Mapping the relationships between joint stiffness, modeled muscle stiffness, and shear wave velocity.

Joint stiffness is often measured to make inferences about the stiffness of muscle groups, but little can be gleaned about individual muscles. Decomposing the muscular origins of joint stiffness may inform treatment targets for conditions like spasticity. To complement joint stiffness, shear wave ultrasound elastography has been used to estimate the material properties of individual muscles. If shear wave measures are to be used to assess the muscular origins of joint stiffness, then changes in shear wave velocity should strongly relate to changes in joint stiffness. Here, we estimated the relationships between shear wave velocity in the primary plantar flexors [soleus (SOL) and medial gastrocnemius (MG)] and ankle joint stiffness. Participants performed isometric plantar flexion tasks at a range of activations (0-40%), while joint stiffness and muscle shear wave velocities were obtained. We observed a strong, linear relationship between plantar flexor shear wave velocities and joint stiffness. Remarkably, the parameter estimates of this stiffness-shear wave relationship strongly agreed with theoretical and literature-based estimates [SOL:MG parameter ratios = 2.83 (observed) vs. 2.85 (expected from theoretical stiffness ratio)]. Finally, a musculoskeletal model of the plantar flexors was able to accurately reproduce joint stiffness estimates, and shear wave velocities could explain 80-95% of the variance in modeled muscle stiffness. These findings suggest that shear wave velocity may be used to infer the muscular origins of changes in joint stiffness. Shear wave velocity is commonly assessed to infer the muscular origins of changes in joint stiffness, but the exact relationship between shear wave velocity changes in muscle and joint stiffness changes remains unknown. Here, we systematically evaluated and quantified this relationship in the plantar flexors. Our results provide evidence for the ability of shear wave velocity to elucidate the muscular origins of joint stiffness changes.