Plantarflexor fiber and tendon slack length are strong determinates of simulated single-leg heel raise height |
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| Affiliation: | 1. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan;2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong;3. Department of Orthopaedics, Clintec, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;4. Department of Medical Image, National Taiwan University Hospital, Department of Surgery, College of Medicine, National Taiwan University, Taiwan;5. Department of Business Administration, Hwa Hsia Institute of Technology, Taipei, Taiwan;1. Assistant Professor of Radiology, Department of Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA;2. Assistant Professor of Orthopedics, Department of Orthopaedic Surgery, Emory School of Medicine, Atlanta, GA;3. Assistant Professor of Radiology and Orthopedics, Department of Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA;4. Head Athletic Trainer, Emory University, Atlanta, GA;5. Research Assistant, Department of Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA;6. Associate Professor of Orthopedics, Department of Orthopaedic Surgery, Emory School of Medicine, Atlanta, GA |
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| Abstract: | Achilles tendon ruptures have been linked with detrimental changes in muscle-tendon structure, which may help explain long-term functional deficits. However, the causal effects of muscle-tendon structure on joint function have not been tested in a controlled setting. Therefore, the purpose of this study was to test the implications of muscle-tendon unit parameters on simulated single-leg heel raise height. We hypothesized that muscle fiber length and resting ankle angle – a clinical surrogate measure of tendon slack length – would predict single-leg heel raise height more strongly than other parameters. To test this hypothesis, we developed a two-part simulation paradigm that recreated clinically relevant muscle-tendon scenarios and then tested these parameters on single-leg heel raise height. We found that longer muscle fibers had the greatest positive effect on single-leg heel raise height. However, tendon slack length, determined by simulating resting ankle angles in a secondary analysis, revealed a stronger negative correlation with heel raise height. Our findings support previous clinical observations that both muscle fascicle length and resting tendon length are important muscle-tendon parameters for patient function. In addition to minimizing tendon elongation following rupture, treatment plans should focus on preserving plantarflexor muscle structure to mitigate functional loses following Achilles tendon ruptures. |
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| Keywords: | Achilles tendon rupture Simulation Musculoskeletal model Muscle-tendon unit Patient function |
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