Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion

Ruth L Chimenti; A. Samuel Flemister; John Ketz; Mary Bucklin; Mark R Buckley; Michael S Richards

doi:10.1016/j.jbiomech.2015.11.008

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Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion

Journal article

Peer reviewed

Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion

Ruth L Chimenti, A. Samuel Flemister, John Ketz, Mary Bucklin, Mark R Buckley and Michael S Richards

Journal of biomechanics, Vol.49(1), pp.39-44

01/04/2016

DOI: 10.1016/j.jbiomech.2015.11.008

PMCID: PMC4761471

PMID: 26655590

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Abstract

Heel lifts are commonly prescribed to patients with Achilles tendinopathy, yet little is known about the effect on tendon compressive strain. The purposes of the current study were to (1) develop a valid and reliable ultrasound elastography technique and algorithm to measure compressive strain of human Achilles tendon in vivo, (2) examine the effects of ankle dorsiflexion (lowering via controlled removal of a heel lift and partial squat) on compressive strain of the Achilles tendon insertion and (3) examine the relative compressive strain between the deep and superficial regions of the Achilles tendon insertion. All tasks started in a position equivalent to standing with a 30mm heel lift. An ultrasound transducer positioned over the Achilles tendon insertion was used to capture radiofrequency images. A non-rigid image registration-based algorithm was used to estimate compressive strain of the tendon, which was divided into 2 regions (superficial, deep). The bland-Altman test and intraclass correlation coefficient were used to test validity and reliability. One-way repeated measures ANOVA was used to compare compressive strain between regions and across tasks. Compressive strain was accurately and reliably (ICC>0.75) quantified. There was greater compressive strain during the combined task of lowering and partial squat compared to the lowering (P=.001) and partial squat (P<.001) tasks separately. There was greater compressive strain in the deep region of the tendon compared to the superficial for all tasks (P=.001). While these findings need to be examined in a pathological population, heel lifts may reduce tendon compressive strain during daily activities.

Ultrasound elastography

Heel lift

Tendon strain

Achilles tendinopathy

Details

Title: Subtitle: Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion
Creators: Ruth L Chimenti - University of Iowa, Department of Physical Therapy and Rehabilitation Science, United States
A. Samuel Flemister - University of Rochester, Department of Orthopaedic Surgery, United States
John Ketz - University of Rochester, Department of Orthopaedic Surgery, United States
Mary Bucklin - University of Rochester, Department of Biomedical Engineering, United States
Mark R Buckley - University of Rochester, Department of Biomedical Engineering, United States
Michael S Richards - University of Rochester, Department of Surgery, United States
Resource Type: Journal article
Publication Details: Journal of biomechanics, Vol.49(1), pp.39-44
DOI: 10.1016/j.jbiomech.2015.11.008
PMID: 26655590
PMCID: PMC4761471
NLM abbreviation: J Biomech
ISSN: 0021-9290
eISSN: 1873-2380
Publisher: Elsevier Ltd
Grant note: DOI: 10.13039/100000002, name: NIH, award: R03 AR06748401; name: University of Rochester Core Center for Musculoskeletal Biology and Medicine
Language: English
Date published: 01/04/2016
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984083876102771

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