University Outpatient Clinic, Department Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany.
Scand J Med Sci Sports. 2018 Jan;28(1):138-143. doi: 10.1111/sms.12874. Epub 2017 Apr 17.
Sonographically detectable intratendinous blood flow (IBF) is found in 50%-88% of Achilles tendinopathy patients as well as in up to 35% of asymptomatic Achilles tendons (AT). Although IBF is frequently associated with tendon pathology, it may also represent a physiological regulation, for example, due to increased blood flow in response to exercise. Therefore, this study aimed to investigate the acute effects of a standardized running exercise protocol on IBF assessed with Doppler ultrasound (DU) "Advanced dynamic flow" in healthy ATs. 10 recreationally active adults (5 f, 5 m; 29±3 years, 1.72±0.12 m, 68±16 kg, physical activity 206±145 minute/wk) with no history of AT pain and inconspicious tendon structure performed 3 treadmill running tasks on separate days (M1-3) with DU examinations directly before and 5, 30, 60, and 120 minutes after exercise. At M1, an incremental exercise test was used to determine the individual anaerobic threshold (IAT). At M2 and M3, participants performed 30- minute submaximal constant load tests (CL /CL ) with an intensity 5% below IAT. IBF in each tendon was quantified by counting the number of vessels. IBF increased in five ATs from no vessels at baseline to one to four vessels solely detectable 5 minutes after CL or CL . One AT had persisting IBF (three vessels) throughout all examinations. Fourteen ATs revealed no IBF at all. Prolonged running led to a physiological, temporary appearance of IBF in 25% of asymptomatic ATs. To avoid exercise-induced IBF in clinical practice, DU examinations should be performed after 30 minutes of rest.
超声下可检测到的腱内血流（Intratendinous Blood Flow，IBF）在 50%-88%的跟腱病患者以及多达 35%的无症状跟腱（Achilles Tendon，AT）中均可被发现。尽管 IBF 常与腱病相关，但它也可能代表一种生理调节，例如，由于运动引起的血流量增加。因此，本研究旨在调查一项标准化跑步运动方案对健康 AT 中使用多普勒超声（Doppler Ultrasound，DU）“先进动态血流”评估的 IBF 的急性影响。10 名有规律运动的成年人（5 女 5 男；29±3 岁，1.72±0.12m，68±16kg，身体活动量 206±145 分钟/周），无跟腱疼痛史，且腱结构无明显异常，在 3 天（M1-3）分别进行 3 次跑步机跑步任务，在运动前、运动后 5、30、60 和 120 分钟进行 DU 检查。在 M1 时，进行递增运动试验以确定个体无氧阈值（Anaerobic Threshold，IAT）。在 M2 和 M3 时，参与者以低于 IAT 强度 5%的强度进行 30 分钟的亚最大恒负荷测试（Constant Load Test，CL/CL）。通过计数血管数量来量化每个肌腱的 IBF。在 5 分钟时，5 个 AT 中的 IBF 从基线时无血管增加到仅可检测到 1-4 个血管，仅在 CL/CL 后。一个 AT 在所有检查中始终存在 IBF（3 个血管）。14 个 AT 根本没有 IBF。长时间跑步导致 25%的无症状 AT 中出现了生理上的、暂时的 IBF。为了避免在临床实践中因运动引起 IBF，DU 检查应在休息 30 分钟后进行。
