Insertional achilles tendinopathy associated with altered transverse compressive and axial tensile strain during ankle dorsiflexion.
Insertional achilles tendinopathy associated with altered transverse compressive and axial tensile strain during ankle dorsiflexion.
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DOI：
10.1002/jor.23338
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Buckley MR
中科院分区：
文献类型：
--
作者：
Chimenti RL;Bucklin M;Kelly M;Ketz J;Flemister AS;Richards MS;Buckley MR
这项病例对照研究 (N=20) 的目的是检查插入性跟腱病 (IAT) 患者与无肌腱病的对照组相比，IAT 和肌腱区域对肌腱应变的影响。在背屈任务（包括站立和半蹲）期间，将超声换能器放置在跟腱插入处。使用基于非刚性图像配准的算法来估计射频超声图像中肌腱的横向压缩应变和轴向拉伸应变，该图像被分割为两个区域（浅层肌腱和深层肌腱）。对于横向压缩应变，双向混合效应方差分析表明，对于两项背屈任务，组和肌腱区域之间存在交互作用（脚跟降低，P = 0.004；部分深蹲，P = 0.008）。对于轴向拉伸应变，IAT 组表现出比对照组更低的拉伸应变的主要影响（站立，P=0.001；半蹲，P=0.033）。与深层肌腱相比，站立时肌腱浅层区域的拉伸应变也有主要影响（P = 0.002），但在半蹲期间则不然（P = 0.603）。 IAT 组中横向压缩应变和轴向拉伸应变的减少表明 IAT 病理区域特有的机械性能发生了改变。此外，压缩应变的模式与导致 IAT 病理学的跟骨撞击理论一致。
The purposes of this case-control study (N=20) were to examine the effects of IAT and tendon region on tendon strain in patients with insertional Achilles tendinopathy (IAT) compared to a control group without tendinopathy. An ultrasound transducer was positioned over the Achilles tendon insertion during dorsiflexion tasks, which included standing and partial squat. A non-rigid image registration-based algorithm was used to estimate transverse compressive and axial tensile strains of the tendon from radiofrequency ultrasound images, which was segmented into two regions (superficial tendon and deep). For transverse compressive strain, two-way mixed effects ANOVAs demonstrated that there were interaction effects between group and tendon region for both dorsiflexion tasks (Heel lowering, P= 0.004; Partial squat, P= 0.008). For axial tensile strain, the IAT group demonstrated a main effect of lower tensile strain than the control group (Standing, P=0.001; Partial squat, P=0.033). There was also a main effect of greater tensile strain in the superficial region of the tendon compared to the deep during standing (P=0.002), but not during partial squat (P=0.603). Reduced transverse compressive and axial tensile strains in the IAT group indicate altered mechanical properties specific to the region of IAT pathology. Additionally, patterns of compressive strain are consistent with the theory of calcaneal impingement contributing to IAT pathology.
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