Centre for Health, Exercise and Sports Medicine, The School of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.
Am J Sports Med. 2010 Sep;38(9):1885-93. doi: 10.1177/0363546510366234. Epub 2010 May 27.
Achilles tendinopathy is a considerable problem for active people. The degenerative processes associated with tendinopathy may be associated with changes in the inherent mechanical properties of the musculotendinous unit.
The purpose of this study was to compare Achilles tendon-aponeurosis strain between male athletes with and without Achilles tendinopathy.
Cross-sectional study; Level of evidence, 3.
Fifteen healthy men (age, 35 +/- 9 years; height, 1.78 +/- 0.05 m; mass, 79 +/- 11 kg) and 14 men with midportion Achilles tendinopathy (age, 40 +/- 8 years; height, 1.77 +/- 0.06 m; mass, 80 +/- 9 kg) who were all running over 20 km per week participated in the study. Each participant was tested in a single session that involved maximal isometric plantar flexion efforts being performed on a calf-raise apparatus while synchronous real-time ultrasonography of the triceps surae aponeurosis was recorded. Achilles tendon-aponeurosis strain (%) was calculated by dividing tendon displacement during plantar flexion by resting tendon length (intrarater reliability: intraclass correlation coefficient = .92).
Participants in the Achilles tendinopathy group (5.2% +/- 2.6%) had significantly (P = .039) higher Achilles tendon-aponeurosis strain compared with the control group (3.4% +/- 1.8%). In contrast, there were no significant between-group differences for maximal isometric plantar flexion force.
Achilles tendon-aponeurosis strain is higher in male athletes with tendinopathy than those without. The results of this study provide a rationale for current clinical approaches to management of Achilles tendinopathy, whereby repetitive mechanical loading may impart a positive benefit through reduced compliance of the musculotendinous unit.
跟腱病是活跃人群的一个重大问题。与腱病相关的退行性过程可能与肌肉肌腱单位固有机械特性的变化有关。
本研究旨在比较有和无跟腱病的男性运动员的跟腱-跟腱膜应变。
横断面研究；证据水平，3 级。
15 名健康男性（年龄，35 ± 9 岁；身高，1.78 ± 0.05 m；体重，79 ± 11 kg）和 14 名患有中段跟腱病的男性（年龄，40 ± 8 岁；身高，1.77 ± 0.06 m；体重，80 ± 9 kg）均每周跑步超过 20 公里，参与了这项研究。每个参与者都在一次测试中接受了测试，该测试涉及在小腿抬高装置上进行最大等长跖屈力，同时对三头肌跟腱膜进行实时超声同步记录。通过将跖屈过程中的跟腱位移除以休息时的跟腱长度来计算跟腱-跟腱膜应变（%）（组内可靠性：组内相关系数=0.92）。
跟腱病组（5.2%±2.6%）的跟腱-跟腱膜应变明显高于对照组（3.4%±1.8%）（P=0.039）。相比之下，两组之间的最大等长跖屈力没有显著差异。
有腱病的男性运动员的跟腱-跟腱膜应变高于无腱病的运动员。本研究结果为目前治疗跟腱病的临床方法提供了依据，即通过肌肉肌腱单位顺应性的降低，重复性机械负荷可能会产生积极的益处。
