Shalabi Adel, Kristoffersen-Wiberg Maria, Aspelin Peter, Movin Tomas
Department of Radiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Med Sci Sports Exerc. 2004 Nov;36(11):1841-6. doi: 10.1249/01.mss.0000145450.75035.61.
To evaluate the tendon response after acute strength training in chronic Achilles tendinosis using magnetic resonance imaging (MRI).
Twenty-two patients (44 Achilles tendons, 15 males, 8 patients with bilateral symptoms) with a median age of 45 yr (range 28-57 yr) were included in the study. In all patients, both Achilles tendons were examined with MRI before and immediately after a standardized training program. The most painful side underwent 6 sets and 15 repetitions of heavy-loaded eccentric training. The contralateral tendons underwent only concentric loading during the training program. The tendon volume and the intratendinous signal were evaluated and calculated by MRI using a seed-growing technique.
The immediate response of eccentric loading on the symptomatic tendons resulted in a 12% increase of the tendon volume, evident on T2-WI, from 7.8 +/- 2.0 to 8.8 +/- 2.7 cm3 (P < 0.001), and a 31% increase of the intratendinous signal evident on PD-WI, from 221 +/- 74 to 278 +/- 78 signal units (SU) (P < 0.001). The corresponding sequences on the contralateral concentrically loaded tendons showed an increase of 17% of tendon volume, from 6.1 +/- 1.5 to 7.0 +/- 1.6 cm3 (P < 0.001), and an increase of 27% of the intratendinous signal, from 170 +/- 55 to 211 +/-57 SU (P < 0.001). There was no significant difference of the mean of the increased tendon volume and the intratendinous signal between the eccentrically heavily loaded symptomatic tendons and the concentrically loaded contralateral tendons.
Both eccentric and concentric loading of the Achilles tendon resulted in increased total tendon volume and intratendinous signal. This increase may be explained by a higher water content and/or hyperemia in the Achilles tendon during and/or immediately after strength training of the gastrocnemius-soleus complex.
使用磁共振成像（MRI）评估慢性跟腱炎患者急性力量训练后的肌腱反应。
本研究纳入了22例患者（44条跟腱，15例男性，8例有双侧症状），中位年龄为45岁（范围28 - 57岁）。所有患者在标准化训练计划前后均接受双侧跟腱的MRI检查。最疼痛侧进行6组、每组15次的重负荷离心训练。对侧肌腱在训练计划期间仅进行向心负荷训练。通过MRI使用种子生长技术评估并计算肌腱体积和肌腱内信号。
症状性肌腱的离心负荷即时反应导致肌腱体积在T2加权成像（T2 - WI）上增加12%，从7.8±2.0立方厘米增至8.8±2.7立方厘米（P < 0.001），肌腱内信号在质子密度加权成像（PD - WI）上增加31%，从221±74信号单位增至278±78信号单位（SU）（P < 0.001）。对侧进行向心负荷训练的肌腱的相应序列显示肌腱体积增加17%，从6.1±1.5立方厘米增至7.0±1.6立方厘米（P < 0.001），肌腱内信号增加27%，从170±55 SU增至211±57 SU（P < 0.001）。重负荷离心训练的症状性肌腱与向心负荷训练的对侧肌腱之间，肌腱体积增加量和肌腱内信号增加量的均值无显著差异。
跟腱的离心和向心负荷均导致肌腱总体积和肌腱内信号增加。这种增加可能是由于在腓肠肌 - 比目鱼肌复合体力量训练期间和/或之后，跟腱中的含水量增加和/或充血所致。
