M.560 Autoantibody titers against various forms of oxidized LDL and Achilles tendon thickness evaluated by ultrasonography in hyperlipidemic patients

Context: Exercise is seen as the most evidence-based treatment for managing tendinopathy and although the type of exercise used to manage tendinopathy may induce adaptation in healthy tendons, it is not clear whether these adaptations occur in tendinopathy and if so whether they are associated with improved clinical outcomes. Objective: The aim of the study was to synthesize available evidence for adaptation of the Achilles tendon to eccentric exercise and the relationship between adaptation (change in tendon thickness) and clinical outcomes among people with Achilles tendinopathy. Evidence Acquisition: The search was performed in September 2018 in several databases. Studies investigating the response (clinical outcome and imaging on ultrasound/magnetic resonance imaging) of pathological tendons (tendinopathy, tendinosis, and partial rupture) to at least 12 weeks of eccentric exercise were included. Multiple studies that investigated the same interventions and outcome were pooled and presented in effect size estimates, mean difference, and 95% confidence intervals if measurement scales were the same, or standard mean difference and 95% confidence intervals if measurements scales were different. Where data could not be pooled the studies were qualitatively synthesized based on van Tulder et al. Evidence Synthesis: Eight studies met the inclusion and exclusion criteria and were included in the review. There was strong evidence that Achilles tendon thickness does not decrease in parallel with improved clinical outcomes. Conclusions: Whether a longer time to follow-up is more important than the intervention (ie, just the time per se) for a change in tendon thickness remains unknown. Future studies should investigate whether exercise (or other treatments) can be tailored to optimize tendon adaptation and function, and whether this relates to clinical outcomes.

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Symptomatic Achilles Tendons are Thicker than Asymptomatic Tendons on Ultrasound Examination in Recreational Long-Distance Runners

Sports ◽

10.3390/sports7120245 ◽

2019 ◽

Vol 7 (12) ◽

pp. 245 ◽

Cited By ~ 2

Author(s):

Bo Tillander ◽

Håkan Gauffin ◽

Johan Lyth ◽

Anders Knutsson ◽

Toomas Timpka

Keyword(s):

Achilles Tendon ◽

Ultrasound Examination ◽

Morphological Changes ◽

Clinical Decision ◽

Multiple Model ◽

Distance Runners ◽

Long Distance ◽

Clinical Indicators ◽

Morphological Findings ◽

Tendon Thickness

There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles tendon detected in ultrasound examinations are associated with local symptoms in middle-age recreational long-distance runners. Forty-two Achilles tendons (21 middle-aged runners) were investigated by ultrasound examination measuring tendon thickness and a morphology score indicating tendinosis. The Generalized Estimating Equations method was applied in multiple models of factors associated with reporting a symptomatic tendon. Eleven symptomatic and 31 asymptomatic Achilles tendons were recorded. In the multiple model that used tendon thickness measured 30 mm proximal to the distal insertion, an association was found between thickness and reporting a symptomatic tendon (p < 0.001; OR 12.9; 95% CI 3.1 to 53.2). A qualitative morphology score was not found to be significantly associated with reporting a symptomatic tendon (p = 0.10). We conclude that symptomatic Achilles tendons were thicker than asymptomatic tendons on ultrasound examination among recreational long-distance runners and that the importance of parallel morphological findings need to be further investigated in prospective studies.

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Computer-based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosis

British Journal of Sports Medicine ◽

10.1136/bjsm.2007.037812 ◽

2007 ◽

Vol 41 (12) ◽

pp. 897-902 ◽

Cited By ~ 17

Author(s):

R Syha ◽

M Peters ◽

H Birnesser ◽

A Niess ◽

A Hirschmueller ◽

...

Keyword(s):

Achilles Tendon ◽

Ultrasound Images ◽

Tendon Thickness ◽

Computer Based ◽

The Mean

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Combination of hormone replacement therapy and high physical activity is associated with differences in Achilles tendon size in monozygotic female twin pairs

Journal of Applied Physiology ◽

10.1152/japplphysiol.91439.2008 ◽

2009 ◽

Vol 106 (4) ◽

pp. 1332-1337 ◽

Cited By ~ 28

Author(s):

T. Finni ◽

V. Kovanen ◽

P. H. A. Ronkainen ◽

E. Pöllänen ◽

G. R. Bashford ◽

...

Keyword(s):

Physical Activity ◽

Hormone Replacement Therapy ◽

Achilles Tendon ◽

Replacement Therapy ◽

Hormone Replacement ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Physically Active ◽

Tendon Thickness

Estrogen concentration has been suggested to play a role in tendon abnormalities and injury. In physically active postmenopausal women, hormone replacement therapy (HRT) has been suggested to decrease tendon diameter. We hypothesized that HRT use and physical activity are associated with Achilles tendon size and tissue structure. The study applied cotwin analysis of fourteen 54- to 62-yr-old identical female twin pairs with current discordance for HRT use for an average of 7 yr. Achilles tendon thickness and cross-sectional areas were determined by ultrasonography, and tendon structural organization was analyzed from the images using linear discriminant analysis (LDA). Maximal voluntary and twitch torques from plantar flexor muscles were measured. Serum levels of estradiol, estrone, testosterone, and sex hormone binding globulin were analyzed. Total daily metabolic equivalent score (MET-h/day) was calculated from physical activity questionnaires. Results showed that, in five physically active (MET > 4) pairs, the cotwins receiving HRT had greater estradiol level ( P = 0.043) and smaller tendon cross-sectional area than their sisters (63 vs. 71 mm2, P = 0.043). Among all pairs, Achilles tendon thickness and cross-sectional area did not significantly differ between HRT using and nonusing twin sisters. Intrapair correlation for Achilles tendon thickness was high, despite HRT use discordance ( r = 0.84, P < 0.001). LDA distinguished different tendon structure only from two of six examined twin pairs who had a similar level of physical activity. In conclusion, the effect of HRT on Achilles tendon characteristics independent of genetic confounding may be present only in the presence of sufficient physical activity. In physically active twin pairs, the higher level of estrogen seems to be associated with smaller tendon size.

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Discrimination of familial hypercholesterolemia and secondary hypercholesterolemia by achilles' tendon thickness

Atherosclerosis ◽

10.1016/0021-9150(77)90199-x ◽

1977 ◽

Vol 28 (1) ◽

pp. 61-67 ◽

Cited By ~ 71

Author(s):

H. Mabuchi ◽

S. Ito ◽

T. Haba ◽

K. Ueda ◽

R. Ueda ◽

...

Keyword(s):

Achilles Tendon ◽

Familial Hypercholesterolemia ◽

Tendon Thickness

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Autoantibody titers against OxLDL are correlated with Achilles tendon thickness in patients with familial hypercholesterolemia

The Journal of Lipid Research ◽

10.1194/jlr.m600109-jlr200 ◽

2006 ◽

Vol 47 (10) ◽

pp. 2208-2214 ◽

Cited By ~ 28

Author(s):

Sofia G. Tsouli ◽

Dimitrios N. Kiortsis ◽

Evangelia S. Lourida ◽

Vasilios Xydis ◽

Loukas D. Tsironis ◽

...

Keyword(s):

Achilles Tendon ◽

Familial Hypercholesterolemia ◽

Tendon Thickness

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Regression of Achilles tendon thickness after statin treatment in patients with familial hypercholesterolemia: An ultrasonographic study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2008.10.032 ◽

2009 ◽

Vol 205 (1) ◽

pp. 151-155 ◽

Cited By ~ 37

Author(s):

Sofia G. Tsouli ◽

Vasilios Xydis ◽

Maria I. Argyropoulou ◽

Alexandros D. Tselepis ◽

Moses Elisaf ◽

...

Keyword(s):

Achilles Tendon ◽

Familial Hypercholesterolemia ◽

Statin Treatment ◽

Tendon Thickness

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Acute Effects of Resistance Training with Blood Flow Restriction on Achilles Tendon Thickness

Journal of Human Kinetics ◽

10.2478/hukin-2021-0032 ◽

2021 ◽

Vol 78 (1) ◽

pp. 101-109

Author(s):

Moisés Picón-Martínez ◽

Iván Chulvi-Medrano ◽

Juan Manuel Cortell-Tormo ◽

Diego A. Alonso-Aubin ◽

Yasser Alakhdar ◽

...

Keyword(s):

Blood Flow ◽

Resistance Training ◽

Achilles Tendon ◽

Plantar Flexion ◽

Blood Flow Restriction ◽

Acute Effects ◽

Flow Restriction ◽

Pressure Cuff ◽

Tendon Thickness ◽

The Individual

Abstract The Achilles tendon is one of the strongest and thickest tendons of the human body. Several studies have reported an immediate decrease in Achilles tendon thickness after a single bout of resistance training. However, the effects of blood flow restriction training on Achilles tendon thickness have not been investigated. The purpose of this study was to investigate the acute effects of different regimens of resistance training on Achilles tendon thickness. Fiftytwo participants (27.3 ± 7 years; 177.6 ± 11 cm; 72.2 ± 13.7 kg) were randomly allocated into one of the three groups: low-intensity exercise without (LI, n = 13) and with blood flow restriction (LI-BFR, n = 24), and high-intensity exercise (HI, n = 15). Participants from LI and LI-BFR groups performed four sets (1 x 30 + 3 x 15 reps) at 30% 1RM, while the HI group performed four sets (1 x 30 with 30% 1RM + 3 x 10 reps with 75% 1RM). All groups performed a plantar flexion exercise. For the LI-BFR group, a blood pressure cuff was placed on the dominant calf and inflated at 30% of the individual´s occlusion pressure (47.6 ± 19.8 mmHg). Sonographic images of Achilles tendon thickness were taken at pre, immediately after, 60 min and 24 h following acute bouts of exercise. Achilles tendon thickness was significantly reduced immediately after, 60 min and 24 h post-LI-BFR exercise (pre: 4.4 ± 0.4 mm vs. IA: 3.8 ± 0.4 mm vs. 60 min: 3.7 ± 0.3 mm vs. 24 h: 4.1 ± 0.3 mm; p < 0.001), whereas Achilles tendon thickness was unchanged for HI and LI groups (p > 0.05). These results suggest that blood flow restriction training may be an effective strategy to stimulate a positive response in Achilles tendon thickness.

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