剪切波弹性成像在辅助软组织松解术后跟腱功能评估中的应用

doi:10.3969/j.issn.1006-9771.2021.09.016

Abstract

Abstract:

Objective To apply real-time shear wave elastography to observe the effect of instrument-assisted soft tissue mobilization (IASTM) on Achilles tendons for healthy adults.Methods From July to December, 2020, 52 healthy adults were assigned into control group (n = 15) and experimental group (n = 37) randomly. The experimental group received IASTM on left Achilles tendons, once another day for two weeks, while the control group received no treatment. The thickness and elastic modulus of the left Achilles tendons were measured with high-frequency ultrasound and shear wave ultrasound elastography on all the subjects, before treatment, immediately after the first treatment and three days after treatment, respectively.Results Five cases dropped down in the experimental group. There was no significant difference in thickness and elastic Young's modulus of the left Achilles tendons between two groups before treatment (t < 0.630, P > 0.05). The thickness of the left Achilles tendons was less in the experimental group than in the control group immediately after the first treatment (t = 2.149, P < 0.05), while average and maximum elastic Young's modulus was less three days after treatment (t > 2.134, P < 0.05).Conclusion Real-time shear wave elastography could quantify the thickness and elasticity of Achilles tendon, to evaluate the effect of IASTM.

Key words: shear wave elastography, instrument-assisted soft tissue mobilization, Achilles tendon, rehabilitation assessment

SHAN Jie-ling,ZHU Yu-lan,RUAN Ting-ting,GU Sheng-chen,HUANG Kai-wen,LI Yun,ZHU Yu-lian. Effect of Instrument-assisted Soft Tissue Mobilization on Achilles Tendon Using Shear Wave Elastography[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(9): 1098-1103.

Figures/Tables 4

References 22

[1]	GE W, ROTH E, SANSONE A. A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons[J]. J Phys Ther Sci, 2017, 29(4):654-657. doi: 10.1589/jpts.29.654
[2]	Effects of instrument-assisted soft tissue mobilization on musculoskeletal properties: corrigendum[J]. Med Sci Sports Exerc, 2020, 52(2):524.
[3]	LAMBERT M, HITCHCOCK R, LAVALLEE K, et al. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review[J]. Phys Ther Rev, 2017, 22(1/2):76-85. doi: 10.1080/10833196.2017.1304184
[4]	IKEDA N, OTSUKA S, KAWANISHI Y, et al. Effects of instrument-assisted soft tissue mobilization on musculoskeletal properties[J]. Med Sci Sports Exerc, 2019, 51(10):2166-2172. doi: 10.1249/MSS.0000000000002035
[5]	ZAGHLOUL H M S, ALI H A, GHALLY S A O, et al. Comparison of the effectiveness of instrument-assisted soft tissue mobilization technique, ultrasound therapy, or deep friction massage on fast recovery and accelerating tissue healing in groin strain[J]. Entomol Appl Sci Lett, 2020, 7(1):54-60.
[6]	FRANKEWYCZ B, HENSSLER L, WEBER J, et al. Changes of material elastic properties during healing of ruptured Achilles tendons measured with shear wave elastography: a pilot study[J]. Int J Mol Sci, 2020, 21:3427. doi: 10.3390/ijms21103427
[7]	AUBRY S, RISSON J R, KASTLER A. Biomechanical properties of the calcaneal tendon in vivo assessed by transient shear wave elastography[J]. Skeletal Radiol, 2013, 42:1143-1150. doi: 10.1007/s00256-013-1649-9
[8]	OTTER S, PAYNE C, JONES A M, et al. Differences in Achilles tendon stiffness in people with gout: a pilot study[J]. BMC Musculoskelet Disord, 2020, 10(7):21. doi: 10.1186/1471-2474-10-21
[9]	卞东林, 王学梅, 黄崑. 实时剪切波弹性成像对跟腱生物力学的评估及其临床应用[J]. 中华超声影像学杂志, 2014, 23(6):545-546.
	BIAN D L, WANG X M, HUANG K. Chin J Ultrasonograph, 2014, 23(6):545-546.
[10]	KLAUSER A S, MIYAMOTO H, BELLMANN-WEILER R, et al. Sonoelastography: musculoskeletal applications[J]. Radiology, 2014, 272(3):622-633. doi: 10.1148/radiol.14121765
[11]	封旭华, 蔡叶华, 华英汇, 等. 高频超声在跟腱腱病诊断与康复疗效评估中的应用[J]. 上海体育学院学报, 2014, 38(5):56-60.
	FENG X H, CAI Y H, HUA Y H, et al. Application of high frequency ultrasound in diagnosing and rehabilitating assessment of Achilles tendinopathy[J]. J Shanghai Univ Sport, 2014, 38(5):56-60.
[12]	林志达, 潘慧. 基于肌骨超声成像技术量化评估优秀运动员跟腱形态学研究[J]. 按摩与康复医学, 2018, 9(11):1-2.
	LIN Z D, PAN H. Chin Manipulat Rehabil Med, 2018, 9(11):1-2.
[13]	DIRRICHS T, QUACK V, GATZ M, et al. Shear wave elastography (SWE) for the evaluation of patients with tendinopathies[J]. Acad Radiol, 2016, 23(10):1204-1213. doi: 10.1016/j.acra.2016.05.012
[14]	黄佳鹏, 秦鹍, 朱毅, 等. 剪切波弹性成像技术在跟腱弹性量化评估中的研究进展[J]. 中国康复医学杂志, 2019, 34(10):1258-1263.
	HUANG J P, QIN K, ZHU Y, et al. Chin J Rehabil Med, 2019, 34(10):1258-1263.
[15]	WATSFORD M L, MURPHY A J, MCLACHLAN K A, et al. A prospective study of the relationship between lower body stiffness and hamstring injury in professional Australian rules footballers[J]. Am J Sports Med, 2010, 38(10):2058-2064. doi: 10.1177/0363546510370197
[16]	HIRATA K, MIYAMOTO-MIKAMI E, KANEHISA H, et al. Muscle-specific acute changes in passive stiffness of human triceps surae after stretching[J]. Eur J Appl Physiol, 2016, 116(5):911-918. doi: 10.1007/s00421-016-3349-3
[17]	ROWLETT C A, HANNEY W J, PABIAN P S, et al. Efficacy of instrument-assisted soft tissue mobilization in comparison to gastrocnemius-soleus stretching for dorsiflexion range of motion: a randomized controlled trial[J]. J Bodyw Mov Therapies, 2019, 23(2):233-240.
[18]	JONES E R, FINLEY M A, FRUTH S J, et al. Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain: a pilot study[J]. J Am Podiatr Med Assoc, 2019, 109(3):193-200. doi: 10.7547/16-105
[19]	RHYU H, HAN H, RHI S. The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players[J]. Technol Health Care, 2018, 26(5):833-842. doi: 10.3233/THC-181384
[20]	KIM J, SUNG D J, LEE J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application[J]. J Exerc Rehabil, 2017, 13(1):12-22. doi: 10.12965/jer.1732824.412
[21]	COVIELLO J P, KAKAR R S, REYNOLDS T J. Short-term effects of instrument-assisted soft tissue mobilization on pain free range of motion in a weight lifter with subacromial pain syndrome[J]. Int J Sports Phys Ther, 2017, 12(1):144-154.
[22]	FOUSEKIS K, VARDA C, MANDALIDIS D, et al. Effects of instrument-assisted soft-tissue mobilization at three different application angles on hamstring surface thermal responses[J]. J Phys Ther Sci, 2020, 32(8):506-509. doi: 10.1589/jpts.32.506

组别	n	性别(男/女, n)	年龄(岁)	体质量(kg)	身高(cm)	BMI (kg/m²)
对照组	15	8/7	23±3.0	63±8.9	171±7.1	21±1.8
试验组	37	13/24	25±3.2	62±9.8	167±8.4	22±2.4
t值			1.922	0.307	1.395	0.856
P值		0.350^a	0.060	0.760	0.169	0.396

组别	项目	治疗前	首次治疗后				末次治疗后
组别	项目	几何均数(CV%)	几何均数(CV%)	几何均数百分比 (95%CI)	F值^a	P值^a	几何均数(CV%)	几何均数百分比(95%CI)	F值^a	P值^a
对照组	厚度(cm)	0.45(12.2)	0.46(11.4)	101(98,104)	0.331	0.574	0.45(15.1)	100(96,104)	0.002	0.969
(n = 15)	弹性模量(kPa)
	最小值	13.64(70.1)	22.06(46.8)	162(74,354)	1.730	0.210	33.14(19.7)	243(86,683)	3.388	0.087
	平均值	94.81(6.3)	95.53(5.1)	101(92,110)	0.034	0.857	91.27(5.9)	96(88,105)	0.906	0.357
	最大值	166.08(5.5)	154.65(4.6)	93(83,104)	1.841	0.196	166.56(4.9)	100(92,110)	0.005	0.945
试验组	厚度(cm)	0.45(12.0)	0.44(12.9)	98(97,99)	10.100	0.003	0.44(12.5)	98(96,100)	3.709	0.063
(n = 37/32)^b	弹性模量(kPa)
	最小值	19.91(48.3)	25.67(31.6)	129(88,190)	1.778	0.191	22.95(35.3)	115(73,181)	0.409	0.527
	平均值	101.17(7.2)	95.97(7.8)	95(87,103)	1.651	0.207	82.06(4.3)	81(73,90)	16.570	< 0.001
	最大值	176.41(6.9)	173.32(7.5)	98(88,109)	0.111	0.741	140.82(6.0)	80(71,90)	13.740	< 0.001

时间		对照组 (n = 15)	试验组 (n = 37/32)^a	几何均数百分比(95%CI)	F/t值	P值
治疗前	厚度〔几何均数(CV%), cm〕	0.45(12.2)	0.45(12.0)	99(94,105 )	0.060^b	0.810
	弹性模量〔几何均数(CV%), kPa〕
	最小值	13.64(70.1)	19.91(48.3)	146(56,382)	0.630^b	0.433
	平均值	94.81(6.3)	101.17(7.2)	107(88,130)	0.440^b	0.512
	最大值	166.08(5.5)	176.41(6.9)	106(86,131)	0.340^b	0.563
首次治疗后	厚度〔最小二乘几何均数^c, cm〕	0.46	0.44	97(95,100)	2.149	0.037
	弹性模量〔最小二乘几何均数^c, kPa〕
	最小值	24.99	24.4	98(55,172)	0.084	0.933
	平均值	98.97	94.61	96(84,109)	0.674	0.503
	最大值	159.1	171.3	108(91,128)	0.879	0.384
末次治疗后	厚度〔最小二乘几何均数^c, cm〕	0.45	0.44	98(94,102)	0.936	0.355
	弹性模量〔最小二乘几何均数^c, kPa〕
	最小值	34.95	22.39	64(36,114)	1.557	0.127
	平均值	92.12	81.7	89(79,99)	2.134	0.039
	最大值	170.5	139.3	82(70,95)	2.660	0.011

Effect of Instrument-assisted Soft Tissue Mobilization on Achilles Tendon Using Shear Wave Elastography

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 22

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Xiao-min ZHU,Yuan-min LIU,Xue-jing DU,Ya-nan WANG,Hua-wei WANG,Hui-lin LIU,Tong ZHANG. Advance in Application of Functional Reach Test (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 583-587.
[2]	Ya-nan WANG,Tong ZHANG,Yuan-min LIU,Xiao-min ZHU,Xue-jin DU. Validity and Reliability of Star Excursion Balance Test for Dynamic Balance Assessment in Stroke Patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 604-608.
[3]	GUO Yi,LI Xue-mei,ZHANG Hao,LU Hai-tao,FENG Bing,WANG Yi-zheng. Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 753-756.
[4]	WANG Yu-zhong,LIANG Dan-yan,HAO Jiang-hui,WEN Shu-zheng,Wang Ji-hong. Application of Achilles Tendon Total Rupture Score in Acute Achilles Tendon Rupture [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(6): 707-710.
[5]	ZHAO Jiang-li, MAO Yu-rong, XU Zhi-qin, CHEN Shao-zhen, HUANG Dong-feng. Validity of Chinese Version of Action Research Arm Test in Patients with Early Cerebral Infarction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(8): 946-955.
[6]	LIU Li-xu, ZHANG Tong, HE Jing-jie. Group of the "Twelfth Five-Year" National Plan for the Science & Technology Support Program of China. Application of Comprehensive ICF Core Set for Stroke for Evaluation for Stroke Patients: A Multi-center Study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(7): 816-821.
[7]	MU Jing-jing, CHEN Bin-juan, LU Xue-feng, ZHANG Tong, WANG Yuan, WANG Yin-di, TONG Ming-hui. Application of Shear Wave Elastography in Type 2 Diabetic Sural Neuropathy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(2): 213-216.
[8]	ZHUO Yan-ling, LIU Si-hai, HAN Xin-zuo, CUI Zhi-gang, WANG Fei, LIU Ke-min. Correlation of Social-psychological Health and Joint Function in Patients during Rehabilitation for Joint Impairment [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(11): 1356-1360.
[9]	XIAO Jing, XU Xin, ZHOU Jing-bing. Advance in Dynamic Functional Rehabilitation after Non-operative Treatment of Acute Achilles Tendon Rupture (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(10): 1162-1167.
[10]	FENG Ya-nan, LI Ya-peng, ZHANG Zhi-jie, ZHU Yi, YANG Jin-chu, LIU Chun-long. Intra- and Inter-rater Reliability of A Novel Hand-held MyotonPRO Device for Achilles Tendon Properties in Healthy Subjects [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(6): 709-712.
[11]	FANG Ke, LI Fan-ling, XIAO Sheng, LI Xin, LIU Hong. Effects of Achilles Tendon Lengthening on Talipes Equinus in Children with Spastic Cerebral Palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(6): 734-736.
[12]	LUO Ping, LIN Hong-sheng, FANG Jian-hui, ZHANG Wen, CAI Chao-chen. Reliability of Ultrasound Tissue Characterization for Quantifing Integrity of Achilles Tendon and Patellar Tendon in People without Tendinopathy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(10): 1166-1170.
[13]	YANG Ling-yu1,2a, LIU Li-xu1,2a, HE Jing-jie1,2a, WEI Dong-jie1,2b, SU Guo-dong1,2c, DOU Fei-fei1,2d, YANG Song-ran. Bilateral Hemiplegia and Pseudobulbar Paralysis Caused by Multiple Cerebral Apoplexy: Case Discussion [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2016, 22(4): 474-477.
[14]	WANG Rong-li;WANG Ning-hua;XIE Bin.. Application of Surface Electromyography in Parkinson's Disease (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2012, 18(2): 144-148.
[15]	ZHANG Xin;YUN Xiao-ping;ZHANG Hui-li;et al.. Reliability and Validity of Revised EC301Calculation and Number Processing Battery in Chinese Version [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2011, 17(6): 523-526.