scholarly journals Ultrasound Structural Changes in Triceps Surae After a 1-Year Daily Self-stretch Program: A Prospective Randomized Controlled Trial in Chronic Hemiparesis

2019 ◽  
Vol 33 (4) ◽  
pp. 245-259 ◽  
Author(s):  
Maud Pradines ◽  
Mouna Ghedira ◽  
Raphaël Portero ◽  
Ingrid Masson ◽  
Christina Marciniak ◽  
...  
Keyword(s):  
Structural Changes ◽  
Controlled Trial ◽  
Triceps Surae ◽  
Medial Gastrocnemius ◽  
Plantar Flexors ◽  
Fascicle Length ◽  
Rehabilitation Programs ◽  
Lower Limb Muscles ◽  
Muscle Fascicle ◽  
Prospective Randomized Controlled Trial

Introduction. The effects of long-term stretching (>6 months) in hemiparesis are unknown. This prospective, randomized, single-blind controlled trial compared changes in architectural and clinical parameters in plantar flexors of individuals with chronic hemiparesis following a 1-year guided self-stretch program, compared with conventional rehabilitation alone. Methods. Adults with chronic stroke-induced hemiparesis (time since lesion >1 year) were randomized into 1 of 2, 1-year rehabilitation programs: conventional therapy (CONV) supplemented with the Guided Self-rehabilitation Contract (GSC) program, or CONV alone. In the GSC group, specific lower limb muscles, including plantar flexors, were identified for a diary-based treatment utilizing daily, high-load, home self-stretching. Blinded assessments included (1) ultrasonographic measurements of soleus and medial gastrocnemius (MG) fascicle length and thickness, with change in soleus fascicle length as primary outcome; (2) maximum passive muscle extensibility (XV1, Tardieu Scale); (3) 10-m maximal barefoot ambulation speed. Results. In all, 23 individuals (10 women; mean age [SD], 56 [±12] years; time since lesion, 9 [±8] years) were randomized into either the CONV (n = 11) or GSC (n = 12) group. After 1 year, all significant between-group differences favored the GSC group: soleus fascicle length, +18.1mm [9.3; 29.9]; MG fascicle length, +6.3mm [3.5; 9.1]; soleus thickness, +4.8mm [3.0; 7.7]; XV1 soleus, +4.1° [3.1; 7.2]; XV1 gastrocnemius, +7.0° [2.1; 11.9]; and ambulation speed, +0.07m/s [+0.02; +0.16]. Conclusions. In chronic hemiparesis, daily self-stretch of the soleus and gastrocnemius over 1 year using GSC combined with conventional rehabilitation increased muscle fascicle length, extensibility, and ambulation speed more than conventional rehabilitation alone.

Plantar Flexor Muscle Architecture Changes as a Result of Eccentric Exercise in Patients With Achilles Tendinosis

2014 ◽  
Vol 7 (6) ◽  
pp. 460-465 ◽  
Author(s):  
Matthew T. Crill ◽  
Gregory Berlet ◽  
Christopher Hyer
Keyword(s):  
Case Series ◽  
Muscle Architecture ◽  
Medial Gastrocnemius ◽  
Eccentric Training ◽  
Plantar Flexors ◽  
Flexor Muscle ◽  
Fascicle Length ◽  
Achilles Tendinosis ◽  
Muscle Fascicle ◽  
Maximal Load

Eccentric training for Achilles tendinosis (AT) has been reported to significantly improve patient symptoms. There has been no biomechanical explanation on the mechanism for specific rehabilitation technique. The purpose of this study was to determine changes in muscle architecture that occurred as a result of Achilles tendinosis injury and a subsequent eccentric rehabilitation program. Twenty-five patients (age, 53.3 ± 17.5 years) diagnosed with AT participated in 6 weeks of rehabilitation. Specific exercises for the ankle plantar flexors consisted of maximal load eccentric muscle action using 3 sets of 15 repetitions. Patients also completed a protocol for AT, which consisting of traditional rehabilitation. Medial gastrocnemius (GM) and lateral gastrocnemius (GL) muscle fascicle length and thickness were measured with ultrasound at 2-week intervals from initial treatment day to the end of 6 weeks of rehabilitation. Medial gastrocnemius fascicle length increased (45.1 ± 10.5 mm to 51.4 ± 10.5 mm; P = .22) between the initial day of rehabilitation and after 6 weeks of rehabilitation. But, GM thickness (16.3 ± 3.5 mm to 16.8 ± 2.0 mm), GL fascicle length (47.2 ± 10.0 mm to 47.1 ± 7.4 mm), and GL thickness (14.9 ± 5.2 mm to 14.4 ± 2.7 mm) did not change as a result of rehabilitation. A 6-week eccentric-biased exercise increased the GM muscle fascicle length by 12%, but GM thickness, GL fascicle length, and GL thickness did not change as a result of rehabilitation. Eccentric training for the treatment of AT is well recognized, but the mechanism of action has not been previously reported. A 6-week eccentric training protocol increased the GM muscle fascicle length by 12%, and this correlated with improvement in a validated patient outcome scoring system. Further study is warranted to determine a predictive relationship between improvement of GM fascicle length and outcome scores. Levels of Evidence: Therapeutic, Level IV: Case series

Neural Compensation Within the Human Triceps Surae During Prolonged Walking

2011 ◽  
Vol 105 (2) ◽  
pp. 548-553 ◽  
Author(s):  
Neil J. Cronin ◽  
Jussi Peltonen ◽  
Thomas Sinkjaer ◽  
Janne Avela
Keyword(s):  
Muscle Activity ◽  
Muscle Activation ◽  
Triceps Surae ◽  
Medial Gastrocnemius ◽  
Neural Activation ◽  
Fascicle Length ◽  
Muscle Fascicle ◽  
Compound Action Potentials ◽  
Triceps Surae Muscles ◽  
Short Time

During human walking, muscle activation strategies are approximately constant across consecutive steps over a short time, but it is unknown whether they are maintained over a longer duration. Prolonged walking may increase tendinous tissue (TT) compliance, which can influence neural activation, but the neural responses of individual muscles have not been investigated. This study investigated the hypothesis that muscle activity is up- or down-regulated in individual triceps surae muscles during prolonged walking. Thirteen healthy subjects walked on a treadmill for 60 min at 4.5 km/h, while triceps surae muscle activity, maximal muscle compound action potentials, and kinematics were recorded every 5 min, and fascicle lengths were estimated at the beginning and end of the protocol using ultrasound. After 1 h of walking, soleus activity increased by 9.3 ± 0.2% ( P < 0.05) and medial gastrocnemius activity decreased by 9.3 ± 0.3% ( P < 0.01). Gastrocnemius fascicle length at ground contact shortened by 4.45 ± 0.99% ( P < 0.001), whereas soleus fascicle length was unchanged ( P = 0.988). Throughout the stance phase, medial gastrocnemius fascicle lengthening decreased by 44 ± 13% ( P < 0.001), whereas soleus fascicle lengthening amplitude was unchanged ( P = 0.650). The data suggest that a compensatory neural strategy exists between triceps surae muscles and that changes in muscle activation are generally mirrored by changes in muscle fascicle length. These findings also support the notion of muscle-specific changes in TT compliance after prolonged walking and highlight the ability of the CNS to maintain relatively constant movement patterns in spite of neuromechanical changes in individual muscles.

Ultrasound reveals negligible cocontraction during isometric plantar flexion and dorsiflexion despite the presence of antagonist electromyographic activity

2015 ◽  
Vol 118 (10) ◽  
pp. 1193-1199 ◽  
Author(s):  
Brent J. Raiteri ◽  
Andrew G. Cresswell ◽  
Glen A. Lichtwark
Keyword(s):  
Cross Talk ◽  
Muscle Activity ◽  
Plantar Flexion ◽  
Medial Gastrocnemius ◽  
Electromyographic Activity ◽  
Plantar Flexors ◽  
Fascicle Length ◽  
Lateral Gastrocnemius ◽  
Muscle Fascicle

Because of the approximate linear relationship between muscle force and muscle activity, muscle forces are often estimated during maximal voluntary isometric contractions (MVICs) from torque and surface electromyography (sEMG) measurements. However, sEMG recordings from a target muscle may contain cross-talk originating from nearby muscles, which could lead to erroneous force estimates. Here we used ultrasound imaging to measure in vivo muscle fascicle length ( Lf) changes and sEMG to measure muscle activity of the tibialis anterior, medial gastrocnemius, lateral gastrocnemius, and soleus muscles during ramp MVICs in plantar and dorsiflexion directions ( n = 8). After correcting longitudinal Lfchanges for ankle rotation, the antagonist Lfat peak antagonist root-mean-square (RMS) amplitude were significantly longer than the agonist Lfat this sEMG-matched level. On average, Lfshortened from resting length by 1.29 to 2.90 mm when muscles acted as agonists and lengthened from resting length by 0.43 to 1.16 mm when muscles acted as antagonists (depending on the muscle of interest). The lack of fascicle shortening when muscles acted as antagonists indicates that cocontraction was likely to be negligible, despite cocontraction as determined by sEMG of between 7 and 23% MVIC across all muscles. Different interelectrode distances (IEDs) over the plantar flexors revealed significantly higher antagonist RMS amplitudes for the 4-cm IEDs compared with the 2-cm IEDs, which further indicates that cross-talk was present. Consequently, investigators should be wary about performing agonist torque corrections for isometric plantar flexion and dorsiflexion based on the antagonist sEMG trace and predicted antagonist moment.

Long-term use of high-heeled shoes alters the neuromechanics of human walking

2012 ◽  
Vol 112 (6) ◽  
pp. 1054-1058 ◽  
Author(s):  
Neil J. Cronin ◽  
Rod S. Barrett ◽  
Christopher P. Carty
Keyword(s):  
Lower Limb ◽  
Muscle Activation ◽  
Triceps Surae ◽  
Medial Gastrocnemius ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Fascicle Length ◽  
High Heel ◽  
Muscle Fascicle

Human movement requires an ongoing, finely tuned interaction between muscular and tendinous tissues, so changes in the properties of either tissue could have important functional consequences. One condition that alters the functional demands placed on lower limb muscle-tendon units is the use of high-heeled shoes (HH), which force the foot into a plantarflexed position. Long-term HH use has been found to shorten medial gastrocnemius muscle fascicles and increase Achilles tendon stiffness, but the consequences of these changes for locomotor muscle-tendon function are unknown. This study examined the effects of habitual HH use on the neuromechanical behavior of triceps surae muscles during walking. The study population consisted of 9 habitual high heel wearers who had worn shoes with a minimum heel height of 5 cm at least 40 h/wk for a minimum of 2 yr, and 10 control participants who habitually wore heels for less than 10 h/wk. Participants walked at a self-selected speed over level ground while ground reaction forces, ankle and knee joint kinematics, lower limb muscle activity, and gastrocnemius fascicle length data were acquired. In long-term HH wearers, walking in HH resulted in substantial increases in muscle fascicle strains and muscle activation during the stance phase compared with barefoot walking. The results suggest that long-term high heel use may compromise muscle efficiency in walking and are consistent with reports that HH wearers often experience discomfort and muscle fatigue. Long-term HH use may also increase the risk of strain injuries.

Alterations in intramuscular water movement associated with mechanical changes in human skeletal muscle fibers: an evaluation using magnetic resonance diffusion-weighted imaging and B-mode ultrasonography

2011 ◽  
Vol 52 (9) ◽  
pp. 1003-1008 ◽  
Author(s):  
Osamu Yanagisawa ◽  
Toshiyuki Kurihara ◽  
Toru Fukubayashi
Keyword(s):  
Magnetic Resonance ◽  
Ankle Joint ◽  
Structural Changes ◽  
Water Movement ◽  
Morphological Changes ◽  
Muscle Fibers ◽  
Medial Gastrocnemius ◽  
Plantar Flexors ◽  
Diffusion Weighted Images ◽  
Diffusion Weighted

Background Intramuscular water movement is expected to be affected by the mechanical changes of the muscle fibers. However, the effect of changes in fiber length (FL) and pennation angle (PA) on the water movement has not been sufficiently investigated in human skeletal muscles. Purpose To determine the relationship between intramuscular water movement and the mechanical changes in human muscle fibers. Material and Methods Axial magnetic resonance diffusion-weighted images of the right leg (eight men) were taken using a 1.5-Tesla device with the ankle joint maximally dorsiflexed and maximally plantar flexed. The apparent diffusion coefficient (ADC) values of both the dorsiflexors (the superficial and deep parts of the tibialis anterior) and the plantar flexors (medial gastrocnemius and soleus) were calculated along three orthogonal axes (S-I: superior-to-inferior, A-P: anterior-to-posterior, and R-L: right-to-left). FL and PA of both muscle groups were also calculated from longitudinal B-mode ultrasound images with the ankle joint maximally dorsiflexed and plantar flexed. Results There was a significant increase in the ADC in superficial ( P < 0.05) and deeP ( P < 0.05) parts of the dorsiflexors in the S-I direction when the ankle was plantar flexed and in the A-P and R-L directions when the ankle was dorsiflexed ( P < 0.05). The plantar flexors showed significantly elevated ADC in the S-I direction when the ankle was dorsiflexed ( P < 0.05), and in the A-P and R-L directions when the ankle was plantar flexed ( P < 0.05). The dorsiflexors also showed significantly increased PA and decreased FL values when the ankle was dorsiflexed ( P < 0.05). The plantar flexors displayed similar morphological changes when the ankle was plantar flexed ( P < 0.05). Conclusion Water diffusion is affected by structural changes in the long axis of the muscle fibers, namely the changes in PA and FL.

scholarly journals Muscle fibre recruitment can respond to the mechanics of the muscle contraction

2006 ◽  
Vol 3 (9) ◽  
pp. 533-544 ◽  
Author(s):  
James M Wakeling ◽  
Katrin Uehli ◽  
Antra I Rozitis
Keyword(s):  
Motor Unit ◽  
Muscle Activity ◽  
The Body ◽  
Motor Unit Recruitment ◽  
Triceps Surae ◽  
Medial Gastrocnemius ◽  
Muscle Fibres ◽  
Strain Rates ◽  
Lower Velocity ◽  
Muscle Fascicle

This study investigates the motor unit recruitment patterns between and within muscles of the triceps surae during cycling on a stationary ergometer at a range of pedal speeds and resistances. Muscle activity was measured from the soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG) using surface electromyography (EMG) and quantified using wavelet and principal component analysis. Muscle fascicle strain rates were quantified using ultrasonography, and the muscle–tendon unit lengths were calculated from the segmental kinematics. The EMG intensities showed that the body uses the SOL relatively more for the higher-force, lower-velocity contractions than the MG and LG. The EMG spectra showed a shift to higher frequencies at faster muscle fascicle strain rates for MG: these shifts were independent of the level of muscle activity, the locomotor load and the muscle fascicle strain. These results indicated that a selective recruitment of the faster motor units occurred within the MG muscle in response to the increasing muscle fascicle strain rates. This preferential recruitment of the faster fibres for the faster tasks indicates that in some circumstances motor unit recruitment during locomotion can match the contractile properties of the muscle fibres to the mechanical demands of the contraction.

Effects of contraction intensity on muscle fascicle and stretch reflex behavior in the human triceps surae

2008 ◽  
Vol 105 (1) ◽  
pp. 226-232 ◽  
Author(s):  
Neil J. Cronin ◽  
Jussi Peltonen ◽  
Masaki Ishikawa ◽  
Paavo V. Komi ◽  
Janne Avela ◽  
...  
Keyword(s):  
Stretch Reflex ◽  
Force Production ◽  
Voluntary Contraction ◽  
Short Latency ◽  
Afferent Feedback ◽  
Triceps Surae ◽  
Medial Gastrocnemius ◽  
Stretch Reflexes ◽  
Muscle Fascicle ◽  
Human Triceps Surae

The aims of this study were to examine changes in the distribution of a stretch to the muscle fascicles with changes in contraction intensity in the human triceps surae and to relate fascicle stretch responses to short-latency stretch reflex behavior. Thirteen healthy subjects were seated in an ankle ergometer, and dorsiflexion stretches (8°; 250°/s) were applied to the triceps surae at different moment levels (0–100% of maximal voluntary contraction). Surface EMG was recorded in the medial gastrocnemius, soleus, and tibialis anterior muscles, and ultrasound was used to measure medial gastrocnemius and soleus fascicle lengths. At low forces, reflex amplitudes increased despite a lack of change or even a decrease in fascicle stretch velocities. At high forces, lower fascicle stretch velocities coincided with smaller stretch reflexes. The results revealed a decline in fascicle stretch velocity of over 50% between passive conditions and maximal force levels in the major muscles of the triceps surae. This is likely to be an important factor related to the decline in stretch reflex amplitudes at high forces. Because short-latency stretch reflexes contribute to force production and stiffness regulation of human muscle fibers, a reduction in afferent feedback from muscle spindles could decrease the efficacy of human movements involving the triceps surae, particularly where high force production is required.

scholarly journals Differences in Plantar Flexor Fascicle Length and Pennation Angle between Healthy and Poststroke Individuals and Implications for Poststroke Plantar Flexor Force Contributions

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
John W. Ramsay ◽  
Thomas S. Buchanan ◽  
Jill S. Higginson
Keyword(s):  
Pennation Angle ◽  
Medial Gastrocnemius ◽  
Plantar Flexor ◽  
Flexor Muscle ◽  
Fascicle Length ◽  
Cross Sectional ◽  
Lateral Gastrocnemius ◽  
Relative Contribution ◽  
Muscle Fascicle ◽  
The Individual

Poststroke plantar flexor muscle weakness has been attributed to muscle atrophy and impaired activation, which cannot collectively explain the limitations in force-generating capability of the entire muscle group. It is of interest whether changes in poststroke plantar flexor muscle fascicle length and pennation angle influence the individual force-generating capability and whether plantar flexor weakness is due to uniform changes in individual muscle force contributions. Fascicle lengths and pennation angles for the soleus, medial, and lateral gastrocnemius were measured using ultrasound and compared between ten hemiparetic poststroke subjects and ten healthy controls. Physiological cross-sectional areas and force contributions to poststroke plantar flexor torque were estimated for each muscle. No statistical differences were observed for any muscle fascicle lengths or for the lateral gastrocnemius and soleus pennation angles between paretic, nonparetic, and healthy limbs. There was a significant decrease (P<0.05) in the paretic medial gastrocnemius pennation angle compared to both nonparetic and healthy limbs. Physiological cross-sectional areas and force contributions were smaller on the paretic side. Additionally, bilateral muscle contributions to plantar flexor torque remained the same. While the architecture of each individual plantar flexor muscle is affected differently after stroke, the relative contribution of each muscle remains the same.

scholarly journals Human ankle plantar flexor muscle–tendon mechanics and energetics during maximum acceleration sprinting

2016 ◽  
Vol 13 (121) ◽  
pp. 20160391 ◽  
Author(s):  
Adrian Lai ◽  
Anthony G. Schache ◽  
Nicholas A. T. Brown ◽  
Marcus G. Pandy
Keyword(s):  
Steady State ◽  
Elastic Strain ◽  
Strain Energy ◽  
Computational Modelling ◽  
Elastic Strain Energy ◽  
Medial Gastrocnemius ◽  
Plantar Flexors ◽  
Flexor Muscle ◽  
Muscle Fascicle ◽  
Human Ankle

Tendon elastic strain energy is the dominant contributor to muscle–tendon work during steady-state running. Does this behaviour also occur for sprint accelerations? We used experimental data and computational modelling to quantify muscle fascicle work and tendon elastic strain energy for the human ankle plantar flexors (specifically soleus and medial gastrocnemius) for multiple foot contacts of a maximal sprint as well as for running at a steady-state speed. Positive work done by the soleus and medial gastrocnemius muscle fascicles decreased incrementally throughout the maximal sprint and both muscles performed more work for the first foot contact of the maximal sprint (FC1) compared with steady-state running at 5 m s −1 (SS5). However, the differences in tendon strain energy for both muscles were negligible throughout the maximal sprint and when comparing FC1 to SS5. Consequently, the contribution of muscle fascicle work to stored tendon elastic strain energy was greater for FC1 compared with subsequent foot contacts of the maximal sprint and compared with SS5. We conclude that tendon elastic strain energy in the ankle plantar flexors is just as vital at the start of a maximal sprint as it is at the end, and as it is for running at a constant speed.

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