Dieterich Angela V, Skerl Katrin, Paskali Filip, Gizzi Leonardo, Azan Mehrin, Carvalho Gabriela F, Kohl Matthias, Haueise Andreas
Ultrasound Lab, Department of Physiotherapy, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Freiburg, Germany.
Institute of Technical Medicine, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Furtwangen, Germany.
Front Physiol. 2025 May 27;16:1593851. doi: 10.3389/fphys.2025.1593851. eCollection 2025.
Knee osteoarthritis (OA) is a prevalent joint condition associated with disability, pain, and stiffness in the muscles surrounding the knee. Myofascial and massage techniques are employed to alleviate these symptoms. Unclear is whether muscle stiffness is measurably increased in the painful muscles, and how measured muscle stiffness relates to perceived stiffness, pain, and functional impairment. Given muscle anisotropy, stiffness changes may occur in the longitudinal plane parallel to muscle fibers or perpendicularly in the transverse plane. Shear wave velocity (SWV) was measured in both scanning planes in 21 individuals with diagnosed knee OA, 21 sex- and age-matched controls, and 20 , focusing on the gastrocnemius medialis and vastus lateralis muscles under four conditions: (a) resting state, (b) holding the shank against gravity, (c) double-leg stance, and (d) single-leg stance. Median stiffness measures, the ratio of longitudinal-to-transverse stiffness, and the ratio of single-leg stance-to-baseline stiffness were compared between groups using the Kruskal- Wallis and Pairwise Asymptotic Wilcoxon rank sum tests. Correlations with the Knee Injury and Osteoarthritis Outcome Score and the Tampa Scale of Kinesiophobia were examined. Longitudinal stiffness of the gastrocnemius medialis muscle was significantly lower in the OA group at double-leg (P = 0.033) and single-leg stance (P = 0.019), with tendencies toward lower median stiffness in both muscles across most tasks. Transverse stiffness of the vastus lateralis muscle was significantly higher in the OA group at baseline (P = 0.027), with tendencies toward higher median stiffness in both muscles across most tasks. Significant moderate to excellent correlations support the clinical relevance of both longitudinal and transverse stiffness measurements. Measured and perceived stiffness were not correlated. Study results suggest that knee OA may differentially affect muscle stiffness in the longitudinal and transverse planes and that transverse stiffness measures may have clinical relevance.
膝关节骨关节炎（OA）是一种常见的关节疾病，与膝关节周围肌肉的残疾、疼痛和僵硬有关。肌筋膜和按摩技术被用于缓解这些症状。尚不清楚疼痛肌肉中的肌肉僵硬是否会显著增加，以及测量的肌肉僵硬与感知到的僵硬、疼痛和功能障碍之间有何关系。考虑到肌肉的各向异性，僵硬变化可能发生在与肌纤维平行的纵向平面或垂直的横向平面。对21名已确诊膝关节OA的个体、21名性别和年龄匹配的对照组以及20名健康人在四种情况下测量了腓肠肌内侧头和股外侧肌在两个扫描平面中的剪切波速度（SWV）：（a）静息状态，（b）抗重力保持小腿，（c）双腿站立，（d）单腿站立。使用Kruskal-Wallis检验和成对渐近Wilcoxon秩和检验比较了各组之间的中位僵硬测量值、纵向与横向僵硬的比率以及单腿站立与基线僵硬的比率。研究了与膝关节损伤和骨关节炎结果评分以及坦帕运动恐惧量表的相关性。在双腿（P = 0.033）和单腿站立（P = 0.019）时，OA组腓肠肌内侧头的纵向僵硬显著降低，在大多数任务中，两块肌肉的中位僵硬均有降低趋势。在基线时，OA组股外侧肌的横向僵硬显著更高（P = 0.027），在大多数任务中，两块肌肉的中位僵硬均有升高趋势。显著的中度至高度相关性支持纵向和横向僵硬测量的临床相关性。测量的僵硬与感知到的僵硬不相关。研究结果表明，膝关节OA可能在纵向和横向平面上对肌肉僵硬产生不同影响，并且横向僵硬测量可能具有临床相关性。
