Zhou Jiping, Yu Jiafeng, Liu Chunlong, Tang Chunzhi, Zhang Zhijie
Clinical Medical College of Acupuncture, Moxibustion, and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Appl Bionics Biomech. 2019 Nov 3;2019:8452717. doi: 10.1155/2019/8452717. eCollection 2019.
Anatomical studies and the mechanical property studies showed that there is a strong correlation between Achilles tendon (AT) elasticity and individual gastrocnemius muscle (the medial head of gastrocnemius (MG) and the lateral head of gastrocnemius (LG)) elasticity. Limited ankle dorsiflexion range of motion has been correlated with decreased flexibility of the MG/LG/AT complex. However, no studies have been conducted to examine the exact correlation between the Achilles tendon and the individual muscle of the gastrocnemius.
The purposes of the present study were (1) to evaluate intra- and interoperator reliabilities of elastic property measurements in the gastrocnemius muscle-Achilles tendon complex by using the shear wave elastography (SWE) and (2) to examine the correlation between the regional elastic properties of the AT and the individual muscle of the gastrocnemius.
Twenty healthy subjects (mean age: 22.50 (3.02) years) were recruited in this study. The elastic properties of the AT and the individual muscle of the gastrocnemius were quantified using the SWE.
The SWE has comparatively high reliability in quantifying the elastic properties of the muscle-tendon range from good to excellent. The intraoperator ICC of the gastrocnemius muscle-Achilles tendon complex was 0.77 to 0.95, while the interoperator ICC was 0.76 to 0.94. The minimal detectable change (MDC) of the muscle was 1.72 kPa, while the AT was 32.90 kPa. A significant correlation was found between the elastic modulus of AT and the elastic modulus of the MG ( = 0.668 and = 0.001 at the relaxing position and = 0.481 and = 0.032 at the neutral position).
The SWE has the potential to assess localized changes in muscle-tendon elastic properties, provide more intuitive relations between elastic properties of the muscle tendon and function, and evaluate the therapeutic effect of the muscle tendon. A significant correlation between the AT and the MG was found, and it may provide a new treatment idea (targeted to the tight muscle heads) for the clinical setting to treat subjects with AT disorders.
解剖学研究和力学性能研究表明，跟腱（AT）弹性与腓肠肌个体（腓肠肌内侧头（MG）和腓肠肌外侧头（LG））弹性之间存在密切关联。踝关节背屈活动范围受限与MG/LG/AT复合体灵活性降低相关。然而，尚未有研究探讨跟腱与腓肠肌个体肌肉之间的确切关联。
本研究的目的是（1）通过剪切波弹性成像（SWE）评估腓肠肌 - 跟腱复合体弹性特性测量的操作者内和操作者间可靠性，以及（2）研究AT区域弹性特性与腓肠肌个体肌肉之间的相关性。
本研究招募了20名健康受试者（平均年龄：22.50（3.02）岁）。使用SWE对AT和腓肠肌个体肌肉的弹性特性进行量化。
SWE在量化肌腱范围内的弹性特性方面具有相对较高的可靠性，从良好到优秀。腓肠肌 - 跟腱复合体的操作者内ICC为0.77至0.95，而操作者间ICC为0.76至0.94。肌肉的最小可检测变化（MDC）为1.72kPa，而AT为32.90kPa。发现在放松位置时AT的弹性模量与MG的弹性模量之间存在显著相关性（r = 0.668，P = 0.001），在中立位置时r = 0.481，P = 0.032。
SWE有潜力评估肌腱弹性特性的局部变化，提供肌腱弹性特性与功能之间更直观的关系，并评估肌腱的治疗效果。发现AT与MG之间存在显著相关性，这可能为临床治疗AT疾病的受试者提供一种新的治疗思路（针对紧张的肌头）。
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