on the non-paretic and paretic side correlated with joint stiffness, the weak correlation indicates that other muscles and other non-contractile tissues, such as the Achilles tendon, likely contribute substantially to joint stiffness. Poor correlations have previously been found in healthy young adults between SW velocity in both the MG and Achilles tendon and joint stiffness 21 . Furthermore, while both joint stiffness and SW velocity have a non-linear relationship with ankle angle, there are distinct differences between the curves as seen in Figure 2.…”

Section: Discussionmentioning

confidence: 76%

“…SW velocity is related to the shear modulus of the tissue such that SWs travel faster in a stiffer material 20 . The length dependence of SW velocity in passive muscle of healthy subjects has been documented in the medial gastrocnemius (MG) 13,21,22 tibialis anterior (TA) 23 , and biceps brachii 24 . SW velocity is also dependent upon activation level 13,16,18 .…”

Section: Introductionmentioning

confidence: 99%

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Passive material properties of stroke-impaired plantarflexor and dorsiflexor muscles

Jakubowski

Terman

Santana

et al. 2017

Clinical Biomechanics

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Background Following a stroke, intrinsic muscle properties such as stiffness may be altered, which is accompanied by increased spasticity and contractures. Previously, quantification of muscle stiffness has been based off of indirect measurements. Using shear wave ultrasound elastography, direct measurements of muscle material properties can be made. Methods Our aim was to evaluate material properties, specifically passive stiffness, using shear wave ultrasound elastography across a range of muscle lengths, in the medial gastrocnemius and the tibialis anterior in chronic stroke survivors. Findings Our main results show significant increases of 27.7% and 26.9 % in shear wave velocity of stroke-impaired medial gastrocnemius compared to the unimpaired contralateral side at 90° ankle angle (P=0.033) and 15° plantarflexion (P=0.001), respectively. However, no significant difference was found in the tibialis anterior between the two sides. Relatively weak correlations were found between SW velocity in the medial gastrocnemius and joint stiffness for both the non-paretic (ρ=0.384, P=0.001), and paretic side (ρ=0.363, P=0.002). Additionally, muscle stiffness estimates of stroke-impaired tibialis anterior from joint torque and angle measurements were significantly greater by 23.1% (P=0.033) than the unimpaired contralateral side. However, no significant difference was found in the medial gastrocnemius. Interpretation These results indicate that there are non-uniform changes in passive stiffness of stroke-impaired muscle. Therefore, muscles need to be evaluated individually to access alterations. Additionally, interpretation of joint-based calculations of muscle stiffness should be made cautiously. Having the ability to non-invasively assess muscle stiffness adaptations in vivo would aid in prognosis, evaluation, and treatment following a stroke.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Passive material properties of stroke-impaired plantarflexor and dorsiflexor muscles

Jakubowski

Terman

Santana

et al. 2017

Clinical Biomechanics

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“…Previous studies estimated the passive behavior of plantar flexors by measuring the shear modulus of the gastrocnemius medialis (GM) muscle during passive dorsiflexion using shear wave elastography (e.g. Ma€ ısetti et al 2012;Chernak et al 2013;Hug et al 2013;Chino & Takahashi, 2015;Freitas et al 2015;Hirata et al 2015Hirata et al , 2016Taniguchi et al 2015;Nakamura et al 2016). To our knowledge, only two studies completed the investigation on the three heads of the triceps surae [GM, the gastrocnemius lateralis (GL) and the soleus (SOL)] (Hirata et al 2015(Hirata et al , 2016.…”

Section: Introductionmentioning

confidence: 99%

Stiffness mapping of lower leg muscles during passive dorsiflexion

et al. 2017

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It is challenging to differentiate the mechanical properties of synergist muscles in vivo. Shear wave elastography can be used to quantify the shear modulus (i.e. an index of stiffness) of a specific muscle. This study assessed the passive behavior of lower leg muscles during passive dorsiflexion performed with the knee fully extended (experiment 1, n = 22) or with the knee flexed at 90° (experiment 2, n = 20). The shear modulus measurements were repeated twice during experiment 1 to assess the inter-day reliability. During both experiments, the shear modulus of the following plantar flexors was randomly measured: gastrocnemii medialis (GM) and lateralis (GL), soleus (SOL), peroneus longus (PL), and the deep muscles flexor digitorum longus (FDL), flexor hallucis longus (FHL), tibialis posterior (TP). Two antagonist muscles tibialis anterior (TA), and extensor digitorum longus (EDL) were also recorded. Measurements were performed in different proximo-distal regions for GM, GL and SOL. Inter-day reliability was adequate for all muscles (coefficient of variation < 15%), except for TP. In experiment 1, GM exhibited the highest shear modulus at 80% of the maximal range of motion (128.5 ± 27.3 kPa) and was followed by GL (67.1 ± 24.1 kPa). In experiment 2, SOL exhibited the highest shear modulus (55.1 ± 18.0 kPa). The highest values of shear modulus were found for the distal locations of both the GM (80% of participants in experiment 1) and the SOL (100% of participants in experiment 2). For both experiments, deep muscles and PL exhibited low levels of stiffness during the stretch in young asymptomatic adults, which was unknown until now. These results provide a deeper understanding of passive mechanical properties and the distribution of stiffness between and within the plantar flexor muscles during stretching between them and thus could be relevant to study the effects of aging, disease progression, and rehabilitation on stiffness.

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“…Promising results have been published in the recent literature on the utility of SWE in the evaluation of several traumatic and pathologic conditions of various musculoskeletal soft tissues, including tendons (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), muscles (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), nerves (30)(31)(32), and ligaments (33)(34)(35).…”

Section: Introductionmentioning

confidence: 99%

“…The majority of these studies are experimental (5,6,(9)(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)27,29,(31)(32)(33) with a smaller number of clinical studies (7,8,15,26,28,30,34,35). Additionally, several studies evaluated viscoelastic properties of the Achilles tendon (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The current literature suggests that shear waves propagate faster in healthy tendons than in those that are tendinopathic, and faster in contracted tendons and muscles than in those that are relaxed.…”

Section: Swe Of Tendons and Musclesmentioning

confidence: 99%

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications

et al. 2017

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In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. Recently introduced on clinical scanners, shearwave elastography (SWE) is considered to be more objective, quantitative, and reproducible than compression sonoelastography with increasing applications to the musculoskeletal system. SWE uses an acoustic radiation force pulse sequence to generate shear waves, which propagate perpendicular to the ultrasound beam, causing transient displacements. The distribution of shear-wave velocities at each pixel is directly related to the shear modulus, an absolute measure of the tissue's elastic properties. Shear-wave images are automatically coregistered with standard B-mode images to provide quantitative color elastograms with anatomic specificity. Shear waves propagate faster through stiffer contracted tissue, as well as along the long axis of tendon and muscle. SWE has a promising role in determining the severity of disease and treatment followup of various musculoskeletal tissues including tendons, muscles, nerves, and ligaments. This article describes the basic ultrasound physics of SWE and its applications in the evaluation of various traumatic and pathologic conditions of the musculoskeletal system.

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The association of muscle and tendon elasticity with passive joint stiffness: In vivo measurements using ultrasound shear wave elastography

Cited by 44 publications

References 21 publications

Passive material properties of stroke-impaired plantarflexor and dorsiflexor muscles

Passive material properties of stroke-impaired plantarflexor and dorsiflexor muscles

Stiffness mapping of lower leg muscles during passive dorsiflexion

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications

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