scholarly journals Elasticity of the Achilles Tendon in Individuals With and Without Plantar Fasciitis: A Shear Wave Elastography Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Weiyi Pan ◽  
Jiping Zhou ◽  
Yuyi Lin ◽  
Zhijie Zhang ◽  
Yulong Wang
Keyword(s):  
Achilles Tendon ◽  
Elastic Properties ◽  
Plantar Fasciitis ◽  
Mechanical Load ◽  
Shear Wave Elastography ◽  
Plantar Fascia ◽  
Neutral Position ◽  
Passive Stiffness ◽  
Cross Sectional ◽  
Tendon Stiffness

The elastic properties of the Achilles tendon (AT) are altered in local injury or other diseases and in response to changes in mechanical load. Recently, elastography has been used to evaluate variations in tendon elastic properties, mainly among healthy individuals or athletes. Therefore, this study evaluated the biomechanical changes in ATs in individuals with and without plantar fasciitis (PF). The purposes were as follows: (1) to evaluate the passive stiffness of three regions of the AT which defined as 0 (AT0 cm), 3 (AT3 cm), and 6 cm (AT6 cm) above the calcaneal tuberosity in participants with and without PF, (2) to investigate the interplay between the passive stiffness in patients with PF and pain, (3) to detect optimal cut-off points of stiffness of the AT in assessing individuals with chronic PF, and (4) to determine the correlation between the plantar fascia thickness (PFT) and pain. This cross-sectional study included 40 participants (mean age = 51 ± 13 years). When the ankle was in a relaxed position, patients with PF experienced increased passive stiffness in AT0 cm (p = 0.006) and AT3 cm (P = 0.003), but not in the neutral position. Significant correlations were observed between pain and stiffness of AT (AT0 cm r = 0.489, P = 0.029; AT3 cm r = 487, P = 0.030; AT6 cm r = 0.471, P = 0.036), but not in the PFT (P = 0.557). Optimal cut-off stiffness was AT (452 kPa) in the relaxed ankle position. The plantar fascia of patients with PF was significantly thicker than that of the controls (P < 0.001). Findings from the present study demonstrate that tendon stiffness is a good indicator of the clinical situation of patients with PF. Monitoring passive tendon stiffness may provide additional information to assess severity of the condition and guide therapeutic. The treatment programs for PF should also be tailored to the distal AT, as conventional therapy might not be targeted to tight tendons.

scholarly journals Regional Elastic Properties of the Achilles Tendon Is Heterogeneously Influenced by Individual Muscle of the Gastrocnemius

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Jiping Zhou ◽  
Jiafeng Yu ◽  
Chunlong Liu ◽  
Chunzhi Tang ◽  
Zhijie Zhang
Keyword(s):  
Elastic Modulus ◽  
Achilles Tendon ◽  
Elastic Properties ◽  
Gastrocnemius Muscle ◽  
High Reliability ◽  
Shear Wave Elastography ◽  
Minimal Detectable Change ◽  
Neutral Position ◽  
Individual Muscle ◽  
The Individual

Background. Anatomical studies and the mechanical property studies showed that there is a strong correlation between Achilles tendon (AT) elasticity and individual gastrocnemius muscle (the medial head of gastrocnemius (MG) and the lateral head of gastrocnemius (LG)) elasticity. Limited ankle dorsiflexion range of motion has been correlated with decreased flexibility of the MG/LG/AT complex. However, no studies have been conducted to examine the exact correlation between the Achilles tendon and the individual muscle of the gastrocnemius. Purposes. The purposes of the present study were (1) to evaluate intra- and interoperator reliabilities of elastic property measurements in the gastrocnemius muscle-Achilles tendon complex by using the shear wave elastography (SWE) and (2) to examine the correlation between the regional elastic properties of the AT and the individual muscle of the gastrocnemius. Methods. Twenty healthy subjects (mean age: 22.50 (3.02) years) were recruited in this study. The elastic properties of the AT and the individual muscle of the gastrocnemius were quantified using the SWE. Findings. The SWE has comparatively high reliability in quantifying the elastic properties of the muscle-tendon range from good to excellent. The intraoperator ICC of the gastrocnemius muscle-Achilles tendon complex was 0.77 to 0.95, while the interoperator ICC was 0.76 to 0.94. The minimal detectable change (MDC) of the muscle was 1.72 kPa, while the AT was 32.90 kPa. A significant correlation was found between the elastic modulus of AT and the elastic modulus of the MG (r=0.668 and p=0.001 at the relaxing position and r=0.481 and p=0.032 at the neutral position). Conclusions. The SWE has the potential to assess localized changes in muscle-tendon elastic properties, provide more intuitive relations between elastic properties of the muscle tendon and function, and evaluate the therapeutic effect of the muscle tendon. A significant correlation between the AT and the MG was found, and it may provide a new treatment idea (targeted to the tight muscle heads) for the clinical setting to treat subjects with AT disorders.

scholarly journals On the morphological relations of the Achilles tendon and plantar fascia via the calcaneus: a cadaveric study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. Singh ◽  
J. Zwirner ◽  
F. Templer ◽  
D. Kieser ◽  
S. Klima ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Plantar Fasciitis ◽  
Functional Relationship ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Strong Correlations ◽  
Cross Sectional ◽  
X Ray ◽  
Plantar Heel Pain ◽  
Morphological Relationship

AbstractCurrent treatments of plantar fasciitis are based on the premise that the Achilles tendon (AT) and plantar fascia (PF) are mechanically directly linked, which is an area of debate. The aim of this study was to assess the morphological relationship between the AT and PF. Nineteen cadaveric feet were x-ray imaged, serially sectioned and plastinated for digital image analyses. Measurements of the AT and PF thicknesses and cross-sectional areas (CSA) were performed at their calcaneal insertion. The fiber continuity was histologically assessed in representative subsamples. Strong correlations exist between the CSA of the AT and PF at calcaneal insertion and the CSA of PF’s insertional length (r = 0.80), and between the CSAs of AT’s and PF’s insertional lengths. Further correlations were observed between AT and PF thicknesses (r = 0.62). This close morphological relationship could, however, not be confirmed through x-ray nor complete fiber continuity in histology. This study provides evidence for a morphometric relationship between the AT and PF, which suggests the presence of a functional relationship between these two structures following the biological key idea that the structure determines the function. The observed morphological correlations substantiate the existing mechanical link between the AT and PF via the posterior calcaneus and might explain why calf stretches are a successful treatment option for plantar heel pain.

Is 2D SWE sufficient as clinical diagnosis in patients with plantar fasciitis?

2021 ◽  
pp. 028418512110589
Author(s):  
Engin Beydoğan ◽  
Atilla Yalçın
Keyword(s):  
Plantar Fasciitis ◽  
Shear Wave Elastography ◽  
Plantar Fascia ◽  
Thickness Measurement ◽  
Clinical Findings ◽  
Imaging Method ◽  
Control Groups ◽  
Measurement Results ◽  
Healthy Control ◽  
Foot Function

Background The use of shear wave elastography (SWE) seems to be an important imaging method in the diagnosis of plantar fasciitis (PF). Purpose To compare patients diagnosed with PF with similar and young healthy control groups in terms of B-mode ultrasound (US) and SWE results and to evaluate the elasticity of the plantar fascia. Material and Methods A total of 140 feet of 70 participants were evaluated, including 30 patients and 40 healthy individuals as the control. Clinical, B-mode US, and SWE evaluations were performed for each patient. In addition, American Orthopedic Foot and Ankle Score (AOFAS) was calculated to evaluate pain and foot function in both groups. Results Of the patients in the PF group, 40 (88%) were women and the healthy control groups had similar sex distributions ( P = 0.23). The AOFAS score was lower in feet with PF compared to the other groups ( P < 0.001). Of 30 patients with PF, 15 (50%) had bilateral PF and 15 (50%) unilateral PF. In addition, ≥4 mm thickness measurement, which was used as a diagnostic criterion for PF as a US finding, could be shown in 11 (73.3%) patients with unilateral PF and 6 (40%) patients with bilateral PF. Conclusion In conclusion, the evaluation of the diagnosis of PF with clinical findings and regular follow-up of measurements with SWE can provide measurement results with higher sensitivity in the diagnosis of PF.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals Frequency of plantar fasciitis due to improper shoes among different universities students

2021 ◽  
Vol 12 (1) ◽  
pp. 454-464
Author(s):  
Abdul wahid ◽  
Muhammad Arsalan Ali Sajid ◽  
Ambreen Muzaffar ◽  
Muhammad Zohaib Hussain
Keyword(s):  
Plantar Fasciitis ◽  
Severe Pain ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Moderate Pain ◽  
Cross Sectional ◽  
Mild Pain ◽  
Plantar Fasciopathy ◽  
Back Ground ◽  
Multiple Etiology

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.

scholarly journals NORMAL PLANTAR FASCIA THICKNESS IN ADULT

2022 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
Yusak Mangara Tua Siahaan ◽  
Pricilla Yani Gunawan ◽  
Jeffry Foraldy Haryanto ◽  
Veli Sungono
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Heel Pain ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Female Ratio ◽  
History Of ◽  
Male To Female

Background: Plantar fasciitis is a common problem caused by thickening of the plantar fascia. The normal plantar fascia thickness ranged between 2-3 mm and it was generally accepted that value more than 4mm was considered pathologic. Objective: to identify normal plantar fascia thickness in adults using ultrasonography. Methods: This is a cross sectional study measuring the thickness of plantar fascia in 145 subjects with no history of heel pain. Plantar fascia thickness was measured in both feet using an ultrasound. Age, height and weight were recorded and analysed. Results: As much as 145 subjects were included in this study. Male to female ratio was 0.7. Mean age was 44 and body mass index (BMI) was mostly within normal range. Plantar fascia thickness in male was 2.71 ± 0.48 mm in right foot, and 2.74 ± 0.47 mm in left foot. Fascia thickness in female was 2.55 ± 0.50 mm in right foot, and 2.57 ± 0.45 mm in left foot. There was a significant plantar fascia thickness difference between male and female (p = 0.035 in right foot, and p=0.04 in left foot). Age, weight and BMI had a significant correlation towards plantar fascia thickness. In multivariate analysis, age and BMI revealed to have a linear correlation to plantar fascia thickness Conclusion: Age and BMI were found to be the best predictive factor of plantar fascia thickness.

scholarly journals THE COMPARISON BETWEEN NORMAL, OVERWEIGHT, AND OBESE BODY MASS INDEX CATEGORIES WITH RISK OF HAVING PLANTAR FASCIITIS IN WOMEN ADULTS AT GIANYAR DISTRICT

2018 ◽  
Vol 6 (2) ◽  
pp. 32
Author(s):  
I Putu Adi Merta ◽  
I Made Niko Winaya ◽  
I Wayan Sugiritama
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Plantar Fasciitis ◽  
Data Distribution ◽  
Sampling Technique ◽  
Plantar Fascia ◽  
Chi Square ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Elevated body mass can increases plantar pressure, so that causing overstretch the plantar fascia and occurs inflammation. The aims of this study was to compare the risk of having plantar fasciitis in women with normal, overweight, and obese body mass index at Gianyar district. This study is a cross-sectional analytic study. Samples are selected using purposive sampling technique. The samples consists of 3 groups, which amounted to 25 people in each group. Group A was women with normal BMI, group B was women with overweight BMI, and group C was women with obese BMI. The result of pearson chi-square p = 0.022 (p ? 0.05) indicating that there is a significant data distribution difference. The relative risk for overweight-obese compared to normal BMI was RR=3.34 [95% CI 1.09 - 10.16]. Concluded that there is a difference proportion of risk having plantar fasciitis between normal BMI (4%), overweight BMI (10,7%), obesity BMI (16%) and overweight-obese BMI have 3,34 times greater risk of having plantar fasciitis than the normal BMI category. Keywords: Body Mass Index, overweight, obese, plantar fasciitis, women

scholarly journals Assessment of Passive Stiffness of Medial and Lateral Heads of Gastrocnemius Muscle, Achilles Tendon, and Plantar Fascia at Different Ankle and Knee Positions Using the MyotonPRO

2018 ◽  
Vol 24 ◽  
pp. 7570-7576 ◽  
Author(s):  
Jiapeng Huang ◽  
Kun Qin ◽  
Chunzhi Tang ◽  
Yi Zhu ◽  
Cliff S. Klein ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Gastrocnemius Muscle ◽  
Plantar Fascia ◽  
Passive Stiffness

Morphological Characteristics of Passive and Active Structures of the Foot Across Populations With Different Levels of Physical Activity

2021 ◽  
pp. 1-7
Author(s):  
Inmaculada Reina-Martin ◽  
Santiago Navarro-Ledesma ◽  
Ana Belen Ortega-Avila ◽  
Kevin Deschamps ◽  
Alfonso Martinez-Franco ◽  
...  
Keyword(s):  
Physical Activity ◽  
Achilles Tendon ◽  
Patellar Tendon ◽  
Morphological Characteristics ◽  
Plantar Fascia ◽  
Posterior Tibial Tendon ◽  
Cross Sectional ◽  
Posterior Tibial ◽  
Longitudinal Measurement ◽  
The Right

Background: Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities. Objective: To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle. Design: Cross-sectional and observational. Participants: The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements). Results: Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P = .007 and P = .005). This was also the case for the cross-sectional area (P < .01) and the plantar fascia at the heel insertion in both limbs (P = .034 and P = .026) and for patellar tendon thickness for the longitudinal measurement (P < .01). At the transversal level, however, the differences were only significant in the right limb (P = .040). Conclusion: The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary.

scholarly journals Shear wave and strain sonoelastography for the evaluation of the Achilles tendon during isometric contractions

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Alessandro Schneebeli ◽  
Ilaria Fiorina ◽  
Chandra Bortolotto ◽  
Marco Barbero ◽  
Deborah Falla ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Reference Material ◽  
Achilles Tendon ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Achilles Tendinopathy ◽  
Isometric Contractions ◽  
Tendon Stiffness ◽  
Healthy Participants

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.

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