跟腱在个体之间表现出肌腱下扭曲的解剖学差异,它的顺应性可能会因为跟腱病等疾病而改变。然而,当前的肌肉骨骼模型忽略了这些材料和形态变化。本研究旨在探讨改变跟腱插入点和顺应性对肱三头肌肌力的影响。因此肌腱负荷,在一名跟腱病患者的动态锻炼过程中。首先,基于特定于受试者的3D徒手超声模型和三种类型的肌腱下扭曲,在肌肉骨骼模型中改变了肌腱下插入点:低,中等,和高。第二,基于实验值对肌腱顺应性进行建模,创建三个肌肉骨骼模型:兼容,意思是,和僵硬。结果表明,肌腱顺应性对肱三头肌肌力的影响大于肌腱扭曲。与无扭曲模型相比,将肌腱下插入点更改为三种类型的扭曲显示出肌肉力量贡献的最大变化为2.3%。在偏心康复运动期间-康复期间的常见运动选择-与通用(对照)肌肉骨骼模型相比,顺应性肌腱模型显示出实质性差异,导致腓肠肌内侧(-3.5%)和腓肠肌外侧(-3.2%)的贡献减少,比目鱼肌的贡献增加(6.6%)。我们的研究结果强调了在肌肉骨骼模型中纳入肌腱顺应性以准确预测肱三头肌肌肉力量的必要性,尤其是在肌腱顺应性增加的个体中,如跟腱病患者。这些发现有助于更准确地预测肌肉力量,因此,个性化康复策略。
The Achilles tendon exhibits anatomical variations in subtendon
twist among individuals, and its compliance can change due to conditions like Achilles tendinopathy. However, current musculoskeletal models overlook these material and morphological variations. This study aimed to investigate the impact of altering Achilles subtendon insertion points and compliance on the triceps surae muscle forces, and therefore tendon loading, during dynamic exercises in one Achilles tendinopathy patient. First, subtendon insertion points were altered in the musculoskeletal model based on a subject-specific 3D freehand ultrasound model and for three types of subtendon twists: low, medium, and high. Second, tendon compliance was modeled based on experimental values, creating three musculoskeletal models: compliant, mean, and stiff. Results indicated that tendon compliance had a larger effect than tendon
twist on triceps surae muscle forces. Altering subtendon insertion points to the three types of
twist showed a maximal change of 2.3% in muscle force contribution compared to the no-
twist model. During the eccentric rehabilitation exercise-a common exercise choice during rehabilitation-the compliant tendon model showed substantial differences compared to the generic (control) musculoskeletal model, resulting in decreased gastrocnemius medialis (-3.5%) and gastrocnemius lateralis (-3.2%) contributions and increased soleus contribution (+ 6.6%). Our study results highlight the necessity of incorporating tendon compliance in musculoskeletal models to accurately predict triceps surae muscle forces, especially in individuals with increased tendon compliance, such as patients with Achilles tendinopathy. Such findings contribute to more accurate predictions of muscle forces and hence, personalized rehabilitation strategies.