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

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.

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.

scholarly journals Rate of Force Development and Muscle Architecture after Fast and Slow Velocity Eccentric Training

Sports ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 41 ◽  
Author(s):  
Angeliki-Nikoletta Stasinaki ◽  
Nikolaos Zaras ◽  
Spyridon Methenitis ◽  
Gregory Bogdanis ◽  
Gerasimos Terzis
Keyword(s):  
Resistance Training ◽  
Vastus Lateralis ◽  
Muscle Architecture ◽  
Rate Of Force Development ◽  
Vastus Lateralis Muscle ◽  
Eccentric Training ◽  
Fascicle Length ◽  
Force Development ◽  
Muscle Fascicle ◽  
Slow Velocity

The aim of the study was to investigate the rate of force development (RFD) and muscle architecture early adaptations in response to training with fast- or slow-velocity eccentric squats. Eighteen young novice participants followed six weeks (two sessions/week) of either fast-velocity (Fast) or slow-velocity (Slow) squat eccentric-only training. Fast eccentric training consisted of nine sets of nine eccentric-only repetitions at 70% of 1-RM with <1 s duration for each repetition. Slow eccentric training consisted of five sets of six eccentric-only repetitions at 90% of 1-RM with ~4 sec duration for each repetition. Before and after training, squat 1-RM, countermovement jump (CMJ), isometric leg press RFD, and vastus lateralis muscle architecture were evaluated. Squat 1-RM increased by 14.5 ± 7.0% (Fast, p < 0.01) and by 5.4 ± 5.1% (Slow, p < 0.05). RFD and fascicle length increased significantly in the Fast group by 10–19% and 10.0 ± 6.2%, p < 0.01, respectively. Muscle thickness increased only in the Slow group (6.0 ± 6.8%, p < 0.05). Significant correlations were found between the training induced changes in fascicle length and RFD. These results suggest that fast eccentric resistance training may be more appropriate for increases in rapid force production compared to slow eccentric resistance training, and this may be partly due to increases in muscle fascicle length induced by fast eccentric training.

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.

scholarly journals Triceps surae torque-length relationships relevant for walking activity levels with and without an ankle exoskeleton

2019 ◽  
Author(s):  
Anthony L. Hessel ◽  
Brent J. Raiteri ◽  
Michael J. Marsh ◽  
Daniel Hahn
Keyword(s):  
Muscle Activity ◽  
Metabolic Cost ◽  
Activity Levels ◽  
Plantar Flexor ◽  
Plantar Flexors ◽  
Flexor Muscle ◽  
Fascicle Length ◽  
Lateral Gastrocnemius ◽  
Work Requirements ◽  
Ankle Exoskeleton

AbstractAnkle exoskeletons have been developed to assist walking by offloading the plantar flexors work requirements, which reduces muscle activity level. However, reduced muscle activity alters plantar flexor muscle-tendon unit dynamics in a way that is poorly understood. We therefore evaluated torque-fascicle length properties of the soleus and lateral gastrocnemius during voluntary contractions at simulated activity levels typical during late stance with and without an ankle exoskeleton. Soleus activity levels (100, 30, and 22% maximal voluntary activity) were produced by participants via visual electromyography feedback at ankle angles ranging from −10° plantar flexion to 35° dorsiflexion. Using dynamometry and ultrasound imaging, torque-fascicle length data of the soleus and lateral gastrocnemius were produced. The results indicate that muscle activity reductions observed with an exoskeleton shift the torque-angle and torque-fascicle length curves to more dorsiflexed ankle angles and longer fascicle lengths where no descending limb is physiologically possible. This shift is in line with previous simulations that predicted a similar increase in the operating fascicle range when wearing an exoskeleton. These data suggest that a small reduction in muscle activity causes changes to torque-fascicle length properties, which has implications for the design and testing of future ankle exoskeletons for assisted walking.Significance StatementAssistive lower-limb exoskeletons reduce the metabolic cost of walking by reducing the positive work requirements of the plantar flexor muscles. However, if the exoskeleton reduces plantar flexor muscle activity too much, then the metabolic benefit is lost. The biological reasons for this are unclear and hinder further exoskeleton development. This research study is the first to directly evaluate if a reduction in plantar flexor muscle activity similar to that caused by wearing an exoskeleton affects muscle function. We found that reduced muscle activity changes the torque-length properties of two plantar flexors, which could explain why reducing muscle activity too much can increase metabolic cost.

Impact of Askling L-PROTOCOL on muscle architecture, flexibility and sprint performance.

2021 ◽  
Author(s):  
Diego Alonso-Fernandez ◽  
Juan Martinez-Fernandez ◽  
Pedro Docampo-Blanco ◽  
Rosana Fernandez-Rodriguez
Keyword(s):  
Muscle Architecture ◽  
Sprint Performance ◽  
Moderate Intensity ◽  
Control Group ◽  
Maximum Speed ◽  
Eccentric Training ◽  
Fascicle Length ◽  
Hamstring Flexibility ◽  
The Impact ◽  
Experimental Group

Eccentric training has been shown to be important for hamstring strain injuries rehabilitation and prevention. The Askling L-PROTOCOL (L-P), comprising three exercises aimed at eccentric training and hamstring lengthening, was shown to improve this injuries recovery and relapse times in comparison with other traditional exercise-based protocols. However, the causes of these results remain unclear. This study looks at the impact of an 8-week L-P followed by 4 weeks of detraining on the architecture of the biceps femoris long head, hamstring flexibility and sprint performance. Twenty-eight healthy individuals were divided into two groups: an experimental group, which carried out the L-P, and a control group with no training. Muscle architecture was measured using 2Dultrasound, hamstring flexibility using goniometry and sprint performance using sports radar equipment before(M1) and after(M2) the training period and after detraining(M3). No significant changes were observed between M1 and M2 in the experimental group with regard to fascicle length(t=-0.79,P>.05), theoretical maximum speed (t=-1.43,P>.05), horizontal force (t=0.09,P>.05), force application during sprint running(t=-0.09,P>.05) and horizontal power (t =-0.97,P>.05), but, however, changes were observed in hamstring flexibility (t=-4.42,d=0.98,P<.001) returning to pre-training values after detraining period(t=-1.11,P>.05). L-P has been shown to be an eccentric protocol of moderate intensity and easy implementation that could be interesting to include throughout a sport season.

Effects of the Functional Heel Drop Exercise on the Muscle Architecture of the Gastrocnemius

2020 ◽  
Vol 29 (8) ◽  
pp. 1053-1059
Author(s):  
Diego Alonso-Fernandez ◽  
Yaiza Taboada-Iglesias ◽  
Tania García-Remeseiro ◽  
Águeda Gutiérrez-Sánchez
Keyword(s):  
Repeated Measures ◽  
Muscle Thickness ◽  
Pennation Angle ◽  
Muscle Architecture ◽  
Medial Gastrocnemius ◽  
Control Group ◽  
Fascicle Length ◽  
Rehabilitation Programs ◽  
Architectural Characteristics ◽  
Induced Changes

Context: The architectural characteristics of a muscle determine its function. Objective: To determine the architectural adaptations of the lateral gastrocnemius (LG) and medial gastrocnemius (MG) muscles after a functional eccentric strength training protocol consisting of heel drop exercises, followed by a subsequent detraining period. Design: Pretest and posttest. Setting: Training rooms and laboratory. Participants: The participants (N = 45) who were randomly divided into an experimental group (EG, n = 25) and a control group (CG, n = 20). Interventions: The 13-week intervention included participants (N = 45) who were randomly divided into an EG (n = 25) and a CG (n = 20). The EG performed a week of control and training, 8 weeks of eccentric training, and 4 weeks of detraining. The CG did not perform any type of muscular training. The architectural characteristics of the LG and MG muscles were evaluated at rest in both groups using 2-D ultrasound before (pretest–week 1) and after (posttest–week 9) the training, and at the end of the detraining period (retest–week 13). Main Outcome Measures: One-way repeated measures analysis of variance was used to determine training-induced changes in each of the variables of the muscle architecture. Results: After the training period, the members of the EG experienced a significant increase in the fascicle length of LG (t = −9.85, d = 2.78, P < .001) and MG (t = −8.98, d = 2.54, P < .001), muscle thickness (t = −6.71, d = 2.86, P < .001) and (t = −7.85, d = 2.22, P < .001), and the pennation angle (t = −10.21, d = 1.88, P < .05) and (t = −1.87, d = 0.53, P < .05), respectively. After the detraining period, fascicle length, muscle thickness, and pennation angle showed a significant decrease. In the CG, no significant changes were observed in any of the variables. Conclusions: The heel drop exercise seems to generate adaptations in the architectural conditions of LG and MG, which are also reversible after a detraining period. These results may have practical implications for injury prevention and rehabilitation programs.

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.

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