scholarly journals Myotonometry for the evaluation of Achilles tendon mechanical properties: a reliability and construct validity study

2020 ◽  
Vol 6 (1) ◽  
pp. e000726 ◽  
Author(s):  
Alessandro Schneebeli ◽  
Deborah Falla ◽  
Ron Clijsen ◽  
Marco Barbero

ObjectiveThis study evaluates the intra-rater and inter-rater reliability of the MyotonPRO and its construct validity for the assessment of Achilles tendon stiffness.DesignReliability and construct validity study.MethodsForty healthy participants were assessed using the MyotonPRO by two raters on two different occasions. Tendon was evaluated in three different positions (relaxed, 0° plantarflexion and standing) and during different isometric contractions (range 0–3 kg). Reliability was calculated using intraclass correlation coefficient (ICC and 95% CI) standard error of measurement and minimal detectable change. Construct validity was evaluated between the different positions and the different contraction intensities using Friedman test.ResultsIntra-rater reliability was very high ICC2,k 0.87–0.98. The reliability of the 0.5 kg contraction was moderate with an ICC2,k of 0.59. Inter-rater reliability ranged from high to very high with an ICC2,k of 0.76–0.86. The reliability of the 0.5 kg, 1 kg contraction and the standing position was moderate with an ICC2,k of 0.55, 0.54 and 0.56 respectively. Inter-session reliability ranged from high to very high with an ICC2,k of 0.70–0.89. The reliability of the 0.5 kg contraction was moderate with an ICC2,k of 0.54. Construct validity was demonstrated between different contraction levels and different positions.ConclusionMyotonPRO is a reliable tool for the evaluation of Achilles tendon stiffness during different contraction levels and in different positions. Construct validity was supported by changes of tendon stiffness during the explored conditions. MyotonPRO can be implemented, as a ready to use device, in the evaluation of tendon tissue mechanical properties.

2009 ◽  
Vol 106 (4) ◽  
pp. 1249-1256 ◽  
Author(s):  
Anthony D. Kay ◽  
Anthony J. Blazevich

The effects of static stretch on muscle and tendon mechanical properties and muscle activation were studied in fifteen healthy human volunteers. Peak active and passive moment data were recorded during plantar flexion trials on an isokinetic dynamometer. Electromyography (EMG) monitoring of the triceps surae muscles, real-time motion analysis of the lower leg, and ultrasound imaging of the Achilles-medial gastrocnemius muscle-tendon junction were simultaneously conducted. Subjects performed three 60-s static stretches before being retested 2 min and 30 min poststretch. There were three main findings in the present study. First, peak concentric moment was significantly reduced after stretch; 60% of the deficit recovered 30 min poststretch. This was accompanied by, and correlated with ( r = 0.81 ; P < 0.01) reductions in peak triceps surae EMG amplitude, which was fully recovered at 30 min poststretch. Second, Achilles tendon length was significantly shorter during the concentric contraction after stretch and at 30 min poststretch; however, no change in tendon stiffness was detected. Third, passive joint moment was significantly reduced after stretch, and this was accompanied by significant reductions in medial gastrocnemius passive muscle stiffness; both measures fully recovered by 30 min poststretch. These data indicate that the stretching protocol used in this study induced losses in concentric moment that were accompanied by, and related to, reductions in neuromuscular activity, but they were not associated with alterations in tendon stiffness or shorter muscle operating length. Reductions in passive moment were associated with reductions in muscle stiffness, whereas tendon mechanics were unaffected by the stretch. Importantly, the impact on mechanical properties and neuromuscular activity was minimal at 30 min poststretch.


Author(s):  
Katherine L. Marks ◽  
Alessandra Verdi ◽  
Laura E. Toles ◽  
Kaila L. Stipancic ◽  
Andrew J. Ortiz ◽  
...  

Objective The purpose of this study was to examine the psychometric properties of an ecological vocal effort scale linked to a voicing task. Method Thirty-eight patients with nodules, 18 patients with muscle tension dysphonia, and 45 vocally healthy control individuals participated in a week of ambulatory voice monitoring. A global vocal status question was asked hourly throughout the day. Participants produced a vowel–consonant–vowel syllable string and rated the vocal effort needed to produce the task on a visual analog scale. Test–retest reliability was calculated for a subset using the intraclass correlation coefficient, ICC(A, 1). Construct validity was assessed by (a) comparing the weeklong vocal effort ratings between the patient and control groups and (b) comparing weeklong vocal effort ratings before and after voice rehabilitation in a subset of 25 patients. Cohen's d, the standard error of measurement ( SEM ), and the minimal detectable change (MDC) assessed sensitivity. The minimal clinically important difference (MCID) assessed responsiveness. Results Test–retest reliability was excellent, ICC(A, 1) = .96. Weeklong mean effort was statistically higher in the patients than in controls ( d = 1.62) and lower after voice rehabilitation ( d = 1.75), supporting construct validity and sensitivity. SEM was 4.14, MDC was 11.47, and MCID was 9.74. Since the MCID was within the error of the measure, we must rely upon the MDC to detect real changes in ecological vocal effort. Conclusion The ecological vocal effort scale offers a reliable, valid, and sensitive method of monitoring vocal effort changes during the daily life of individuals with and without vocal hyperfunction.


2018 ◽  
Vol 21 (02) ◽  
pp. 1850009
Author(s):  
Yohei Kanno ◽  
Hajime Toda ◽  
Tsutomu Horiuchi ◽  
Masaki Katayose

Objective: The aim of this study was to establish intra-rater and inter-rater reliability of a measurement method for the pathway of the supraspinatus intramuscular tendon by 3.0 tesla MRI images. Methods: The scapula and intramuscular tendon extraction DICOM data was made to extract only a scapula domain and intramuscular tendon domain. The shear force angle anterior posterior (SFA-AP) was measured as the pathway of supraspinatus intramuscular tendon with respect to the glenoid plane on three-dimensional (3D) models of the bone and intramuscular tendon. SFA-AP of supraspinatus was measured on 3D models of the bone and intramuscular tendon. The mean and standard deviation of SFA-AP of supraspinatus was calculated. Intra-rater reliability and inter-rater reliability were evaluated by the intraclass correlation coefficient (ICC), the standard error of the mean (SEM) and the minimal detectable change (MDC). Inter-rater reliability was evaluated by three raters. Results: As for intra-rater reliability, SFA-AP of supraspinatus measured averaged [Formula: see text], with ICC (1,1) of 0.978, with ICC (1,3) of 0.993, with SEM of 0.53, with MDC of 1.46[Formula: see text]. As for inter-rater reliability, SFA-AP of supraspinatus measured averaged [Formula: see text] (rater1), SFA-AP measured averaged [Formula: see text] (rater2), SFA-AP measured averaged [Formula: see text] (rater3), with ICC (2,1) of 0.896, with ICC (2,3) of 0.963, with SEM of 1.11, with MDC of 3.09[Formula: see text]. Conclusions: 3D models of the bone and intramuscular tendon were evaluated as intra-rater and inter-rater reliabilities. SFA-AP of supraspinatus is guaranteed by one measurement.


2013 ◽  
Vol 114 (5) ◽  
pp. 523-537 ◽  
Author(s):  
Alexandre Fouré ◽  
Antoine Nordez ◽  
Christophe Cornu

Eccentric training is a mechanical loading classically used in clinical environment to rehabilitate patients with tendinopathies. In this context, eccentric training is supposed to alter tendon mechanical properties but interaction with the other components of the muscle-tendon complex remains unclear. The aim of this study was to determine the specific effects of 14 wk of eccentric training on muscle and tendon mechanical properties assessed in active and passive conditions in vivo. Twenty-four subjects were randomly divided into a trained group ( n = 11) and a control group ( n = 13). Stiffness of the active and passive parts of the series elastic component of plantar flexors were determined using a fast stretch during submaximal isometric contraction, Achilles tendon stiffness and dissipative properties were assessed during isometric plantar flexion, and passive stiffness of gastrocnemii muscles and Achilles tendon were determined using ultrasonography while ankle joint was passively moved. A significant decrease in the active part of the series elastic component stiffness was found ( P < 0.05). In contrast, a significant increase in Achilles tendon stiffness determined under passive conditions was observed ( P < 0.05). No significant change in triceps surae muscles and Achilles tendon geometrical parameters was shown ( P > 0.05). Specific changes in muscle and tendon involved in plantar flexion are mainly due to changes in intrinsic mechanical properties of muscle and tendon tissues. Specific assessment of both Achilles tendon and plantar flexor muscles allowed a better understanding of the functional behavior of the muscle-tendon complex and its adaptation to eccentric training.


Author(s):  
Weeerapong Sanmontree ◽  
Peera Wongupparaj

The Short-Term Assessment of Risk and Treatability (START) is deemed the most appropriate instrument for assessing violence risks and management because of its balanced approach between dynamic risk and protective factors. Although several facets of reliability and predictive validity of this tool were strong, its inter-rater reliability, construct validity, and implementation in Asian population were under-investigated. The objective of this research was to examine the inter-rater reliability and construct validity of the START: Thai version within forensic psychiatric inpatients. The participants consisted of 118 forensic psychiatric inpatients hospitalized at Galya Rajanagarindra Institute in Thailand. Trained mental health professionals (i.e., psychiatrists, forensic nurses, clinical psychologists, social workers, and occupational therapists) assessed each participant across twenty domains of the Thai START. The inter-rater reliability was examined using the intraclass correlation coefficient and a confirmatory factor analysis for ordinal data was used to test the construct validity of the scale. The main finding showed a good-to-excellent inter-rater reliability and supported two relational constructs (i.e., strength vs vulnerability subscales) of the Thai START. The Thai START is a promising tool for using in Thai forensic psychiatric setting but some items were not significant in contributing to the scale. This study also provides the guideline for implementing the tool in non-Western forensic psychiatric populations.


Author(s):  
Alfredo Bravo-Sánchez ◽  
Pablo Abián ◽  
Filipa Sousa ◽  
Fernando Jimenez ◽  
Javier Abián-Vicén

Regular sport practice could prevent age-related changes in tendinous tissues. The purpose of the study was to investigate the effect of regular badminton practice on patellar and Achilles tendon mechanical properties in senior competitive badminton players (>35 years old) and to compare the results with physically active people matched by age. One hundred ninety-two badminton players and 193 physically active people were divided by age into four groups, between 35 and 44 (U45), between 45 and 54 (U55), between 55 and 64 (U65), and over 65 (O65) years old. A LogiqS8 transducer in elastography mode and a MyotonPRO myotonometer were used to assess patellar and Achilles mechanical properties. Achilles tendon stiffness was higher in the control group than the badminton players for the U45, U55, and O65 age groups (p < .01). Also, the elastography index was higher in the control group than the badminton players for the U45, U55, U65, and O65 age groups (p < .05). In conclusion, regular badminton practice could prevent the decline in mechanical properties of the patellar and Achilles tendons.


2021 ◽  
pp. 036354652110271
Author(s):  
Mark J. Scholes ◽  
Matthew G. King ◽  
Kay M. Crossley ◽  
Denise M. Jones ◽  
Adam I. Semciw ◽  
...  

Background: The International Hip Outcome Tool–33 (iHOT-33) was developed to evaluate patients seeking surgery for hip and/or groin (hip/groin) pain and may not be appropriate for those seeking nonsurgical treatment. Purpose: To evaluate the psychometric properties of the iHOT-33 total (iHOT-Total) score and all subscale scores in adults with hip/groin pain who were not seeking surgery. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Patients with hip/groin pain who were not seeking surgery were recruited from 2 ongoing studies in Australia. Semistructured one-on-one interviews assessed content validity. Construct validity was assessed by testing hypothesized correlations between iHOT-33 and Copenhagen Hip and Groin Outcome Score (HAGOS) subscale scores. Test-retest reliability was assessed in patients not undertaking treatment and who reported “no change” in their Global Rating of Change (GROC) score at 6-month follow-up. Scores were reliable at group and individual levels if intraclass correlation coefficients (ICCs) were ≥0.80 and ≥0.90, respectively. Scores were responsive if Spearman rank correlations (ρ) between the change in the iHOT-33 score and the GROC score were ≥0.40. Results: In total, 278 patients with hip/groin pain (93 women; mean age, 31 years) and 55 pain-free control participants (14 women; mean age, 29 years) were recruited. The iHOT-33 demonstrated acceptable content validity. Construct validity was acceptable, with all hypothesized strong positive correlations between iHOT-33 and HAGOS subscale scores confirmed ( r range, 0.60-0.76; P < .001), except for one correlation between the iHOT-Sport and HAGOS-Sport ( r = .058; P < .001). All scores were reliable at the group level, except for the iHOT-33 job subscale (iHOT-Job) (ICC range, 0.78-0.88 [95% CI, 0.60-0.93]). None of the subscales met the criteria for adequate reliability for use at the individual level (all ICCs <0.90). Minimal detectable change values (group level) ranged from 2.3 to 3.7 (95% CI, 1.7-5.0). All iHOT-33 subscale scores were responsive (ρ range, 0.40-0.58; P≤ .001), except for the iHOT-Job in patients not undertaking treatment (ρ = 0.27; P = .001). Conclusion: All iHOT-33 subscale scores were valid for use in patients with hip/groin pain who were not seeking surgery. Acceptable test-retest reliability was found for all subscale scores at the group level, except the iHOT-Job. All subscale scores, excluding the iHOT-Job, were responsive, regardless of undertaking physical therapist–led treatment or no treatment.


Author(s):  
Tomas Gallego-Izquierdo ◽  
Enrique Arroba-Díaz ◽  
Gema García-Ascoz ◽  
María del Alba Val-Cano ◽  
Daniel Pecos-Martin ◽  
...  

The aim of this study was to assess the psychometric properties of the mobile application forward head posture in terms of validity, inter- and intra-rater reliability, minimum detectable change, sensitivity, and specificity to measure craniovertebral angle. In total, 44 subjects (mean age 23.30 ± 4.44 years) were evaluated in the standing position with markers on the tragus and cutaneous prominence of seventh cervical vertebra (C7). We had two experienced and trained physiotherapists assess cervical posture using the mobile application forward head posture and photogrammetry. Intraclass correlation coefficients were used to determine validity and reliability. A contingency table was made to determine sensitivity and specificity. Intra-rater reliability of the mobile application forward head posture had an intraclass correlation coefficient of 0.88. The inter-rater reliability generated an intraclass correlation coefficient of 0.83 to 0.89. Criterion validity data were above 0.82. The minimum detectable change was 4.96° for intra-rater and 5.52° for inter-rater reliability. The smartphone application exhibited 94.4% sensitivity and 84.6% specificity. The smartphone application forward head posture is a valid and reliable tool to measure craniovertebral angle in a standing position and, therefore, could be a useful assessment tool in clinical practice.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Alessandro Schneebeli ◽  
Ilaria Fiorina ◽  
Chandra Bortolotto ◽  
Marco Barbero ◽  
Deborah Falla ◽  
...  

Abstract Objectives Changes in mechanical loading as well as pathology can modify the Achilles tendon mechanical properties and therefore detection of these changes is relevant for the diagnosis and management of Achilles tendinopathy. The aim of this study was to evaluate strain and shear wave sonoelastography for their ability to detect changes in the Achilles tendon mechanical properties during a series of isometric contractions. Methods Longitudinal sonoelastography images of the Achilles tendon were acquired from 20 healthy participants using four different ultrasound devices; two implementing strain sonoelastography technology (SE1, SE2) and two, shear wave elastography technology (SWE1, SWE2). Results SE1 measured a decreasing strain ratio (tendon become harder) during the different contraction levels from 1.51 (0.92) to 0.33 (0.16) whereas SE2 mesaured a decreasing strain ratio from 1.08 (0.76) to 0.50 (0.32). SWE1 measured decreasing tendon stiffness during contractions of increasing intensity from 33.40 (19.61) to 16.19 (2.68) whereas SWE2 revealed increasing tendon stiffness between the first two contraction levels from 428.65 (131.5) kPa to 487.9 (121.5) kPa followed by decreasing stiffness for the higher contraction levels from 459.35 (113.48) kPa to 293.5 (91.18) kPa. Conclusions Strain elastography used with a reference material was able to detect elasticity changes between the different contraction levels whereas shear wave elastography was less able to detect changes in Achilles tendon stiffness when under load. Inconsistent results between the two technologies should be further investigated.


PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6764 ◽  
Author(s):  
Amelie Werkhausen ◽  
Neil J. Cronin ◽  
Kirsten Albracht ◽  
Gøran Paulsen ◽  
Askild V. Larsen ◽  
...  

Background During the stance phase of running, the elasticity of the Achilles tendon enables the utilisation of elastic energy and allows beneficial contractile conditions for the triceps surae muscles. However, the effect of changes in tendon mechanical properties induced by chronic loading is still poorly understood. We tested the hypothesis that a training-induced increase in Achilles tendon stiffness would result in reduced tendon strain during the stance phase of running, which would reduce fascicle strains in the triceps surae muscles, particularly in the mono-articular soleus. Methods Eleven subjects were assigned to a training group performing isometric single-leg plantarflexion contractions three times per week for ten weeks, and another ten subjects formed a control group. Before and after the training period, Achilles tendon stiffness was estimated, and muscle-tendon mechanics were assessed during running at preferred speed using ultrasonography, kinematics and kinetics. Results Achilles tendon stiffness increased by 18% (P < 0.01) in the training group, but the associated reduction in strain seen during isometric contractions was not statistically significant. Tendon elongation during the stance phase of running was similar after training, but tendon recoil was reduced by 30% (P < 0.01), while estimated tendon force remained unchanged. Neither gastrocnemius medialis nor soleus fascicle shortening during stance was affected by training. Discussion These results show that a training-induced increase in Achilles tendon stiffness altered tendon behaviour during running. Despite training-induced changes in tendon mechanical properties and recoil behaviour, the data suggest that fascicle shortening patterns were preserved for the running speed that we examined. The asymmetrical changes in tendon strain patterns supports the notion that simple in-series models do not fully explain the mechanical output of the muscle-tendon unit during a complex task like running.


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