Publications
Reliability of myotonometry to measure gastrocnemii and Achilles tendon stiffness in unloaded and loaded conditions
Authors: Anh Phong Nguyena 1, 2, Julien Verdebout 1, Antoine Fontaine 1, Philippe Mahaudens 1, 2, 3, 4, Christine Detrembleur 1, 2
Affiliations:
- Universite catholique de Louvain, Faculte des Sciences de la motricite, Place Pierre de Coubertin 1, 1348 Louvain-La-Neuve, Belgium
- Universite catholique de Louvain, Institut de Recherche Experimentale et Clinique, Neuromusculoskeletal lab, avenue mounier 53, 1200 Brussels, Belgium
- Cliniques universitaires Saint-Luc, Service d’orthopedie et de traumatologie de l’appareil locomoteur, Avenue Hippocrate 10, B-1200 Brussels, Belgium
- Cliniques universitaires Saint-Luc, Service de medecine physique et readaptation, Avenue Hippocrate 10, B-1200 Brussels, Belgium
Journal: European Rehabilitation Journal - August 2024, Volume 4, Issue 1, Article no. 42 (DOI: 10.52057/erj.v4i1.42)
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Field & Applications:
- Reliability
- Methodology
- The MyotonPRO© could provide reliable quantitative measurements for monitoring the effects of Achilles tendon rehabilitation and offer clinicians improved monitoring possibilities for therapeutic trials.
Background: Clinically accessible and reproductible musculotendinous stiffness measurements are important for research and clinical monitoring of muscle-tendon injuries, in particular for plantar flexor muscles, including the gastrocnemii and theAchilles tendon, despite their crucial role in both walking and running.
Objectives: To establish the reliability of stiffness measurements using the MyotonPRO® and to determine clinically relevant points of measurement for the gastrocnemii muscle and Achilles tendon.
Design: Cross-sectional study.
Methods: Stiffness was evaluated using the MyotonPRO® device on both legs in 22 healthy individuals. Achilles tendon stiffness was measured at 4 points, and gastrocnemius stiffness at 6 points. Two conditions were assessed: at rest (lying) and under load (standing). All participants underwent 2 measurement sessions, one week apart, to evaluate intra- and inter- reliability.
Results: Intraclass correlation coefficients demonstrated moderate to excellent reliability in lying, with coefficients ranging from 0.735 to 0.933 depending on the location. The standard error of measurement varied from 3.7% to 19.8% depending on the location, and the minimal detectable change ranged from 10.3% in the best condition to 54.5% in the worst. In standing, measurement reliability was poor to good forthe Achilles tendon (ranging from 0.000 to 0.636) and excellent for the gastrocnemii (ranging between 0.902 and 0.986).
Conclusion: Reliability of stiffness measurements of the ankle plantar flexor muscles using the MyotonPRO® was good to excellent. Achilles tendon stiffness should be measured at least 6 cm above the distal insertion to the bone, both in lying and standing.
Keywords: clinical monitoring, recommendation, reliability, reproducibility, stiffness
In summary, we found good to excellent reliability of stiffness measurements of the ankle plantar flexor muscles using the MyotonPRO®. Achilles tendon stiffness should be measured at least 6 cm above the distal insertion to the bone, both in lying and standing. The gastrocnemii stiffness measurements were excellent in both lying and standing.