THE ACUTE TRANSVERSE STRAIN RESPONSE OF THE PATELLAR TENDON TO QUADRICEPS EXERCISE: A GENDER BASED COMPARATIVE PILOT STUDY.

Volume 7, Issue 5, October 2023     |     PP. 408-424      |     PDF (418 K)    |     Pub. Date: October 20, 2023
DOI: 10.54647/sociology841204    68 Downloads     159238 Views  

Author(s)

EDET UKPONG-DAN, BMBCh, MD CCST (Orth/Tr.), MSc-Sport/Exercise Med. Hinchingbrooke Hospital, Huntingdon, United Kingdom

Abstract
Introduction: Tendons are highly adaptive to changes in loading forces put on them always from walking, running, jumping and in other sporting activities. There are few studies involving the Patellar tendon (35, 29), reported a studies on the Acute Transverse Strain response of the Patellar Tendon to quadriceps exercises, a response similar to the Achilles and other tendon studies reported. Resistive exercises are therefore shown to significantly alter the sonographic measures of the patellar tendon structure; the strain, entropy and echogenicity.
Method: Ten adult males and ten adult females, with no previous ankle or knee pathology, between 22 and 55 years of age, an average age of 38.5 +/- 15 years; height of 1.60 to 1.80 m and weight of 60 to 90 kg, were recruited.
A 5- to 10- MHz linear array transducer was used to obtain standardized sagittal sonograms (8), of the patellar tendon immediately before and after 50 repetitions of leg extensions exercise, 20 mm distal to the inferior pole of the patellar. The transverse strain ε, (Hencky strain) was calculated as a percentage ratio of the post- to pre-exercise tendon thickness and the result statistically analysed (35).
Result: There was immediate decrease in patellar tendon thickness (P < 0.05), after the quadriceps exercise in both groups. A transverse strain of -13.8% +/- 7.8% occurred in the males and the females had a transverse strain of -9.6% +/- 3.5%. There were echotexture changes; increased tendon echogenicity (P < 0.05), decrease in entropy (P < 0.05) in both groups.
The patellar tendon echogenicity was higher for all participants post exercise while the entropy dropped in the post exercise measurement in all participants. There was also a significant difference in the magnitude of transverse strain response (P < 0.05) between males and females; -13.8% for males against -9.6% for females a difference of 30%.
Conclusion: This is a pilot study comparing the male and female acute strain response of the patellar tendon to quadriceps exercise and the consistency of the response in females. This strain response is consistent in both males and females but with a lower magnitude of response in females.

Keywords
TENDONS, EXERCISE, IMAGING, STRUCTURE, PHYSIOLOGY, PATELLA, STRAIN, STRESS

Cite this paper
EDET UKPONG-DAN, THE ACUTE TRANSVERSE STRAIN RESPONSE OF THE PATELLAR TENDON TO QUADRICEPS EXERCISE: A GENDER BASED COMPARATIVE PILOT STUDY. , SCIREA Journal of Sociology. Volume 7, Issue 5, October 2023 | PP. 408-424. 10.54647/sociology841204

References

[ 1 ] Andarawis-Puri, N. and Flatow, EL (2011) Tendon fatigue in response to mechanical loading: J Musculoskelet Neuronal Interact; 11(2):106-114.
[ 2 ] Boushel R, Langberg H, Green S, Skogaard D, Bulow J, Kjaer M (2000) Blood flow and oxygenation in peritendinous tissue and calf muscle during dynamic exercise in humans, J Physiol:524(Pt.1):305-313.
[ 3 ] Collinger JL, Fullerton B, Impink BG, Koontz AM, Boninger ML (2010) Validation of greyscale-based quantitative ultrasound in manual whellchair users; relationship to established clinical measures of shoulder pathology, Am J Phys Med Rehabil, 89(5): 390 – 400.
[ 4 ] Couppé C, Kongsgaard M, Aagaard P, Hansen P, Bojsen-Moller J, Kjaer M, Magnusson SP (2008) Habitual loading results in tendon hypertrophy and increased stiffness of the human patellar tendon, J Appl Physiol 105(3): 805 -810.
[ 5 ] Cook JL, Khan KM, Harcourt PR, Kiss ZS, Fehrmann MW, Griffiths L, Wark JD (1998) Patellar Tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons, Victorian Institute of Sport Tendon Study Group, Clin J Sport Med:8(2):73 – 7.
[ 6 ] Chiquet M, Gelman L, Lutz R, Maier S (2009) From Mechanotransduction to extracellular matrix gene expression in fibroblast; Biochim Biophys Acta; 1793(5): 911 – 20.
[ 7 ] Dideriksen K, Sindby AKR, Krogsgaard M, Schjerling P, Holm L and Langberg H, (2013), Effect of acute exercise on patella tendon protein synthesis and gene expression, SpringerPlus, 2:109.
[ 8 ] Fredberg U, Bolvig L, Andersdon NT, Stengaard-Pedersen K (2008) Ultrasonography in evaluation of Achilles and patellar tendon thickness, Ultrashall med.;29(1): 60 -65.
[ 9 ] Fornage BD (1986) Achilles tendon US examination, Radiology;159;759-64.
[ 10 ] Fredberg U, Bolvig L, Lauridsen A, Stengaard-Pederesn K (2007) Influence of acute physical activity immediately before ultrasonographic measurement of Achilles tendon thickness, Scand J Rheumatol,36;488-9.
[ 11 ] Fahlstrom M, Alfredson H (2010) Ultrasound and Doppler findings in the Achilles tendon among middle-aged recreational floor ball players in direct relation to a match; Br J Sports Med. 44(2):140-3.
[ 12 ] Frohm A, Halvorsen K, Thorstensson A (2007) Patellar tendon load in different kinds of eccentric squats, Clin Biomech, 22(6):704 – 11.
[ 13 ] Grigg NL, Wearing SC, Smearthers JE (2009) Eccentric calf muscle exercise produces a greater acute reduction in Achilles tendon thickness than concentric exercise, Br J Sports Med.; 43(4) :280 – 283.
[ 14 ] Heinemeier KM, Kjaer M (2011) In vivo investigation of tendon responses to mechanical loading, J Musculoskeletal neuronal Interact, 11(2):115 – 123.
[ 15 ] Hohmann E, Bryant A, Clarke R, Bennell K, Payne C and Murphy A,(2012) Estrogen fluctuations in females influence the mechanical behaviour of the human Achilles Tendon in vivo; J Bone Joint Surg Br; 94-B no. SUPP XXIII 230.
[ 16 ] Hansen M, Miller BF, Holm L, Doessing S, Petersen SG, Skovgaard D, Frystyk J, Flyvbjerg A, Koskinen S, Pingel J, Kjaer M and Langberg H (2009) Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissues in young women, J Appl Physiol 106(4);1434-43.
[ 17 ] Hansen M, Koskinen SO, Petersen SG, Doessing S, Frystyk J, Flyvbjerg A, Westh E, Magnusson SP, Kjaer M and Langberg H (2008) Ethynil oestradiol administration in women suppresses synthesis of collagen in tendon in response to exercise, J Physiol 15;586(Pt 12):3005-16.
[ 18 ] Iwanuma S, Akagi R, Kurihara T, Ikegawa S, Kanehisa H, Fukunaga T, Kawakami Y, (2011) Longitudinal and transverse deformation of human Achilles tendon induced by isometric plantar flexion at different intensities, J. Appl. Physiol. 110(6):1615 – 1621.
[ 19 ] Kader D, Saxena A, Movin T, Maffulli N (2002) Achilles tendinopathy: some aspects of basic science and clinical management. Br J Sports Med.36:239-49.
[ 20 ] Kannus P, (2000) Structure of the tendon connective tissue. Scand J Med Sci Sports,:10(6):312 – 20.
[ 21 ] Klein EE, Weil ( Jr) L, Weil (Sr) L, Fleischer AE (2013), Body Mass Index and Achilles Tendonitis: A 10-Year Retrospective Analysis. Foot Ankle Spec, August 2013 vol. 6 no. 4 276-282
[ 22 ] Kongsgaard M, Aagaard P, Kjaer M, Magnusson SP (2005) Structural Achilles Tendon properties in athletes subjected to different exercise modes and in Achilles tendon rupture patients; J Appl Physiol;99(5):1965 – 1971.
[ 23 ] Larni Y, Saland EL, Foux A (1988) Physico-chemical and mirco-structural changes in collagen fibre bundles following stretch in-vitro; Biorheology 25(4):591-604.
[ 24 ] Lokshin O, Larni Y (2009) Micro and macro rheology of planar tissues; Biomaterials:30:3118-27.
[ 25 ] Lee K S (2012) Musculoskeletal Sonography of the Tendon, JUM 31(12) 1879-1884.
[ 26 ] Magnusson SP, Hansen P, Kjaer M (2003) Tendon properties in relation to muscular activity and physical training, Scand J Med Sci Sports 13: 211 – 223.
[ 27 ] Maffulli N, Regine R, Angelillo M (1987), Ultrasound diagnosis of Achilles tendon pathology in runners, Br.J Sports med. 21:158 – 62.
[ 28 ] Pillen S, Keimpema M, Nievelstein RAJ, Verrips A, Kruijsbergen-Raijmann W, Zwarts MJ (2006) Skeletal muscle ultrasonography: visual versus quantitative evaluation. Ultrasound Med Biol. 32(9):1315-21.
[ 29 ] Pearson SJ, Ritchings T, Mohammed ASA (2014) Regional Strain variations in the Human Patellar Tendon; Am. J Sports Med. 46(7): 1343 – 1351.
[ 30 ] Rosager S, Aagaard P, Dyhre-Poulson P, Neergaard K, Kjaer M, Magnusson SP, (2002), Load-displacement properties of the human triceps surae aponeurosis and tendon in runners and non-runners, Scand J Med Sci Sport 12(2):90-8.
[ 31 ] Shalabi A, Kristoffersen-Wiberg M, Aspelin P, Movin T (2004) Immediate Achilles Tendon Response After Strength Training Evaluated by MRI, Med Sci Sports Exerc:36(11): 1841-6.
[ 32 ] Tipton CM, Vailas AC, Matthes RD (1986) Experimental studies on the influences of physical activity on ligaments, tendons and joints: A brief review. Acta Med Scand; Suppl 711:157-68.
[ 33 ] Truesdell C. and Noll W eds (2004) The non-linear field theories of mechanics: Springer Berlin Heidelberg, Tanner RI, Tanner E (2003) Heinrich Hencky : a rheological pioneer, Rheol Acta, , 42(1-2); 93 – 101.
[ 34 ] Tardioli A, Malliaras P, Maffulli N (2002); Immediate and short term effect of exercise on tendon structure: biochemical, biomechanical and imaging responses, Br Med Bull 103(1):169 – 202.
[ 35 ] Wearing SC, Smearthers JE, Urry SR, Hooper SL (2008) The time-course of acute changes in Achilles tendon morphology following exercise, In: The Impact of Technology on Sports 11, eds, Fuss FK, Subic A, Ujihashi S, Taylor and Francis, Singapore:65 – 68
[ 36 ] Wearing SC, Hooper SL, Purdam C, Cook J. (2013) The Acute transverse strain response of the Patellar tendon to quadriceps exercise, Am. J Sports Med. 45(4): 772 – 777.
[ 37 ] Westh E, Kongsgaard M, Bojsen-Moller J, Aagaard P, Hansen M, Kjaer M, and Magnusson SP, (2008) Effect of habitual exercise on the structural and mechanical properties of human tendon, in vivo, in men and women. Scand.J Med Sci Sports;;18(1);23 – 30.
[ 38 ] Wu H (2004) Continuum Mechanics and Plasticity (Modern Mechanics and Mathematics) Chapman and Hall/CRC
[ 39 ] Wren TAL, Beaupre GS, Carter D (2000) Tendon and ligament adaptation to exercise, immobilization and remobilization; J Rehab Research and Dev. 37(2): 217-24.
[ 40 ] Woo SL-Y, Ritter MA, Amiel D, Sanders TM, Gomez MA, Kuei SC, Garfin SR and Akeeson WH (1980) The biomechanical and biochemical properties of swine tendons—long term effects of exercise on the digital extensors. Connect Tissue Res. 7(3):177-83.
[ 41 ] Wearing SC, Grigg NL, Hooper SL, Appleton EA, Smeathers JE (2011) The acute response of tendon to loading: implications for rehabilitation, J Foot Ankle Res.; 4(Suppl 1): I13.