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Steven J. Obst, Lee Barber, Ashton Miller and Rod S. Barrett

Estimates of in vivo Achilles tendon (AT) force are needed to measure tendon mechanical properties as a function of the measured net ankle joint torque, and to understand AT function using musculoskeletal modeling approaches. The AT moment arm is required to convert the measured external ankle

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Sabrina S.M. Lee, Gregory S. Lewis and Stephen J. Piazza

The accuracy of an algorithm for the automated tracking of tendon excursion from ultrasound images was tested in three experiments. Because the automated method could not be tested against direct measurements of tendon excursion in vivo, an indirect validation procedure was employed. In one experiment, a wire “phantom” was moved a known distance across the ultrasound probe and the automated tracking results were compared with the known distance. The excursion of the musculotendinous junction of the gastrocnemius during frontal and sagittal plane movement of the ankle was assessed in a single cadaver specimen both by manual tracking and with a cable extensometer sutured to the gastrocnemius muscle. A third experiment involved estimation of Achilles tendon excursion in vivo with both manual and automated tracking. Root mean squared (RMS) error was calculated between pairs of measurements after each test. Mean RMS errors of less than 1 mm were observed for the phantom experiments. For the in vitro experiment, mean RMS errors of 8–9% of the total tendon excursion were observed. Mean RMS errors of 6–8% of the total tendon excursion were found in vivo. The results indicate that the proposed algorithm accurately tracks Achilles tendon excursion, but further testing is necessary to determine its general applicability.

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Stephen J. Pearson, Tim Ritchings and Ahmad S.A. Mohamed

The work describes an automated method of tracking dynamic ultrasound images using a normalized cross-correlation algorithm, applied to the patellar and gastrocnemius tendon. Displacement was examined during active and passive tendon excursions using B-mode ultrasonography. In the passive test where two regions of interest (2-ROI) were tracked, the automated tracking algorithm showed insignificant deviations from relative zero displacement for the knee (0.01 ± 0.04 mm) and ankle (–0.02 ± 0.04 mm) (P > .05). Similarly, when tracking 1-ROI the passive tests showed no significant differences (P > .05) between automatic and manual methods, 7.50 ± 0.60 vs 7.66 ± 0.63 mm for the patellar and 11.28 ± 1.36 vs 11.17 ± 1.35 mm for the gastrocnemius tests. The active tests gave no significant differences (P > .05) between automatic and manual methods with differences of 0.29 ± 0.04 mm for the patellar and 0.26 ± 0.01 mm for the gastrocnemius. This study showed that automatic tracking of in vivo displacement of tendon during dynamic excursion under load is possible and valid when compared with the standardized method. This approach will save time during analysis and enable discrete areas of the tendon to be examined.

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Laura C. Slane, Stijn Bogaerts, Darryl G. Thelen and Lennart Scheys

Chronic tendon injuries, such as tendinopathy, commonly occur in energy-storing tendons and can have a high socioeconomic impact on the general population, both in terms of lost work and the effects on normal daily living. 1 Intriguingly, tendinopathies often arise in consistent locations

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Jared R. Fletcher and Brian R. MacIntosh

Direct measurement of muscle forces in vivo is highly invasive, 1 so muscle forces are typically estimated from measurement of joint moments. 2 , 3 Estimating muscle forces from joint moments requires knowledge of the muscle/tendon moment arm, that is, the perpendicular distance from the joint

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Carly C. Sacco, Erin M. Gaffney and Jesse C. Dean

. While less well studied than tactile enhancement, stochastic resonance can also be used to enhance muscle proprioceptive feedback. Early human 19 and animal 20 experiments found that white noise tendon vibration increases the stretch-sensitivity of muscle spindles embedded in the vibrated

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Kurt Manal and Thomas S. Buchanan

Tendon develops force proportional to the distance it is stretched beyond its slack length. Tendon slack length is an important parameter for musculoskeletal models because it can greatly affect estimations of muscle force. Unfortunately, tendon slack length is a difficult parameter to measure, and therefore values for it are not often reported in the literature. In this paper we present a numerical method for estimating tendon slack length from architectural parameters of the muscle. Specifically, tendon slack length is computed iteratively from musculotendon lengths determined when a corresponding joint is held at two angles, and from knowledge of the muscle's optimal fiber length. Idealized data generated using SIMM were used to test the tendon slack length algorithm. The method converged to within 1% of the “true” tendon slack length specified in the SIMM model. The advantage of the method outlined in this paper is that it yields subject-specific estimates of tendon slack length, given subject-specific input parameters.

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Niell Elvin, Alex Elvin, Cornie Scheffer, Steven Arnoczky, Edwin Dillon and P. J. Erasmus

The etiology of patellar tendinopathy (jumper’s knee) has been attributed to a significant increase in patellar tendon torques associated with jumping. While some investigators have suggested that patellar tendon torques are greater during takeoff, little is known about the relative magnitudes of patellar tendon torques during takeoff and landing. We hypothesized that peak patellar tendon torques are greater in jump takeoff than in landing, and that there is a linear correlation between jump height and peak patellar tendon torque. Seven asymptomatic, recreational male athletes each performed a series of 21 jumps ranging from low to maximal height. A calibrated fiber-optic sensor, implanted transversely within the patellar tendon was used to measure the knee torque during takeoff and landing. There was no significant difference in the peak patellar tendon torque experienced during takeoff and landing within individuals. There was a moderate correlation (r = .64) between maximum takeoff patellar tendon torques and jump height. There was a weak correlation (r = .52) between maximum landing patellar tendon torques and jump height. There was a moderate correlation (r = .67) between maximum 60°/s isokinetic extension torque and maximum jump height. The lack of a strong correlation between jump height and patellar tendon forces during takeoff or landing suggests that these forces may be technique dependent. Therefore, modifying takeoff and/or landing techniques could reduce patellar tendon force and potentially lessen the incidence of patellar tendinopathy.

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Atsuki Fukutani and Toshiyuki Kurihara

Recent studies have reported that resistance training increases the cross-sectional areas (CSAs) of tendons; however, this finding has not been consistently observed across different studies. If tendon CSA increases through resistance training, resistance-trained individuals should have larger tendon CSAs as compared with untrained individuals. Therefore, in the current study, we aimed to investigate whether resistance training increases tendon CSAs by comparing resistance-trained and untrained individuals. Sixteen males, who were either body builders or rugby players, were recruited as the training group, and 11 males, who did not participate in regular resistance training, were recruited into the control group. Tendon CSAs and muscle volumes of the triceps brachii, quadriceps femoris, and triceps surae were calculated from images obtained by using magnetic resonance imaging. The volumes of the 3 muscles were significantly higher in the training group than in the control group (P < .001 for all muscles). However, a significant difference in tendon CSAs was found only for the distal portion of the triceps surae tendon (P = .041). These findings indicate that tendon CSA is not associated with muscle volume, suggesting that resistance training does not increase tendon CSA.

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Taija Finni and Paavo V. Komi

During dynamic activities it is difficult to assess in vivo length changes in human tendon and aponeurosis. The present study compared the outcome of two methods during unilateral squat jump and drop jump performances of four volunteers. Tendinous tissue elongation of vastus lateralis muscle was estimated using either (a) direct measurement of in vivo fascicle length change and muscletendon length estimation (kinematic method), or (b) prediction using a quadratic force function in combination with direct tendon force measurement (force method). In the kinematic method the most critical measures contributing to the 10% uncertainty were the fascicle angle and fraction of the estimated fascicle length. The force method was most sensitive to resting length, with 1% error margin. Both methods predicted the same pattern of tendinous elongation because of the monotonic force/length relationship. The magnitude of length change, however, differed considerably between both methods. Based on the force method, the changes were only 20% (absolute values) or 30% (strain values) of those obtained with the kinematic method. On average, the maximum strains were 5% with the force method and 15% with the kinematic method. This difference can be explained by the fact that the kinematic method characterizes not only the changes in tendon length but also includes aponeurosis strain along the muscle belly. In addition, the kinematic method may be affected by non-uniform distribution of fascicle length change along the length of the muscle. When applying either method for estimating the patterns of tendon and tendinous tissue length changes during human locomotion, the given methodological considerations should be acknowledged.