小切口微创手术治疗新鲜跟腱断裂的临床价值

目的：探讨小切口微创手术治疗新鲜跟腱断裂的一晦床价值。方法：选取我院新鲜闭合性跟腱断裂患者50例,随机分为实验组和对照组各25例。实验组行小切口手术,对照组行常规切口手术。术后对患者进行随访,采用美国足踝协会（AOFAS）推荐的评分标准对患者术后功能恢复情况进行评价,观察并记录完全恢复患者例数、完全恢复时间、小腿最大周长差和术后并发症发生情况。结果：实验组AOFAS评分为（98．6±9．7）分,痊愈率96．00％,痊愈时间（20．2±3．2）周,两侧小腿最大周长差为（0．79＋0．68）cm,共有1例患者出现并发症,并发症发生率8％;而对照组的AOFAS评分为（91．4±11．5）分,痊愈率92．00％,痊愈时间（22．4±3．8）周,两侧小腿最大周长差为（0．91~0．76）cm;共有6例患者出现并发症,并发症的发生率为24％。两组患者的痊愈率、两侧小腿最大周长差比较差异无统计学意义（痊愈率：x2=-0．355,P=0．552;侧小腿最大周长差：t=O．588,P=0．559）;而与对照组比较,实验组AOFAS评分明显升高,完全恢复时间明显缩短,术后并发症的发生率显著降低,差异均有统计学意义（AOFAS评：t=2．393,P=0．021;恢复时间：t=2．150,P=0．037;并发症发生率：xⅫ．153,P=0．042）。结论：小切口手术与常规切口手术治疗新鲜跟腱断裂的疗效相当,但小切口手术术后恢童时间曼短．并发症更少．临床价值相对更高．     

大鼠肌卫星细胞移植失神经骨骼肌的形态学观测

目的探讨大鼠肌卫星细胞移植能否延缓失神经骨骼肌萎缩。方法将16只成年Wistar大鼠分为实验组与对照组,两组均切断大鼠右后肢胫神经,建立腓肠肌失神经动物模型。实验组：将体外培养的同种异体肌卫星细胞悬液0．2mL缓慢注射到失神经腓肠肌内、外侧头中;对照组：则缓慢注射等量的生理盐水于相同部位。术后第4周,采用肌湿重、肌纤维横截面积形态学观测的方法,检测失神经骨骼肌的萎缩变化情况。结果成功地对成年大鼠肌卫星细胞进行了分离、纯化、鉴定、培养和移植。发现实验组与对照组相比,失神经腓肠肌湿重残存率（由手术侧与自身健侧的肌湿重测定值之比得出）：实验组为0．48±0．050,对照组为0．33±0．059,二者存在显著性差异（P〈0．01）;腓肠肌纤维横截面积残存率（由手术侧与自身健侧的肌纤维横截面积测定值之比得出）：实验组为0．58±0．011,对照组为0．50±0．018,二者存在显著性差异（P〈0．01）。结论本实验表明将肌卫星细胞异体移植到失神经骨骼肌内可明显延缓骨骼肌的萎缩进程,为再生神经到达靶器官提供较多的时间,进而为解决再生神经延伸到靶器官前,靶器官已发生不可逆性萎缩,严重制约再生神经效果的临床难题提供一个新的研究思路。     

女子拳击运动员上肢和腰部肌肉力量训练的肌电分析

目的：利用肌电指标分析拳击运动员上肢和腰部肌肉力量训练效果。方法：用Mega公司的ME6000肌电图仪记录分析10名女子拳击运动员上臂肱二头肌（主动肌）与肱三头肌（拮抗肌）、前臂屈肌（主动肌）与伸肌（拮抗肌）和腰部肌群的运动诱发肌电,规定运动为手持2.5 kg的哑铃负荷进行直拳空击运动直至局部肌肉力竭。结果：直拳空击运动至局部肌肉力竭过程中,上肢拮抗肌的中位频率（MF）下降幅度和速度大于相对应的主动肌,且从肌群作功来看,主动肌作功百分比较拮抗肌大。其中9名普通运动员腰肌的肌电频率（MF）均值较1名指定样本世界冠军的下降缓慢,而且其作功百分比都较小。结论：通过对普通女子拳击运动员上肢和腰部肌群肌电指标测试与世界冠军的比较分析,提示本研究中所测普通拳击运动员拮抗肌和腰部肌肉力量训练不足,有待加强该部肌肉的力量训练。     

改良导管固定法在硬膜外阻滞大鼠模型构建中的应用

目的探讨改良硬膜外导管固定法应用于构建硬膜外阻滞动物模型的可行性及效果。方法采用随机数字法将24只雄性Wistar大鼠分为实验组和对照组,每组12只,用于构建硬膜外阻滞大鼠模型。实验组在切开置管后导管固定使用创新性关卡,采用不透气无菌医用胶带封闭导管;对照组则采用单纯缝线环绕法固定,并保留导管接头固定于后颈部。术后每天硬膜外腔注射0.1%罗哌卡因30 uL,共28 d。对比观察两组术后发生感染率,硬膜外阻滞模型有效时间及硬膜外导管深度变化等情况。结果术后感染发生率：两组间差异无统计学意义（P〉0.05）;模型有效时间：实验组长于对照组（26.2±1.7d＆18.5±3.0d,P〈0.05）;硬膜外腔内导管深度：实验组与对照组比,其均值和离散程度的差异均具有显著性（1.81±0.07＆1.44±0.55,P〈0.05）。结论应用改良导管固定法构建大鼠硬膜外阻滞模型,有助于提高其稳定性和成功率。     

4周低氧训练对男子足球运动员有氧耐力与T淋巴细胞亚群的影响

目的：探讨4周低氧训练对男子足球运动员有氧耐力相关指标与免疫系统中T淋巴细胞亚群的影响。方法：选取某体育学院及其附属竞技学校20名男子足球运动员为受试者,平均分为训练组、低氧组、低氧训练组以及对照组。训练组进行每日60 min,每周5次,持续4周的功率自行车训练,运动强度为65%~75%最大摄氧量;低氧组进行持续4周每日60 min,每周5次处于低氧环境（氧浓度为14.7%）,不进行功率自行车训练;低氧训练组在低氧环境（氧浓度为14.7%）下进行与训练组相同条件的训练;对照组不做任何影响。结果：经4周训练后,低氧训练组红细胞计数、血红蛋白含量较对照组、训练组以及低氧组均存在显著性差异（P < 0.05）;低氧训练组VO₂max水平和3 000 m跑成绩较对照组、训练组以及低氧组均存在显著性差异（P < 0.05）;低氧训练组T淋巴细胞CD3⁺水平较对照组、低氧组均存在显著性差异（P < 0.05）。结论：相比于其他方式,每日60 min,每周5日,持续4周的65%~75%最大摄氧量强度低氧训练更有利于提高男子足球运动员的有氧耐力水平,并且可能有利于运动员机体免疫功能的提高。     

举重训练对男子肌比力、肌纤维的影响

安排9名有一定训练的青少年运动员参加10周举重训练。每周6次,每次8小时。训练前后用电子计算机—X线断层扫描技术(CT)测量大腿肌肉横断面积,股外肌针刺活检取样测定Ⅰ、Ⅱ型肌纤维％和面积。测定大腿伸膝肌最大随意等长力量。将结果(实验前、后)与对照组(13名无训练者)和优秀举重运动员(健将3人、一级4人)进行比较。结果表明,有训练人(实验前、后和优秀)与没有训练人(对照)在肌比力上存有差别。短、长期举重训练后,肌比力与Ⅱ型肌纤维％呈正相关。短、长期举重训练不曾改变肌纤维类型分布。举重训练对Ⅱ型肌纤维有选择性作用,且这个作用不受年龄的影响。结果还提示,肌比力的变化及肌比力与肌纤维之间的关系都会受运动项目专项特点的影响。     

豚鼠眼形觉剥夺后恢复期的生物学参数变化规律探讨

目的探讨豚鼠眼球形觉剥夺后恢复期的生物学参数变化规律。方法普通级2～3周龄豚鼠30只,随机分为两组：①实验组：20只,右眼采用半透明眼罩遮盖进行形觉剥夺4周,随后去遮盖3周,左眼作为自身对照;②正常对照组：10只,双眼不进行任何干预,开放饲养7周。形觉剥夺前、形觉剥夺4周后及去遮盖后第2、6、10、14和21天,测量豚鼠双眼生物学参数：睫状肌麻痹后行带状光检影测量屈光度;A超测量前房深度、晶体厚度和眼轴长度,计算出玻璃体腔长度。结果经过4周形觉剥夺,实验组豚鼠右眼向近视漂移,屈光度为（-2.88±2.30）D,诱导了（-5.50±1.9）D相对近视。去遮盖后,豚鼠右眼重新正视化,屈光度恢复的快速期发生在6 d内,14 d时双眼屈光度差值差异无显著性（t=-2.049,P=0.080）,为（-0.18±0.26）D;右眼玻璃体腔长度缩短,14 d时双眼玻璃体腔长度差值差异无显著性（t=1.652,P=0.14）,为（0.0234±0.0400）mm;右眼眼轴长度缩短,14 d时双眼眼轴长度差值差差异无显著性（t=1.443,P=0.192）,为（0.0183±0.0359）mm。与正常对照组右眼相比,去遮盖6 d,屈光度差异为（-0.48±0.36）D,差异无显著性（t=-1.325,P=0.206）,而2 d时玻璃体腔和眼轴长度差异分别为（0.0961±0.0630）mm、（0.0621±0.0386）mm,差异无显著性（t=1.652,P=0.14;t=1.607,P=0.125）。结论 2～3周龄豚鼠去除形觉剥夺后可以重新进行正视化,伴随玻璃体腔和眼轴长度缩短;去遮盖6 d内为眼生物学参数恢复的主要时期。     

无氧代谢阈值与竞走比赛成绩的关系

本文旨在研究无氧代谢阈值与竞走比賽成绩的相关性,并比较无氧代谢阈值和最大氧耗在与比赛成绩相关程度上的差别。受试者为8名男竞走运动员和12名女竞走运动员。他们的无氧代谢阈值和最大氧耗在竞走比赛前的8至7天内测定,无氧代谢阈值用逐级增加负荷量期间气体交换参数的改变特征加以判定。结果表明,男女运动员的无氧代谢阈值以单位体重氧耗量表示分别为38.4±6。3和31.7±8.9毫升/公斤/分,最大氧耗分别为64.5±7.8和53.3±8.9毫升/公斤/分。无氧代谢阈值无论与男子50公里或女子5公里和10公里竞走比赛成绩均呈现了明显相关,相关系数(r)分别为-0.866(P<0.01),-0.863(P<0.01)和-0.674(P<0.05);然而,最大氧耗仅与女子5公里比赛成绩有相关性联系(r=-0.672,P<0.05)。结果提示,无氧代谢阈值较之最大氧耗更能反映各个体的竞走比赛能力,它可能是一个评估和预测竞走比赛水平的生理学指标。     

髋骨闭孔沟的临床解剖学测量

目的：对闭孔沟进行解剖学观察和测量,为相关应用提供临床解剖学依据和丰富人类学数据。方法：选取结构完整、解剖标志清晰的髋骨108例,其中男性髋骨59例（左侧36例,右侧23例）,女性髋骨49例（其中左侧20例,右侧29例）,对闭孔沟进行观察并测量其长度和闭孔沟中点宽度。结果：试验测得男性左、右侧闭孔沟长度分别为31．4±3．4mm、32．1±2．4min,女性左、右侧闭孔沟长度分别为19．4±2．2mm、20．8±2．7mm;统计学分析显示同性别左、右侧差异无统计学意义（P〉0．05）,男、女性之间差异有统计学意义（P〈0．05）。男性左、右侧闭孔沟中点宽度分别为9．7±1．6mm、10．7±1．5mm,女性左、右侧闭孔沟中点宽度分别为12．1±1．7mm、11．6±2．0mm;同性别左、右侧及男、女间差异均无统计学意义（P〉0．05）。结论：男、女性闭孔沟测量数据可为闭孔处疾病的诊断和治疗提供应用解剖学的考虑依据并丰富人类学数据。     

丹参多酚酸盐对斑马鱼胚胎血管新生的影响及分子机制初步研究

目的:研究丹参多酚酸盐对斑马鱼发育过程中血管新生的影响,并初步探讨其机制。方法:取血管内皮具有绿色荧光蛋白标记的转基因斑马鱼卵后,胚胎分别给0.5%二甲基亚砜(DMSO,对照组)、丹参多酚酸盐(1mg/ml,实验组)处理24h,观察斑马鱼血管发育的变化并记录节间血管长度。定量RT-PCR检测前述药物处理后4、12和24h的斑马鱼胚胎中血管内皮生长因子(VEGF)的表达变化。结果:与对照组相比,使用丹参多酚酸盐药物处理后明显促进斑马鱼节间血管发育,其长度差别具有统计学意义([79.67±2.96)umvs(61.11±2.56)um,n=10,P<0.01)]。实验组较对照组VEGFmRNA表达量升高,在药物作用12h和24h时差异有统计学意义(P<0.05)。结论:丹参多酚酸盐可促进斑马鱼血管新生,可能与通过上调VEGF的表达有关。     

Longitudinal and transverse deformation of human Achilles tendon induced by isometric plantar flexion at different intensities

The present study determined in vivo deformation of the entire Achilles tendon in the longitudinal and transverse directions during isometric plantar flexions. Twelve young women and men performed isometric plantar flexions at 0% (rest), 30%, and 60% of the maximal voluntary contraction (MVC) while a series of oblique longitudinal and cross-sectional magnetic resonance (MR) images of the Achilles tendon were taken. At the distal end of the soleus muscle belly, the Achilles tendon was divided into the aponeurotic (ATapo) and the tendinous (ATten) components. The length of each component was measured in the MR images. The widths of the Achilles tendon were determined at 10 regions along ATapo and at four regions along ATten. Longitudinal and transverse strains were calculated as changes in relative length and width compared with those at rest. The ATapo deformed in both longitudinal and transverse directions at 30%MVC and 60%MVC. There was no difference between the strains of the ATapo at 30%MVC and 60%MVC either in the longitudinal (1.1 and 1.6%) or transverse (5.0～11.4 and 5.0～13.9%) direction. The ATten was elongated longitudinally (3.3%) to a greater amount than ATapo, while narrowing transversely in the most distal region (-4.6%). The current results show that the magnitude and the direction of contraction-induced deformation of Achilles tendon are different for the proximal and distal components. This may be related to the different functions of Achilles tendon, i.e., force transmission or elastic energy storage during muscle contractions.     

Elastic properties of human Achilles tendon are correlated to muscle strength.

The purpose of this study was to investigate whether the mechanical properties of the Achilles tendon were correlated to muscle strength in the triceps surae in humans. Twenty-four men and twelve women exerted maximal voluntary isometric plantar flexion (MVIP) torque. The elongation (DeltaX) and strain of the Achilles tendon (epsilon), the proximal part of which is the composite of the gastrocnemius tendon and the soleus aponeurosis, at MVIP were determined from the displacement of the distal myotendinous junction of the medial gastrocnemius using ultrasonography. The Achilles tendon force at MVIP (F) was calculated from the MVIP torque and the Achilles tendon moment arm. There were no significant differences in either the F-DeltaX or F-epsilon relationships between men and women. DeltaX and epsilon were 9.8 +/- 2.6 mm and 5.3 +/- 1.6%, respectively, and were positively correlated to F (r = 0.39, P < 0.05; r = 0.39, P < 0.05), which meant that subjects with greater muscle strength could store more elastic energy in the tendon. The regression y-intercepts for the F-DeltaX (P < 0.01) and F-epsilon (P < 0.05) relationship were significantly positive. These results might indicate that the Achilles tendon was stiffer in subjects with greater muscle strength, which may play a role in reducing the probability of tendon strain injuries. It was suggested that the Achilles tendon of subjects with greater muscle strength did not impair the potential for storing elastic energy in tendons and may be able to deliver the greater force supplied from a stronger muscle more efficiently. Furthermore, the difference in the Achilles tendon mechanical properties between men and women seemed to be correlated to the difference in muscle strength rather than gender.     

In vivo physiological cross-sectional area and specific force are reduced in the gastrocnemius of elderly men.

Sarcopenia and muscle weakness are well-known consequences of aging. The aim of the present study was to ascertain whether a decrease in fascicle force (Ff) could be accounted for entirely by muscle atrophy. In vivo physiological cross-sectional area (PCSA) and specific force (Ff/PCSA) of the lateral head of the gastrocnemius (GL) muscle were assessed in a group of elderly men [EM, aged 73.8 yr (SD 3.5), height 173.4 cm (SD 4.4), weight 78.4 kg (SD 8.3); means (SD)] and for comparison in a group of young men [YM, aged 25.3 yr (SD 4.4), height 176.4 cm (SD 7.7), weight 79.1 kg (SD 11.9)]. GL muscle volume (Vol) and Achilles tendon moment arm length were evaluated using magnetic resonance imaging. Pennation angle and fiber fascicle length (Lf) were measured using B-mode ultrasonography during isometric maximum voluntary contraction of the plantar flexors. PCSA was estimated as Vol/Lf. GL Ff was calculated by dividing Achilles tendon force by the cosine of theta, during the interpolation of a supramaximal doublet, and accounting for antagonist activation level (assessed using EMG), Achilles tendon moment arm length, and the relative PCSA of the GL within the plantar flexor group. Voluntary activation of the plantar flexors was lower in the EM than in the YM (86 vs. 98%, respectively, P < 0.05). Compared with the YM, plantar flexor maximal voluntary contraction torque and Ff of the EM were lower by 47 and 40%, respectively (P < 0.01). Both Vol and PCSA were smaller in the EM by 28% (P < 0.01) and 16% (P < 0.05), respectively. Also, pennation angle was 12% smaller in the EM, whereas there was no significant difference in Lf between the YM and EM. After accounting for differences in agonists and antagonists activation, the Ff/PCSA of the EM was 30% lower than that of the YM (P < 0.01). These findings demonstrate that the loss of muscle strength with aging may be explained not only by a reduction in voluntary drive to the muscle, but mostly by a decrease in intrinsic muscle force. This phenomenon may possibly be due to a reduction in single-fiber specific tension.     

Ankle joint mechanics and foot proportions differ between human sprinters and non-sprinters

Recent studies of sprinters and distance runners have suggested that variations in human foot proportions and plantarflexor muscle moment arm correspond to the level of sprint performance or running economy. Less clear, however, is whether differences in muscle moment arm are mediated by altered tendon paths or by variation in the centre of ankle joint rotation. Previous measurements of these differences have relied upon assumed joint centres and measurements of bone geometry made externally, such that they would be affected by the thickness of the overlying soft tissue. Using magnetic resonance imaging, we found that trained sprinters have shorter plantarflexor moment arms (p = 0.011) and longer forefoot bones (p = 0.019) than non-sprinters. The shorter moment arms of sprinters are attributable to differences in the location of the centre of rotation (p < 0.001) rather than to differences in the path of the Achilles tendon. A simple computer model suggests that increasing the ratio of forefoot to rearfoot length permits more plantarflexor muscle work during plantarflexion that occurs at rates expected during the acceleration phase following the sprint start.     

Dynamic creep and pre-conditioning of the Achilles tendon in-vivo

Warm-up exercises are often advocated prior to strenuous exercise, but the warm-up duration and effect on muscle–tendon behavior are not well defined. The gastrocnemius–Achilles tendon complexes of 18 subjects were studied to quantify the dynamic creep response of the Achilles tendon in-vivo and the warm-up dose required for the Achilles tendon to achieve steady-state behavior. A custom testing chamber was used to determine each subject's maximum voluntary contraction (MVC) during an isometric ankle plantar flexion effort. The subject's right knee and ankle were immobilized for one hour. Subjects then performed over seven minutes of cyclic isometric ankle plantar flexion efforts equal to 25–35% of their MVC at a frequency of 0.75 Hz. Ankle plantar flexion effort and images from dual ultrasound probes located over the gastrocnemius muscle–Achilles tendon and the calcaneus–Achilles tendon junction were acquired for eight seconds at the start of each sequential minute of the activity. Ultrasound images were analyzed to quantify the average relative Achilles tendon strain at 25% MVC force (ε_25%MVC) for each minute. The ε_25%MVC increased from 0.3% at the start of activity to 3.3% after seven minutes, giving a total dynamic creep of ~3.0%. The ε_25%MVC increased by more than 0.56% per minute for the first five minutes and increased by less than 0.13% per minute thereafter. Therefore, following a period of inactivity, a low intensity warm-up lasting at least six minutes or producing 270 loading cycles is required for an Achilles tendon to reach a relatively steady-state behavior.     

Effect of joint rotation correction when measuring elongation of the gastrocnemius medialis tendon and aponeurosis

It is well known that during maximal plantar flexion contractions the ankle joint rotation overestimates the actual elongation of the tendon and aponeurosis. The aim of this study was to examine the influence of the curve length changes of the Achilles tendon on the joint rotation corrected elongation and strain of the gastrocnemius medialis (GM) tendon and aponeurosis. Nine subjects (age: 29.4 ± 5.7 years, body mass: 78.8 ± 6.8 kg, body height: 178 ± 4 cm) participated in the study. The subjects performed maximal voluntary isometric plantarflexion contractions in the prone position on a Biodex-dynamometer. Ultrasonography (Aloka SSD 4000) was used to visualize the muscle belly of the GM muscle-tendon unit. To calculate the curve length changes of the Achilles tendon its surface contour was reconstructed using a series of small reflective skin markers having a diameter of 2.5 mm. The elongation of the GM tendon and aponeurosis was calculated (a) as the difference of the measured and the passive (due to joint rotation) displacement of the tendon and aponeurosis and (b) as the difference of the measured displacement and the length changes of the reconstructed Achilles tendon surface contour. The absolute difference between the elongation obtained by both methods were 1.2 ± 0.4 mm. These differences were due to the higher changes in length obtained by the reconstruction of the tendon curved surface contour as compared to the changes observed in the passive displacement of the digitised point at the aponeurosis. Without correcting for angle joint rotation, the measured elongation clearly overestimates the actual elongation of the GM tendon and aponeurosis. After the passive displacement correction the calculated elongation still overestimates the actual elongation of the GM tendon and aponeurosis. However, this overestimation has a negligible effect on the examined in vivo strain (0.3%) of the tendon and aponeurosis.     

Structural Achilles tendon properties in athletes subjected to different exercise modes and in Achilles tendon rupture patients.

The prevalence of Achilles tendon (AT) injury is high in various sports, and AT rupture patients have been reported to have a 200-fold risk of sustaining a contralateral rupture. Tendon adaptation to different exercise modes is not fully understood. The present study investigated the structural properties of the AT in male elite athletes that subject their AT to different exercise modes as well as in Achilles rupture patients. Magnetic resonance imaging of the foot and leg, anthropometric measurements, and maximal isometric plantar flexion force were obtained in 6 male AT rupture patients and 25 male elite athletes (kayak/control group n = 9, volleyball n = 8 and endurance running n = 8). AT cross-sectional area (CSA) was normalized to body mass. Runners had a larger normalized AT CSA along the entire length of the tendon compared with the control group (P < 0.05). The volleyball subjects had a larger normalized CSA compared with the control group (P < 0.05) in the area of thinnest tendon CSA. No structural differences of the AT were found in the rupture subjects compared with the control group. Rupture subjects did not subject their AT to greater force or stress during a maximal voluntary isometric plantar flexion than the other groups. The CSA of the triceps surae musculature was the strongest predictor of AT CSA (r(s) = 0.569, P < 0.001). This study is the first to show larger CSA in tendons that are subjected to intermittent high loads. AT rupture patients did not display differences in structural or loading properties of the tendons.     

Comparison of elasticity of human tendon and aponeurosis in knee extensors and ankle plantar flexors in vivo

The purposes of this study were to compare the elasticity of tendon and aponeurosis in human knee extensors and ankle plantar flexors in vivo and to examine whether the maximal strain of tendon was correlated to that of aponeurosis. The elongation of tendon and aponeurosis during isometric knee extension (n = 23) and ankle plantar flexion (n = 22), respectively, were determined using a real-time ultrasonic apparatus, while the participants performed ramp isometric contractions up to voluntary maximum. To calculate the strain values from the measured elongation, we measured the respective length of tendon and aponeurosis. For the knee extensors, the maximal strain of aponeurosis (12.1 +/- 2.8 %) was significantly greater than that of the patella tendon (8.3 +/- 2.4 %), p < 0.001. On the contrary, the maximal strain of Achilles tendon (5.9 +/- 1.4 %) was significantly greater than that of aponeurosis in ankle plantar flexors (2.7 +/- 1.4 %), p < 0.001. Furthermore, for both knee extensors and ankle plantar flexors there was no significant correlation between maximal strain of tendon and aponeurosis. These results would be important for understanding the different roles of tendon and aponeurosis during human movements and for more accurate muscle modeling.     

Identifying factors related to Achilles tendon stress, strain, and stiffness before and after 6 months of growth in youth 10-14 years of age

The purposes of this study were (1) determine if youth peak Achilles tendon (AT) strain, peak AT stress, and AT stiffness, measured during an isometric plantar flexion, differed after six months (mos) of growth, and (2) determine if sex, physical activity level (Physical Activity Questionnaire (PAQ-C)), and/or growth rate (GR) were related to these properties. AT stress, strain, and stiffness were quantified in 20 boys (13.47±0.81 years) and 22 girls (11.18±0.82 years) at 2 times (0 and 6 mos). GR (change in height in 6 mos) was not significantly different between boys and girls (3.5±1.4 and 3.4±1.1cm/6 mos respectively). Peak AT strain and stiffness (mean 3.8±0.4% and 128.9±153.6N/mm, respectively) did not differ between testing sessions or sex. Peak AT stress (22.1±2.4 and 24.0±2.1MPa at 0 and 6 mos, respectively) did not differ between sex and increased significantly at 6 mos due to a significant decrease in AT cross-sectional area (40.6±1.3 and 38.1±1.6mm(2) at 0 and 6 mos, respectively) with no significant difference in peak AT force (882.3±93.9 and 900.3± 65.5N at 0 and 6 mos, respectively). Peak AT stress was significantly greater in subjects with greater PAQ-C scores (9.1% increase with 1 unit increase in PAQ-C score) and smaller in subjects with faster GRs (13.8% decrease with 1cm/6 mos increase in GR). These results indicate that of the AT mechanical properties quantified, none differed between sex, and only peak AT stress significantly differed after 6 months and was related to GR and physical activity.     

Soleus aponeurosis strain distribution following chronic unloading in humans: an in vivo MR phase-contrast study.

The in vivo strain properties of human skeletal muscle-tendon complexes are poorly understood, particularly following chronic periods of reduced load bearing. We studied eight healthy volunteers who underwent 4 wk of unilateral lower limb suspension (ULLS) to induce chronic unloading. Before and after the ULLS, maximum isometric ankle plantar flexion torque was determined by using a magnetic resonance (MR)-compatible dynamometry. Volumes of the triceps surae muscles and strain distribution of the soleus aponeurosis and the Achilles tendon at a constant submaximal plantar flexion (20% pre-maximal voluntary contraction) were measured by using MRI and velocity-encoded, phase-contrast MRI techniques. Following ULLS, volumes of the soleus and the medial gastrocnemius and the maximum isometric ankle plantar flexion (maximum voluntary contraction) decreased by 5.5+/-1.9, 7.5+/-2.7, and 48.1+/-6.1%, respectively. The strain of the aponeurosis along the length of the muscle before the ULLS was 0.3+/-0.3%, ranging from -1.5 to 2.7% in different locations of the aponeurosis. Following ULLS, the mean strain was -6.4+/-0.3%, ranging from -1.6 to 1.3%. The strain distribution of the midregion of the aponeurosis was significantly influenced by the ULLS, whereas the more distal component showed no consistent changes. Achilles tendon strain was not affected by the ULLS. These results raise the issue as to whether these changes in strain distribution affect the functional properties of the triceps surae and whether the probability of strain injuries within the triceps surae increases following chronic unloading in those regions of this muscle complex in which unusual strains occur.