Normative Achilles and patellar tendon shear wave speeds and loading patterns during walking in typically developing children

Autor: Jack A. Martin, Robyn L. Kuchler, Robin L. Pomeroy, Anahid Ebrahimi, Isaac F. Loegering, Darryl G. Thelen
Rok vydání: 2021
Předmět:
Zdroj: Gait Posture
ISSN: 0966-6362
DOI: 10.1016/j.gaitpost.2021.05.023
Popis: BACKGROUND: Motion analysis is commonly used to evaluate joint kinetics in children with cerebral palsy who exhibit gait disorders. However, one cannot readily infer muscle-tendon forces from joint kinetics. This study investigates the use of shear wave tensiometry to characterize Achilles and patellar tendon forces during gait. RESEARCH QUESTION: How do Achilles and patellar tendon wave speed and loading modulate with walking speed in typically developing children? METHODS: Twelve typically developing children (9 to 16 years old, walked on an instrumented treadmill with shear wave tensiometers over their Achilles (n=11) and patellar (n=9) tendons. Wave speeds were recorded at five leg length-normalized walking speeds (very slow to very fast). Achilles and patella tendon moment arms were measured with synchronized ultrasound and motion capture. The tendon wave speed-load relationship was calibrated at the typical walking speed and used to estimate tendon loading at other walking speeds. RESULTS: Characteristic Achilles and patellar tendon wave speed trajectories exhibited two peaks over a gait cycle. Peak Achilles tendon force closely aligned with peak ankle plantarflexor moment during pushoff, though force exhibited less modulation with walking speed. A second peak in late swing Achilles loading, which was not evident from the ankle moment, increased significantly with walking speed (p < 0.001). The two peaks in patellar tendon loading occurred at 13 ± 1% and 68 ± 6% of the gait cycle, matching the timing of peak knee extension moment in early stance and early swing. Both peak patellar tendon loads increased significantly with walking speed (p < 0.05). SIGNIFICANCE: This is the first study to use shear wave tensiometry to characterize Achilles and patellar tendon loading during gait in children. These data could serve as a normative comparison when using tensiometry to identify abnormal tendon loading patterns in individuals who exhibit equinus and/or crouch gait.
Databáze: OpenAIRE