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Title: Sonographic evaluation of the effect of long-term exercise on achilles tendon stiffness using shear wave elastography
Authors: Siu, WL
Chan, CH
Lam, CH
Lee, CM
Ying, M 
Keywords: Physical activity
Exercise physiology
Elasticity imaging techniques
Elastic modulus
Issue Date: 2016
Publisher: Elsevier
Source: Journal of science and medicine in sport, Nov. 2016, v. 19, no. 11, p. 883-887 How to cite?
Journal: Journal of science and medicine in sport 
Abstract: Objectives: This study aimed to assess the feasibility of using quantitative shear wave elastography (SWE) to assess the stiffness (Young's modulus) of Achilles tendon and to investigate the effect of long-term weight-bearing exercise on the stiffness of human Achilles tendon by comparing the frequent and infrequent exercise groups. Design: Case-control study. Methods: A total of 36 healthy subjects aged 19-25 were recruited. Subjects were categorized into frequent and infrequent exercise groups dependent on their level of lower limb weight bearing exercise. B-mode and shear-wave ultrasound examination of Achilles tendon were performed. Measurements of the Achilles tendon stiffness were conducted with the foot position standardized by an ankle fixer. To evaluate inter and intra-operator reliability of Young's modulus measurements, each subject was scanned by three operators and each operator scanned the subject three times. Results: The intra-operator reliability of Young's modulus measurements ranged between 0.803 and 0.845. The inter-operator measurement reliability was 0.585. Result showed that Achilles tendon on non-dominant ankle in frequent-exercisers (median: 320.1 kPa) was significantly stiffer than that in infrequent-exercisers (median: 296 kPa)(p < 0.05), whereas there was no significant difference in Achilles tendon stiffness on dominant ankle between the two groups (p > 0.05). Conclusions: Shear wave elastography is feasible for assessing the Achilles tendon's stiffness in vivo. The stiffness of Achilles tendon of frequent-exercisers was significantly higher than that of infrequent exercisers on non-dominant ankle but not on dominant ankle. With the use of an ankle fixer, there was high repeatability and moderate reproducibility in SWE measurement of Achilles tendon stiffness.
ISSN: 1440-2440
EISSN: 1878-1861
DOI: 10.1016/j.jsams.2016.02.013
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