Assessing musculo-articular stiffness using free oscillations: theory, measurement and analysis.

Stiffness, the relationship between applied load and elastic deformation, is an important neuromechanical component related to muscular performance and injury risk. The free-oscillation technique is a popular method for stiffness assessment. There has been wide application of this technique assessing a variety of musculature, including the triceps surae, knee flexors, knee extensors and pectorals. The methodology involves the modelling of the system as a linear damped mass-spring system. The use of such a model has certain advantages and limitations that will be discussed within this review. Perhaps the major advantage of such a model is the specificity of the measure, whereby it is possible for the assessment conditions to simulate the type of loading witnessed during functional tasks and sporting situations. High levels of reliability and construct validity have typically been reported using such procedures. Despite these assurances of accuracy, a number of issues have also been identified. The literature reveals some concerns surrounding the use of a linear model for stiffness assessment. Further, procedural issues surrounding the administration of the perturbation, attention focus of the participant during the perturbation, signal collection, data processing and analysis, presentation of stiffness as a linear or torsional value, assessment load (single vs multiple vs maximal) and the stiffness-load relationship have been identified, and are all fundamentally related to the quality of the calculated output data. Finally, several important considerations for practitioners have been recommended to ensure the quality and consistency of stiffness data collection, processing and interpretation.