November 2022

Five-Compressions Protocol as a Valid Myotonometric Method to Assess the Stiffness of the Lower Limbs: A Brief Report

Authors: Alfredo Bravo-Sanchez 1, Pablo Abian 2, Jorge Sanchez-Infante 3, Maria Ramirez-delaCruz 4, Paula Esteban-Garcia 4, Fernando Jimenez 4, Javier Abian-Vicen 4


  1. Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcon, Spain
  2. Faculty of Humanities and Social Sciences, Comillas Pontifical University, C. Alberto Aguilera 23, 28049 Madrid, Spain
  3. Hospital Universitario de Toledo, Castilla La Mancha, 45007 Toledo, Spain
  4. Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain

Journal: International Journal of Environmental Research and Public Health - November 2022, Volume 19, Issue 21, Article no. 14425 (DOI: 10.3390/ijerph192114425)

  • We can conclude that the short protocol is a reliable method for assessing myotendinous stiffness.
  • Reducing the measurement time would improve efficiency in research studies and increase the possibilities of the MyotonPRO application for the assessment of myotendinous mechanical properties in different research environments.

The objective of this study was to evaluate the validity of a short assessment MyotonPRO protocol to measure the stiffness of the superficial muscles and tendons of the lower limbs.

The stiffness of the dominant lower limb vastus lateralis (VL), rectus femoris (RF) and patellar tendon (PT) was evaluated in 52 healthy participants (26.9 ± 3.4 years) with two MyotonPRO protocols: the standard protocol (10 mechanical taps) and the short protocol (five mechanical taps). The myotonometry was performed at the midpoint of the length from the upper pole of the patella to the greater trochanter for the VL, and to the anterior superior iliac spine for the RF. The PT was evaluated 1 cm caudal from the inferior pole of the patella. Pearson’s correlation coefficients were calculated to determine the relationships between protocols. The validity of the short protocol was evaluated with Student’s t-test.

High positive correlations were observed between the short and standard protocols in the stiffness of the VL (r = 0.959; p < 0.001), the RF (r = 0.967; p < 0.001) and the PT (r = 0.953; p < 0.001) and no differences were found between both protocols in the stiffness assessment of the VL, RF and PT (p > 0.05).

Therefore, the five-compressions protocol is a valid protocol for the assessment of lower limb mechanical properties.


Keywords: MyotonPRO, mechanical properties, lower limbs, muscle, tendon

In conclusion, our study demonstrated that the five-compressions protocol (short protocol) is valid for the assessment of lower limb myotendinous mechanical properties. Therefore, the time for myotonometer assessment could be reduced in future research works and daily clinical practice.