Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Institute of Human Movement Science, Sport and Health, University of Graz, Mozartgasse 14, 8010, Graz, Austria.
Knee Surg Sports Traumatol Arthrosc. 2022 Dec;30(12):4203-4213. doi: 10.1007/s00167-022-07076-2. Epub 2022 Jul 29.
Human muscle-tendon units (MTUs) are highly plastic and undergo changes in response to specific diseases and disorders. To investigate the pathological changes and the effects of therapeutic treatments, the use of valid and reliable examination methods is of crucial importance. Therefore, in this study, a simple 3D ultrasound approach was developed and evaluated with regard to: (1) its validity in comparison to magnetic resonance imaging (MRI) for the assessment of the gastrocnemius medialis (GM) MTU, muscle belly, and Achilles tendon lengths; and (2) its reliability for static and dynamic length measurements.
Sixteen participants were included in the study. To evaluate the validity and reliability of the novel 3D ultrasound approach, two ultrasound measurement sessions and one MRI assessment were performed. By combining 2D ultrasound and 3D motion capture, the tissue lengths were assessed at a fixed ankle joint position and compared to the MRI measurements using Bland-Altman plots. The intra-rater and inter-rater reliability for the static and dynamic length assessments was determined using the coefficient of variation, standard error of measurement (SEM), minimal detectable change (MDC), and intraclass correlation coefficient (ICC).
The 3D ultrasound approach slightly underestimated the length when compared with MRI by 0.7%, 1.5%, and 1.1% for the GM muscle belly, Achilles tendon, and MTU, respectively. The approach showed excellent intra-rater as well as inter-rater reliability, with high ICC (≥ 0.94), small SEM (≤ 1.3 mm), and good MDC (≤ 3.6 mm) values, with even better reliability found for the static length measurements.
The proposed 3D ultrasound approach was found to be valid and reliable for the assessment of the GM MTU, muscle belly, and Achilles tendon lengths, as well as the tissue lengthening behavior, confirming its potential as a useful tool for investigating the effects of training interventions or therapeutic treatments (e.g., surgery or conservative treatments such as stretching and orthotics).
Level II.
人类的肌肉-肌腱单位（MTU）具有高度的可塑性，并会针对特定的疾病和障碍发生变化。为了研究病理变化和治疗效果，使用有效且可靠的检查方法至关重要。因此，在这项研究中，我们开发了一种简单的 3D 超声方法，并对其进行了评估，内容涉及：（1）与磁共振成像（MRI）相比，评估比目鱼肌（GM）MTU、肌腹和跟腱长度的有效性；（2）用于静态和动态长度测量的可靠性。
本研究纳入了 16 名参与者。为了评估新的 3D 超声方法的有效性和可靠性，进行了两次超声测量和一次 MRI 评估。通过将 2D 超声和 3D 运动捕捉相结合，在固定的踝关节位置评估组织长度，并使用 Bland-Altman 图将其与 MRI 测量值进行比较。使用变异系数、测量误差（SEM）、最小可检测变化（MDC）和组内相关系数（ICC）来确定静态和动态长度评估的内部和内部评估者可靠性。
与 MRI 相比，3D 超声方法略微低估了长度，GM 肌腹、跟腱和 MTU 的长度分别低估了 0.7%、1.5%和 1.1%。该方法表现出良好的内部和外部评估者可靠性，ICC 值较高（≥0.94），SEM 值较小（≤1.3mm），MDC 值较好（≤3.6mm），静态长度测量的可靠性甚至更高。
所提出的 3D 超声方法在评估 GM MTU、肌腹和跟腱长度以及组织延长行为方面被证明是有效和可靠的，证实了其作为一种有用的工具，可用于研究训练干预或治疗效果（例如手术或保守治疗，如伸展和矫形器）的潜力。
2 级。
