The effect of static neck flexion on mechanical and neuromuscular behaviors of the cervical spine

Occupations that involve sustained or repetitive neck flexion are associated with a higher incidence of neck pain. Little in vivo information is available on the impact of static neck flexion on cervical spinal tissue. The aim of this study was to assess changes in mechanical and neuromuscular behaviors to sustained neck flexion in healthy adults. Sixty healthy subjects aged 20–35 years participated in this study. The participants were exposed to static neck flexion at a fixed angle of full flexion for 10 min. Mechanical and neuromuscular responses of the cervical spine to sudden perturbations were measured pre- and post-exposure. Magnitude of load-relaxation during flexion exposure, stiffness, peak head angular velocity, and reflexive activities of cervical muscles were recorded. Effective neck stiffness decreased significantly, especially in female participants (P = 0.0001). The reflexive response of the cervical erector spinae muscles to head perturbation delayed significantly (P = 0.0001). Peak head angular velocity was significantly increased after exposure to neck flexion for 10 min, especially in female participants (P = 0.001). In the present study, static flexion resulted in changes in mechanical and neuromuscular behavior of the cervical spine, potentially leading to decreased stiffness of the cervical spine. The results confirm the importance of maintaining a correct head and neck position during work and improving the work environment to reduce the cervical spinal load and work-related neck pain.     

Dependence of elbow joint stiffness measurements on speed,angle, and muscle contraction level

Elbow joint stiffness is critical to positioning the hand. Abnormal elbow joint stiffness may affect a person's ability to participate in activities of daily living. In this work, elbow joint stiffness was measured in ten healthy young adults with a device adapted from one previously used to measure stiffness in other joints. Measurements of elbow stiffness involved applying a constant-velocity rotational movement to the elbow and measuring the resultant displacement, torque, and acceleration. Elbow stiffness was then computed using a previously-established model for joint stiffness. Measurements were made at two unique elbow joint angles, two speeds, and two forearm muscle contraction levels. The results indicate that the elbow joint stiffness is significantly affected by both rotational speed and forearm muscle contraction level.     

Soft tissue stiffness over the hip increases with age and its implication in hip fracture risk in older adults

Risk of hip fracture depends on the bone strength as well as the impact force delivered to the proximal femur during falls, and femoral soft tissue may help to reduce the hip fracture risk by attenuating the impact force. Femoral soft tissue stiffness was measured from a large sample, and compared how this was affected by age, gender and site.One hundred fifty healthy individuals (fifty-two young (aged between 19 and 29), forty-eight middle-aged (30–64), and fifty old (over 65)) participated. Each age group included an equal number of males and females. Using an automated hand-held indentation device, soft tissue stiffness was measured over twelve sites with respect to the greater trochanter (GT).For both left and right hips, the stiffness was associated with age (p < 0.0005), gender (p < 0.0005), and site (p < 0.0005). On average, the stiffness was 26% greater in older than young adults (321.5 versus 254.3 N/m). On average across twelve sites, the regression analysis indicated that the stiffness increases 1.33 N/m every year (“soft tissue stiffness over the hip = 1.33*age + 221.8”; R = 0.518, p < 0.0005). Furthermore, the stiffness was 18% greater in male than female (308.8 versus 262.6 N/m), and differed across twelve sites over the hip, being greatest (424.2 N/m) at the GT, and least (206.3 N/m) at the superior gluteal region.The results provide insights into the shock absorbing property of soft tissue over the hip, and inform the improvement of fall-related injury prevention interventions (i.e., hip protector, safe landing strategies) in older adults.     

Cervical spine posteroanterior stiffness differs with neck position

PurposeSpinal stiffness is commonly considered when treating patients with neck pain, but there are few studies reporting the objective measurement of cervical spine stiffness or the possible kinesiological factors that may affect its quantification. The aim of this study was to determine if the position of the neck affects cervical spine stiffness.MethodsAn instrumented stiffness assessment device measured posteroanterior cervical spine stiffness at C4 of 25 prone-lying asymptomatic subjects in three neck positions in randomised order: maximal flexion, maximal extension, and neutral. The device applied five standardised mechanical oscillatory pressures while measuring the applied force and concurrent displacement, defining stiffness as the slope of the linear portion of the force–displacement curve. Repeated measures analysis of variance with Bonferroni-adjusted post hoc comparisons determined whether stiffness differed between neck positions.ResultsThere was a significant difference in cervical spine stiffness between different neck positions (F_(1.6,38.0) = 16.6, P < 0.001). Stiffness was least in extension with a mean of 3.09 N/mm (95% CI 2.59, 3.58) followed by neutral (3.94, 95% CI 3.49, 4.39), and then flexion (4.32, 95% CI 3.96, 4.69).ConclusionWhen assessing cervical spine stiffness, neck position should be standardised to ensure maximal reliability and utility of stiffness judgments.     

Neurophysiological aspects of the regulation of the head’s position in the normal state and left- and right-sided forms of spasmodic torticollis

We have studied the spatiotemporal distribution of coherent EEG links in 10 healthy right-handed subjects under the conditions of comfortable wakefulness with a straight position of the head and with the head voluntarily turned to fixed left and right positions. The computations were made separately in each standard range of EEG frequencies (Δ, θ, α, and β). The results were compared with the data obtained during studies of right-handed patients with right-sided (RS, n = 9) and left-sided (LS; n = 8) forms of spasmodic torticollis (ST). It has been shown that, upon a voluntary right turn of the head, the number of strong and moderate coherent EEG links in healthy subjects increases considerably more than upon a left turn. This may be accounted for by the greater functional importance of the control of the right part of the visual space as the area of manipulation of the dominant hand. In patients with RS ST, the number of intra- and interhemispheric strong and moderate coherent EEG links increased in all four frequency ranges, as compared to healthy subjects, upon the right turn of the head. In patients with LS ST, the spatial structure of the bioelectric potential field of the brain is less reorganized upon the voluntary left turn of the head as compared to the level of coherent EEG links in healthy subjects. Presumably, this phenomenon reflects a stronger insufficiency of neurophysiological mechanisms of postural control and compensation for its disturbances in patients with the LS form of ST, which results in a more severe disability as compared to patients with right-sided ST.     

Morphology and Ecology of Siroloxophyllum utriculariae (Penard, 1922) N. G., N. Comb. (Ciliophora, Pleurostomatida) and an Improved Classification of Pleurostomatid Ciliates

ABSTRACT. The morphology and infraciliature of Siroloxophyllum utriculariae (Penard, 1922) n. g., n. comb. were studied in live cells, with the scanning and transmission electron microscope, as well as in specimens impregnated with protargol and silver carbonate. The new genus, Siroloxophyllum , belongs to the Loxophyllidae and has a specific combination of characters, viz. an oral bulge surrounding almost the entire cell, three perioral kineties, a single brush kinety, and a single right dorsolateral kinety. The ecology and faunistics of S. utriculariae are reviewed. It is a rare and infrequent predator preferring clean freshwaters. The somatic monokinetid of S. utriculariae has typical haptorid ultrastructure, including two transverse microtubular ribbons. The oral bulge is patterned string-like with riffles containing the transverse microtubular ribbons originating from the oral kinetids. Perioral kineties 1 and 2 consist of dikinetids having one basal body each ciliated; the nonciliated basal body is associated with a nematodesmal and a transverse microtubular ribbon. Perioral kinety 3 consists of ciliated monokinetids having a fine structure similar to the somatic kinetids; they form triads with the dikinetids from perioral kinety 2. The classification of pleurostomatid ciliates is reviewed. Two suborders (Amphileptina, Litonotina) and three families (Amphileptidae, Litonotidae, Loxophyllidae n. fam.) are recognized and defined.     

Quantification of plantar soft tissue changes due to aging in various metatarsophalangeal joint angles with realistic tissue deformation

The nonlinearity of plantar soft tissue is seldom examined because of the small extent of deformation induced during indentation for measurement purposes. Furthermore, in most indentation experiments, the metatarsophalangeal joint (MTPJ) angle is not well controlled, although it has been proven to have a significant stiffening effect on sub-metatarsal head (MTH) pads. Hence, the study aims to quantify changes in the mechanical properties of plantar soft tissue due to aging under an experimental condition which is similar to walking. This is done by subjecting the tissue to an appropriate level of deformation at various MTPJ angles. A custom-made in vivo tissue indenter was used to measure directly the force-indentation response of the plantar tissue of two healthy groups: “Young” (n=25, mean age 22) and “Elderly” (n=25, mean age 67) subjects. Tests were performed on the 2nd sub-MTH pad at angles of 0°, 20°, 40° MTPJ dorsiflexion, as well as at the hallux and heel pad at 0° MTPJ angle. At all three plantar sites tested, elderly subjects showed significantly higher tissue stiffness than the young (p<0.05). However, the stiffening effect of MTPJ angle was not notably influenced by aging. In this work, tissue stiffness is quantified in stiffness constant (K) based on the proposed indentation technique. It is hypothesized that the increase in stiffness with age observed is probably due to compositional change in the plantar soft tissue.     

Impact of pinna compression on the RF absorption in the heads of adult and juvenile cell phone users

The electromagnetic exposure of cell phone users depends on several parameters. One of the most dominant of these is the distance between the cell phone and the head tissue. The pinna can be regarded as a spacer between the top of the phone and the head tissue. The size of this spacer has not yet been systematically studied. The objective of this article is to investigate the variations of distance as a function of age of the exposed person, and the mechanical force on the pinna and how it affects the peak spatial specific absorption rate (psSAR). The distances were measured for adults and children (6–8 years of age) while applying a well‐defined force on the pinna using a custom‐developed measurement device. The average distances of the pinnae to the heads and their standard deviations showed no major differences between the two age groups: 10.5 ± 2.0 mm for children (6–8 years) and 9.5 ± 2.0 mm for adults. The pinnae of our anatomical high‐resolution head models of one adult and two children were transformed according to the measurement results. The numerical exposure analysis showed that the reduced distance due to the pinna compression can increase the maximum 10 g psSAR by approximately 2 dB for adults and children, if the exposure maximum is associated with the upper part of the phone. Bioelectromagnetics 31:406–412, 2010. © 2010 Wiley‐Liss, Inc.     

A controlled evaluation of dermabrasion versus CO2 laser resurfacing for the treatment of perioral wrinkles

Facial skin treatments with laser resurfacing, dermabrasion, and chemical peels were responsible for a significant portion of the 2.7 million cosmetic procedures performed in 1998. Perioral wrinkles are a common problem for which plastic surgical consultation is obtained. The aim of this study was to compare and quantify the advantages and disadvantages of laser resurfacing versus dermabrasion in the treatment of perioral wrinkles. Twenty female patients provided informed consent and participated in the study. Half of the perioral area was treated with dermabrasion and half was treated with the UltraPulse CO2 laser. The two procedures were compared using high-quality photographs; a biophysical evaluation of skin color, hydration, and mechanical properties; and patient evaluation of outcomes. Photographs were evaluated by 10 board-certified plastic surgeons who were blinded to the treatment methods. The laser treatment had a significantly higher erythema score at 1 month and a small but significantly greater improvement in perioral wrinkles at 6 months. Thirteen subjects selected the laser treatment as producing the best result, despite the greater intraoperative pain for this procedure. Biomechanical measurements suggest that the laser treatment produced a skin state more similar to skin in younger patients, presumably with higher levels and/or greater organization of the collagen and elastin. Patient preference was inferred from the resurfacing method that they would recommend to a friend. Although the laser was selected as the best result in a majority of cases, patient preference was equally distributed between the two treatments. The authors think that by studying and quantifying the biophysical changes that occur as a result of CO2 laser resurfacing, greater improvements in restoring actinic damage (e.g., wrinkles) can be achieved. Patients consider more than the objective skin changes from a resurfacing technique when making a recommendation to a friend.     

Task Dependency of Grip Stiffness—A Study of Human Grip Force and Grip Stiffness Dependency during Two Different Tasks with Same Grip Forces

It is widely known that the pinch-grip forces of the human hand are linearly related to the weight of the grasped object. Less is known about the relationship between grip force and grip stiffness. We set out to determine variations to these dependencies in different tasks with and without visual feedback. In two different settings, subjects were asked to (a) grasp and hold a stiffness-measuring manipulandum with a predefined grip force, differing from experiment to experiment, or (b) grasp and hold this manipulandum of which we varied the weight between trials in a more natural task. Both situations led to grip forces in comparable ranges. As the measured grip stiffness is the result of muscle and tendon properties, and since muscle/tendon stiffness increases more-or-less linearly as a function of muscle force, we found, as might be predicted, a linear relationship between grip force and grip stiffness. However, the measured stiffness ranges and the increase of stiffness with grip force varied significantly between the two tasks. Furthermore, we found a strong correlation between regression slope and mean stiffness for the force task which we ascribe to a force stiffness curve going through the origin. Based on a biomechanical model, we attributed the difference between both tasks to changes in wrist configuration, rather than to changes in cocontraction. In a new set of experiments where we prevent the wrist from moving by fixing it and resting it on a pedestal, we found subjects exhibiting similar stiffness/force characteristics in both tasks.     

Role of loading on head stability and effective neck stiffness and viscosity

This experiment tests the hypothesis that loading the head would increase head stability. In particular, we hypothesized that an arrangement of the head so that muscle activation is required to counteract a load would significantly increase effective neck stiffness and viscosity, which would be associated with lower peak head angular velocity following abrupt force perturbations applied to the head. Seven young healthy subjects had their head loaded (preload) using a weight/pulley apparatus. Then, the head was pulled either forward or backward by dropping an additional weight onto the preload, causing an impulse of force followed by an increase in load. We recorded the applied force and head angular velocity. Neck viscoelastic properties as a function of loading were estimated by fitting experimental data to a second-order mathematical model of the head biomechanics. Across preloads varying from 2.22 to 8.89 N, peak head angular velocity decreased by 18.2% for the backward and by 19.9% for forward perturbations. As preload increased, simulated effective neck stiffness and viscosity significantly increased leading to lower peak angular velocity. These results demonstrated that loading reduces peak head angular velocity and that change in muscle stiffness and viscosity is a feasible explanation for this effect. We propose that reduction in peak head velocity could be caused by modulation of the strength of the vestibulo-collic reflex.     

Shear Modulus Estimation on Vastus Intermedius of Elderly and Young Females over the Entire Range of Isometric Contraction

Elderly people often suffer from sarcopenia in their lower extremities, which gives rise to the increased susceptibility of fall. Comparing the mechanical properties of the knee extensor/flexors on elderly and young subjects is helpful in understanding the underlying mechanisms of the muscle aging process. However, although the stiffness of skeletal muscle has been proved to be positively correlated to its non-fatiguing contraction intensity by some existing methods, this conclusion has not been verified above 50% maximum voluntary contraction (MVC) due to the limitation of their measurement range. In this study, a vibro-ultrasound system was set up to achieve a considerably larger measurement range on muscle stiffness estimation. Its feasibility was verified on self-made silicone phantoms by comparing with the mechanical indentation method. The system was then used to assess the stiffness of vastus intermedius (VI), one of the knee extensors, on 10 healthy elderly female subjects (56.7±4.9 yr) and 10 healthy young female subjects (27.6±5.0 yr). The VI stiffness in its action direction was confirmed to be positively correlated to the % MVC level (R² = 0.999) over the entire range of isometric contraction, i.e. from 0% MVC (relaxed state) to 100% MVC. Furthermore, it was shown that there was no significant difference between the mean VI shear modulus of the elderly and young subjects in a relaxed state (p>0.1). However, when performing step isometric contraction, the VI stiffness of young female subjects was found to be larger than that of elderly participants (p<0.001), especially at the relatively higher contraction levels. The results expanded our knowledge on the mechanical property of the elderly’s skeletal muscle and its relationship with intensity of active contraction. Furthermore, the vibro-ultrasound system has a potential to become a powerful tool for investigating the elderly’s muscle diseases.     

A comparison and update of direct kinematic-kinetic models of leg stiffness in human running

Direct kinematic-kinetic modelling currently represents the “Gold-standard” in leg stiffness quantification during three-dimensional (3D) motion capture experiments. However, the medial-lateral components of ground reaction force and leg length have been neglected in current leg stiffness formulations. It is unknown if accounting for all 3D would alter healthy biologic estimates of leg stiffness, compared to present direct modelling methods. This study compared running leg stiffness derived from a new method (multiplanar method) which includes all three Cartesian axes, against current methods which either only include the vertical axis (line method) or only the plane of progression (uniplanar method). Twenty healthy female runners performed shod overground running at 5.0 m/s. Three-dimensional motion capture and synchronised in-ground force plates were used to track the change in length of the leg vector (hip joint centre to centre of pressure) and resultant projected ground reaction force. Leg stiffness was expressed as dimensionless units, as a percentage of an individual’s bodyweight divided by standing leg length (BW/LL). Leg stiffness using the line method was larger than the uniplanar method by 15.6%BW/LL (P < .001), and multiplanar method by 24.2%BW/LL (P < .001). Leg stiffness from the uniplanar method was larger than the multiplanar method by 8.5%BW/LL (6.5 kN/m) (P < .001). The inclusion of medial-lateral components significantly increased leg deformation magnitude, accounting for the reduction in leg stiffness estimate with the multiplanar method. Given that limb movements typically occur in 3D, the new multiplanar method provides the most complete accounting of all force and length components in leg stiffness calculation.     

Nasal vestibule wall elasticity: interactions with a nasal dilator strip.

We studied the effect of an adhesive external nasal dilator strip (ENDS) on external nasal geometry in 20 healthy Caucasian adults (10 men, 10 women; age 21-45 yr). The recoil force exerted by ENDS was estimated by bending the device (n = 10) with known weights. In the horizontal direction, a small/medium-sized ENDS in situ exerted a unilateral recoil force of 21.4-22.6 g. Application of ENDS resulted in a displacement of the lateral nasal vestibule walls that had both anterosuperior and horizontal components and that was maintained over an 8-h period. The resultant unilateral nasal vestibule wall displacement at the tip of the device was at 47.6 +/- 2.0 degrees to the horizontal (as related to the plane of the device when in situ) and had a magnitude of 3.5 +/- 0.1 mm. ENDS increased external nasal cross-sectional area by 23.0-65.3 mm2. Nasal vestibule wall compliance was estimated at 0.05-0.16 mm/g. Thus ENDS applies a relatively constant abducting force irrespective of nasal width. Variable responsiveness to ENDS may be related to differences in elastic properties of the nasal vestibule wall.     

A reproducibility study on musculotendinous stiffness quantification, using a new transportable ankle ergometer device

The use of biomechanical methods to quantify functional/physiological parameters in malnourished humans can provide new insights into the understanding of effects of malnutrition on human muscles. Therefore, a transportable ankle ergometer device was developed, which allows the quantification of mechanical properties of the human plantarflexor muscles in field experiments. More precisely, the ergometer quantifies isometric force in static conditions and musculotendinous stiffness in dynamic conditions. This latter parameter is obtained by the quick-release technique. The aim of the study was first to conduct a reproducibility study on musculotendinous stiffness. Seven healthy subjects were tested three times in alternate days. The results showed the well-known linear relationship between musculotendinous stiffness and torque, where the slope was used as a stiffness index (SI(MT)). Individual regression line comparison indicated that SI(MT) values were not significantly different between the three repeated measurements (P>0.05). Mean coefficient of variation was 4.5+/-1.0%. The individual SI(MT) data were within the range of those reported in the literature. The reproducibility study showed that the quantification of musculotendinous stiffness by means of the quick-release technique is a reliable method, using a transportable ankle ergometer device.     

ABCA1-dependent serum cholesterol efflux capacity inversely correlates with pulse wave velocity in healthy subjects

The capacity of HDL to induce cell cholesterol efflux is considered one of its main antiatherogenic properties. Little is known about the impact of such HDL function on vascular physiology. We investigated the relationship between ABCA1-dependent serum cholesterol efflux capacity (CEC), an HDL functionality indicator, and pulse wave velocity (PWV), an indicator of arterial stiffness. Serum of 167 healthy subjects was used to conduct CEC measurement, and carotid-femoral PWV was measured with a high-fidelity tonometer. J774 macrophages, labeled with [³H]cholesterol and stimulated to express ABCA1, were exposed to sera; the difference between cholesterol efflux from stimulated and unstimulated cells provided specific ABCA1-mediated CEC. PWV is inversely correlated with ABCA1-dependent CEC (r = −0.183; P = 0.018). Moreover, controlling for age, sex, body mass index, mean arterial pressure, serum LDL, HDL-cholesterol, and fasting plasma glucose, PWV displays a significant negative regression on ABCA1-dependent CEC (β = −0.204; 95% confidence interval, −0.371 to −0.037). The finding that ABCA1-dependent CEC, but not serum HDL cholesterol level (r = −0.002; P = 0.985), is a significant predictor of PWV in healthy subjects points to the relevance of HDL function in vascular physiology and arterial stiffness prevention.     

Optical rheology of porcine sclera by birefringence imaging

Purpose

To investigate a relationship between birefringence and elasticity of porcine sclera ex vivo using polarization-sensitive optical coherence tomography (PS-OCT).

Methods

Elastic parameters and birefringence of 19 porcine eyes were measured. Four pieces of scleral strips which were parallel to the limbus, with a width of 4 mm, were dissected from the optic nerve head to the temporal side of each porcine eye. Birefringence of the sclera was measured with a prototype PS-OCT. The strain and force were measured with a uniaxial material tester as the sample was stretched with a speed of 1.8 mm/min after preconditioning. A derivative of the exponentially-fitted stress-strain curve at 0% strain was extracted as the tangent modulus. Power of exponential stress-strain function was also extracted from the fitting. To consider a net stiffness of sclera, structural stiffness was calculated as a product of tangent modulus and thickness. Correlations between birefringence and these elastic parameters were examined.

Results

Statistically significant correlations between birefringence and all of the elastic parameters were found at 2 central positions. Structural stiffness and power of exponential stress-strain function were correlated with birefringence at the position near the optic nerve head. No correlation was found at the position near the equator.

Conclusions

The evidence of correlations between birefringence and elasticity of sclera tested uniaxially was shown for the first time. This work may become a basis for in vivo measurement of scleral biomechanics using PS-OCT.     

Comparison of whole-body vertical stiffness and leg stiffness during single-leg hopping in place in children and adults

In the hopping literature, whole-body vertical stiffness and leg stiffness are used interchangeably, due to most of the movement occurring in the vertical direction. However, there is some anterior/posterior movement of the center of mass and displacements of the foot during hopping in place in both children and adults. Further it is not understood if leg stiffness show a similar pattern as whole-body vertical stiffness when increasing hopping frequency. The purpose of this study was to test if whole-body vertical stiffness and leg stiffness are different during single-leg hopping in-place in children and adults, across a range of frequencies. Seventeen children aged 5–11 years and 16 young adults participated in this study. The subjects hopped at their preferred frequency as well as 20% below, 20% above and 40% above preferred frequency. Our results demonstrate that both whole-body vertical stiffness and leg stiffness increase when increasing hopping frequency for children and adults. However, whole-body vertical stiffness consistently overestimates leg stiffness due to a similar peak force but a greater leg length change compared to vertical COM displacement. This suggests a considerable horizontal COM movement from landing to mid-stance during hopping. Children aged 5–11 years old showed lower absolute values but higher normalized values of two stiffness measures than adults. This suggests somewhat adult-like stiffness control in children, but a reduced ability to manipulate the horizontal movement during single-leg hopping in place when compared to adults.     

Transorbital Sonographic Evaluation of Normal Optic Nerve Sheath Diameter in Healthy Volunteers in Bangladesh

Introduction

Measurement of optic nerve sheath diameter (ONSD) by ultrasound is increasingly used as a marker to detect raised intracranial pressure (ICP). ONSD varies with age and there is no clear consensus between studies for an upper limit of normal. Knowledge of normal ONSD in a healthy population is essential to interpret this measurement.

Methods

In a prospective observational study, ONSD was measured using a 15 MHz ultrasound probe in healthy volunteers in Chittagong, Bangladesh. The aims were to determine the normal range of ONSD in healthy Bangladeshi adults and children, compare measurements in males and females, horizontal and vertical beam orientations and left and right eyes in the same individual and to determine whether ONSD varies with head circumference independent of age.

Results

136 subjects were enrolled, 12.5% of whom were age 16 or under. Median ONSD was 4.41 mm with 95% of subjects in the range 4.25–4.75 mm. ONSD was bimodally distributed. There was no relationship between ONSD and age (≥4 years), gender, head circumference, and no difference in left vs right eye or horizontal vs vertical beam.

Conclusions

Ultrasonographic ONSD in Bangladeshi healthy volunteers has a narrow bimodal distribution independent of age (≥4 years), gender and head circumference. ONSD >4.75 mm in this population should be considered abnormal.     

Effects of tracking landmarks and tibial point of resistive force application on the assessment of patellar tendon mechanical properties in vivo

The different methods used to assess patellar tendon elongation in vivo may partly explain the large variation of mechanical properties reported in the literature. The present study investigated the effects of tracking landmark position and tibial point of resistive force application during leg extensions in a dynamometer.Nineteen adults performed isometric contractions with a proximal and distal dynamometer shank pad position. Knee joint moments were calculated employing an inverse dynamics approach. Tendon elongation was measured using the patellar apex and either the tibial tuberosity (T) or plateau (P) as tracking landmark.Using P for tracking introduced a bias towards greater values of tendon elongation at all force levels from 100 N to maximum tendon force (TFmax; p < 0.05). The differences between landmarks considering maximum tendon strain were greater at the proximal shank pad position (p < 0.05). Tendon stiffness was lower for P compared with T, but only in intervals up to 50% of TFmax (p < 0.05). The agreement between T and P for stiffness calculated between 50% and TFmax was acceptable with the distal, but poor with the proximal pad position.We demonstrated that using the tibia plateau and not the insertion as tracking landmark clearly affects the assessment of the force–elongation curve of the patellar tendon. However, using a distal point of resistive force application and calculating tendon stiffness between 50% and TFmax seems to yield an acceptable agreement between landmarks. These findings have important implications for the assessment of tendon properties in vivo and cross-study comparisons.