Recommendation for stiffness measurement on gastrocnemii and Achilles tendon at rest and in loaded conditions

Nguyen, Anh Phong;Verdebout, Julien;Fontaine, Antoine;Mahaudens, Philippe;Detrembleur, Christine
(2024) European Rehabilitation Journal — Vol. 4, n° 1, p. 1-10 (2024)

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Background: Clinically accessible and reproductible musculotendinous stiffness measurements are important for research and clinical monitoring of muscle-tendon injuries, in particular for plantar flexor muscles, including the gastrocnemii and the Achilles tendon, despite their crucial role in both walking and running. Objectives: To establish the reliability of stiffness measurements using the MyotonPro® and to determine clinically relevant points of measurement for the gastrocnemii muscle and Achilles tendon. Methods: Design: cross-sectional study. Stiffness was evaluated using the MyotonPro® device on both legs in 22 healthy individuals. Achilles tendon stiffness was measured at 4 points, and gastrocnemius stiffness at 6 points. Two conditions were assessed: at rest (lying) and under load (standing). All participants underwent 2 measurement sessions, one week apart, to evaluate intra- and inter- reliability. Results: Intraclass correlation coefficients demonstrated moderate to excellent reliability in lying, with coefficients ranging from 0.735 to 0.933 depending on the location. The standard error of measurement varied from 3.7% to 19.8% depending on the location, and the minimal detectable change ranged from 10.3% in the best condition to 54.5% in the worst. In standing, measurement reliability was poor to good for the Achilles tendon (ranging from 0.000 to 0.636) and excellent for the gastrocnemii (ranging between 0.902 and 0.986). Conclusion: Reliability of stiffness measurements of the ankle plantar flexor muscles using the MyotonPro® was good to excellent. Achilles tendon stiffness should be measured at least 6 cm above the distal insertion to the bone, both in lying and standing.
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Nguyen, A. P., Verdebout, J., Fontaine, A., Mahaudens, P., & Detrembleur, C. (2024). Recommendation for stiffness measurement on gastrocnemii and Achilles tendon at rest and in loaded conditions. European Rehabilitation Journal, 4(1), 1-10. https://doi.org/10.52057/erj.v4i1.42 (Original work published 2024)