Risch Lucie, Stoll Josefine, Schomöller Anne, Engel Tilman, Mayer Frank, Cassel Michael
University Outpatient Clinic, Sports Medicine and Orthopedics, University of Potsdam, Potsdam, Germany.
Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
Front Physiol. 2021 Jul 6;12:617497. doi: 10.3389/fphys.2021.617497. eCollection 2021.
This study investigated intraindividual differences of intratendinous blood flow (IBF) in response to running exercise in participants with Achilles tendinopathy.
This is a cross-sectional study.
The study was conducted at the University Outpatient Clinic.
Sonographic detectable intratendinous blood flow was examined in symptomatic and contralateral asymptomatic Achilles tendons of 19 participants (42 ± 13 years, 178 ± 10 cm, 76 ± 12 kg, VISA-A 75 ± 16) with clinically diagnosed unilateral Achilles tendinopathy and sonographic evident tendinosis.
IBF was assessed using Doppler ultrasound "Advanced Dynamic Flow" before (Upre) and 5, 30, 60, and 120 min (U5-U120) after a standardized submaximal constant load run.
IBF was quantified by counting the number () of vessels in each tendon.
At Upre, IBF was higher in symptomatic compared with asymptomatic tendons [mean 6.3 (95% CI: 2.8-9.9) and 1.7 (0.4-2.9), < 0.01]. Overall, 63% of symptomatic and 47% of asymptomatic Achilles tendons responded to exercise, whereas 16 and 11% showed persisting IBF and 21 and 42% remained avascular throughout the investigation. At U5, IBF increased in both symptomatic and asymptomatic tendons [difference to baseline: 2.4 (0.3-4.5) and 0.9 (0.5-1.4), = 0.05]. At U30 to U120, IBF was still increased in symptomatic but not in asymptomatic tendons [mean difference to baseline: 1.9 (0.8-2.9) and 0.1 (-0.9 to 1.2), < 0.01].
Irrespective of pathology, 47-63% of Achilles tendons responded to exercise with an immediate acute physiological IBF increase by an average of one to two vessels ("responders"). A higher amount of baseline IBF (approximately five vessels) and a prolonged exercise-induced IBF response found in symptomatic ATs indicate a pain-associated altered intratendinous "neovascularization."
本研究调查了跟腱病患者在跑步运动后腱内血流（IBF）的个体差异。
这是一项横断面研究。
研究在大学门诊进行。
对19名临床诊断为单侧跟腱病且超声检查显示有腱病的参与者（42±13岁，身高178±10厘米，体重76±12千克，VISA - A评分为75±16）的患侧有症状的跟腱和对侧无症状的跟腱进行超声检测腱内血流情况。
在标准化次最大恒定负荷跑步前（Upre）以及跑步后5、30、60和120分钟（U5 - U120），使用多普勒超声“高级动态血流”评估IBF。
通过计算每条肌腱内血管数量（）对IBF进行量化。
在Upre时，有症状的肌腱的IBF高于无症状的肌腱[平均值分别为6.3（95%置信区间：2.8 - 9.9）和1.7（0.4 - 2.9），P < 0.01]。总体而言，63%有症状的跟腱和47%无症状的跟腱对运动有反应，而在整个研究过程中，16%有症状的和11%无症状的跟腱显示IBF持续存在，21%有症状的和42%无症状的跟腱始终无血管。在U5时，有症状和无症状的肌腱的IBF均增加[与基线的差异：2.4（0.3 - 4.5）和0.9（0.5 - 1.4），P = 0.05]。在U30至U120时，有症状的肌腱的IBF仍增加，而无症状的肌腱则未增加[与基线的平均差异：1.9（0.8 - 2.9）和0.1（ - 0.9至1.2），P < 0.01]。
无论病理情况如何，47% - 63%的跟腱对运动有反应，运动后急性生理IBF立即平均增加一到两条血管（“反应者”）。有症状的跟腱中较高的基线IBF（约五条血管）以及运动诱导的IBF反应延长表明存在与疼痛相关的腱内“新生血管形成”改变。
