To What Extent Do Musculoskeletal Ultrasound Biomarkers Relate to Pain, Flexibility, Strength, and Function in Individuals With Chronic Symptomatic Achilles Tendinopathy?

Introduction: Achilles tendinopathy (AT) is a chronic musculoskeletal pathology best evaluated by ultrasound imaging. This cross-sectional study aimed at better understanding the relationship between musculoskeletal ultrasound biomarkers (MUBs) of Achilles tendon and localized pain, ankle flexibility, ankle strength, and functional abilities.Method: Forty-one participants with unilateral midportion chronic AT had their tendon images analyzed bilaterally in the longitudinal and transverse planes. The Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) and Lower Extremity Functional Scale (LEFS) assessed pain and function, respectively, during standing and walking-related activities. Ankle flexibility was evaluated by weight-bearing lunge tests, while ankle isometric peak strength was measured using an instrumented dynamometer. Achilles tendon ultrasonographic images were analyzed using geometric (thickness), composition (echogenicity), and texture (homogeneity) MUBs. Discriminative validity was evaluated using paired Student's t-tests to compare MUBs between symptomatic and asymptomatic sides. Predictive validity was evaluated by computing the Pearson product-moment correlations coefficient between MUBs and pain, ankle flexibility, ankle strength, and function.Results: Significant differences were found in MUBs between the symptomatic and asymptomatic sides, confirming the discriminative validity of the selected MUBs. On the symptomatic side, thickness was found 29.9% higher (p < 0.001), echogenicity 9.6% lower (p < 0.001), and homogeneity 3.8% higher (p = 0.001) when compared with the asymptomatic side. However, predictive validity was scarcely confirmed, as most of the correlation coefficients were found negligible for the associations investigated between MUBs with localized pain, ankle flexibility, strength, and function. Only 14 statistically significant low to moderate associations were found, with negative and positive correlations ranging between −0.31 and −0.55 and between 0.34 and 0.54, respectively.Discussion: Musculoskeletal ultrasound biomarkers have a clinical utility in visualizing in vivo tendon integrity and diagnosing AT. MUBs should be valued as part of a comprehensive neuro-musculoskeletal assessment as they complement pain, flexibility, strength, and function measures. Altogether, they may inform the development and monitoring of a personalized rehabilitation treatment plan.

The effect of ankle flexibility on the relationship between knee isokinetic strength and the speed of underwater dolphin kicks in male competitive swimmers

BACKGROUND: Lower-extremity muscle strength and ankle flexibility play key roles in underwater swimming movements. OBJECTIVES: To investigate the relationship between knee isokinetic strength and the speed of underwater dolphin kicks (UDK-S) in competitive male swimmers and identify whether ankle flexibility affects the association between knee isokinetic strength and UDK-S. METHODS: Fifty-two highly trained male swimmers participated in this study. The speed at which the participants travelled 15 m performing UDKs was calculated as UDK-S. Knee flexor and extensor concentric isokinetic strength at fast (240∘/s) and slow (60∘/s) velocities and ankle flexibility were evaluated. Bayesian framework analysis was conducted to examine the relationship between these variables and determine whether this relationship is influenced by ankle flexibility. RESULTS: There was strong-to-extremely strong evidence (Bayes factor = 24.4 to 198.3) that knee extensor (60∘/s) and knee flexor (60∘/s and 240∘/s) strength are positively and generally moderately correlated with UDK-S. Ankle plantar flexion flexibility was identified to be a moderator between knee extensor strength (60∘/s) and UDK-S. CONCLUSIONS: Knee extensor and knee flexor strength were significantly correlated with UDK-S, and the relationship between knee muscle strength and UDK-S was influenced by ankle plantar flexion flexibility in male competitive swimmers.

Keseimbangan dan Kelentukan Pergelangan Kaki: Bagaimanakah Korelasinya dengan Kemampuan Shooting Sepakbola?

Tujuan penelitian ini adalah untuk mengetahui korelasi keseimbangan dan kelentukan pergelangan kaki dengan kemampuan shooting siswa peserta ekstrakurikuler sepakbola SMP Negeri 2 Kembaran Banyumas. Metode penelitian ini adalah korelasional dengan pendekatan cross sectional, teknik sampling menggunakan purposive sampling dengan kriteria inklusi dan ekslusi dan diperoleh sampel sebanyak 60 siswa. Instrumen penelitian yang digunakan meliputi Diagonal Dynamic Balance Test (Roy & Ghosh, 2017) dan kelentukan pergelangan kaki & Shooting (Widiastuti, 2015). Teknik analisis data yang digunakan adalah uji korelasi pearson product moment dan korelasi ganda. Dari hasil penelitian diketahui bahwa tidak ada korelasi antara keseimbangan dengan kemampuan shooting dengan nilai rx1.y = 0,071 < r(0,05)(60) = 0,254, Ada korelasi antara kelentukan pergelangan kaki dengan kemampuan shooting dengan nilai rx2.y = 0,341 > r(0,05)(60) = 0,254, dan Tidak ada korelasi antara keseimbangan dan kelentukan pergelangan kaki dengan kemampuan shooting dengan nilai rx1,x2,.y = 0,129 < r(0,05)(60) = 0,254, dari hasil tersebut dapat diperoleh kesimpulan bahwa tidak ada korelasi antara keseimbangan dan kelentukan pergelangan kaki dengan kemampuan shooting. The purpose of this study was to determine the correlation between ankle balance and flexibility and the shooting ability of students participating in soccer extracurricular at SMP Negeri 2 Kembaran Banyumas. This research method is correlational with cross sectional approach, the sampling technique uses purposive sampling with inclusion and exclusion criteria and a sample of 60 students is obtained. The research instruments used include the Diagonal Dynamic Balance Test (Roy & Ghosh, 2017) and ankle elasticity & shooting (Widiastuti, 2015). The data analysis technique used is Pearson product moment correlation test and multiple correlation. From the results of the study note that there is no correlation between balance with shooting ability with a value of rx1.y = 0.071 <r (0.05) (60) = 0.254, there is a correlation between ankle flexibility with shooting ability with a value of rx2.y = 0.341> r (0.05) (60) = 0.254, and there is no correlation between ankle balance and flexibility and shooting ability with rx1, x2, .y = 0.129 <r (0.05) (60) = 0.254, from the results It can be concluded that there is no correlation between balance and ankle flexibility and shooting ability.

Relationship between Stature and Length of Tendo Achilles in Adult Male and Female of Bangladesh

Background: Tendo Achilles injuries are usually related to poor ankle flexibility and strength and to overuse. Morphology of tendo Achilles is an important tool for its assessment which can be done by measuring tendon thickness, cross-sectional area and length of tendon. Objective: The aim of the study was to correlate length of tendo Achilles with stature in several age groups of sedentary people as measured by ultrasonography. Materials and method: This cross sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2013 to June 2014. The present study was performed on 200 tendo Achilles of 100 people (50 male and 50 female) randomly selected from the patients who came to the Radiology department of Dhaka Medical College Hospital for ultrasonography of any region of their body other than leg. Results: In this study length of tendo Achilles was measured in both legs of adult people and was correlated with stature. Highly significant correlation was found between length of tendo Achilles with stature (p<0.001). Conclusion: The data of length of tendo Achilles obtained from the present study may provide valuable information in different aspects of medical science as a guide line for physiotherapists, radiologists, sports professionals and ortho-surgeons in early detection and monitoring of rehabilitation especially of professional athletes. Delta Med Col J. Jul 2019 7(2): 80-83