Radovanović Goran, Bohm Sebastian, Arampatzis Adamantios, Legerlotz Kirsten
Movement Biomechanics, Institute of Sports Sciences, Humboldt-Universität zu Berlin, 10099 Berlin, Germany.
Department Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, Medical School Hamburg-University of Applied Sciences and Medical University, 20457 Hamburg, Germany.
J Clin Med. 2023 Jan 31;12(3):1102. doi: 10.3390/jcm12031102.
As inter-limb asymmetries can be associated with higher injury risk, we aimed to investigate their role in Achilles tendinopathy patients.
In Achilles tendinopathy patients (n = 41), we assessed inter-limb asymmetries of mechanical, material, and morphological musculoskeletal properties and function and how those were affected by 12 weeks of exercise intervention (high-load protocol, n = 13; Alfredson protocol, n = 11). Moreover, we assessed whether asymmetry reductions correlated with improved Patient-Reported Outcomes (VISA-A score).
At baseline, tendinopathic tendons demonstrated lower tendon force ( = 0.017), lower tendon stress ( < 0.0001), larger tendon cross-sectional area (CSA) ( < 0.001), and increased intratendinous ( = 0.042) and tendon overall ( = 0.021) vascularization. For the high-load group, PRE-to-POST asymmetry comparisons revealed an asymmetry increase for the counter-movement jump (CMJ) ( = 0.034) and PRE-to-POST VISA-A score improvements correlated with CSA asymmetry reductions ( = 0.024). Within the Alfredson group, PRE-to-POST VISA-A score improvements correlated with CMJ asymmetry reductions ( = 0.044) and tendon stiffness asymmetry increases ( = 0.037). POST-to-POST in-between group comparisons revealed lower asymmetry in the high-load group for tendon elongation ( = 0.021) and tendon strain ( = 0.026).
The tendinopathic limb differs from the asymptomatic limb while therapeutic exercise interventions have little effect on asymmetries. Asymmetry reductions are not necessarily associated with tendon health improvements.
由于肢体间不对称可能与较高的损伤风险相关，我们旨在研究其在跟腱病患者中的作用。
在跟腱病患者（n = 41）中，我们评估了机械、材料和形态学肌肉骨骼特性及功能的肢体间不对称情况，以及这些不对称如何受到为期12周的运动干预的影响（高负荷方案，n = 13；阿尔弗雷德森方案，n = 11）。此外，我们评估了不对称性的降低是否与患者报告结局（VISA - A评分）的改善相关。
在基线时，患侧肌腱表现出较低的肌腱力（ = 0.017）、较低的肌腱应力（ < 0.0001）、较大的肌腱横截面积（CSA）（ < 0.001），以及腱内（ = 0.042）和肌腱整体（ = 0.021）血管化增加。对于高负荷组，前后不对称性比较显示反向移动跳跃（CMJ）的不对称性增加（ = 0.034），且前后VISA - A评分的改善与CSA不对称性的降低相关（ = 0.024）。在阿尔弗雷德森组中，前后VISA - A评分的改善与CMJ不对称性的降低（ = 0.044）和肌腱刚度不对称性的增加（ = 0.037）相关。组间后测比较显示，高负荷组在肌腱伸长（ = 0.021）和肌腱应变（ = 0.026）方面的不对称性较低。
患侧肢体与无症状肢体不同，而治疗性运动干预对不对称性影响不大。不对称性的降低不一定与肌腱健康的改善相关。
