Mylle Ine, Funaro Alessia, Crouzier Marion, Bogaerts Stijn, Vanwanseele Benedicte
Human Movement Biomechanics Research Group, Department of Movement Science, KU Leuven, Leuven, Belgium.
Movement Interactions Performance, MIP, UR 4334, Nantes University, Nantes, France.
Front Bioeng Biotechnol. 2024 Jul 18;12:1399611. doi: 10.3389/fbioe.2024.1399611. eCollection 2024.
The Achilles tendon exhibits anatomical variations in subtendon twist among individuals, and its compliance can change due to conditions like Achilles tendinopathy. However, current musculoskeletal models overlook these material and morphological variations. This study aimed to investigate the impact of altering Achilles subtendon insertion points and compliance on the triceps surae muscle forces, and therefore tendon loading, during dynamic exercises in one Achilles tendinopathy patient. First, subtendon insertion points were altered in the musculoskeletal model based on a subject-specific 3D freehand ultrasound model and for three types of subtendon twists: low, medium, and high. Second, tendon compliance was modeled based on experimental values, creating three musculoskeletal models: compliant, mean, and stiff. Results indicated that tendon compliance had a larger effect than tendon twist on triceps surae muscle forces. Altering subtendon insertion points to the three types of twist showed a maximal change of 2.3% in muscle force contribution compared to the no-twist model. During the eccentric rehabilitation exercise-a common exercise choice during rehabilitation-the compliant tendon model showed substantial differences compared to the generic (control) musculoskeletal model, resulting in decreased gastrocnemius medialis (-3.5%) and gastrocnemius lateralis (-3.2%) contributions and increased soleus contribution (+ 6.6%). Our study results highlight the necessity of incorporating tendon compliance in musculoskeletal models to accurately predict triceps surae muscle forces, especially in individuals with increased tendon compliance, such as patients with Achilles tendinopathy. Such findings contribute to more accurate predictions of muscle forces and hence, personalized rehabilitation strategies.
跟腱在个体之间的腱下扭转存在解剖学差异，并且其顺应性会因跟腱病等情况而改变。然而，当前的肌肉骨骼模型忽略了这些材料和形态学上的差异。本研究旨在调查在一名跟腱病患者进行动态运动期间，改变跟腱腱下插入点和顺应性对小腿三头肌力量以及由此产生的肌腱负荷的影响。首先，基于个体特异性的三维徒手超声模型，在肌肉骨骼模型中改变腱下插入点，并针对三种类型的腱下扭转：低、中、高。其次，根据实验值对肌腱顺应性进行建模，创建三个肌肉骨骼模型：顺应性、平均和僵硬。结果表明，肌腱顺应性对小腿三头肌力量的影响比肌腱扭转更大。与无扭转模型相比，将腱下插入点改变为三种扭转类型时，肌肉力量贡献的最大变化为2.3%。在离心康复运动（康复期间常见的运动选择）中，顺应性肌腱模型与通用（对照）肌肉骨骼模型相比显示出显著差异，导致内侧腓肠肌贡献减少（-3.5%）和外侧腓肠肌贡献减少（-3.2%），而比目鱼肌贡献增加（+6.6%）。我们的研究结果强调了在肌肉骨骼模型中纳入肌腱顺应性以准确预测小腿三头肌力量的必要性，特别是在肌腱顺应性增加的个体中，如跟腱病患者。这些发现有助于更准确地预测肌肉力量，从而制定个性化的康复策略。
