Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy
Abstract The treatment of Achilles tendinopathy is challenging, as 40% of patients do not respond to existing rehabilitation protocols. These protocols neglect individual Achilles tendon (AT) characteristics, which are crucial for healing of the tendon tissue. Although prior studies suggest an optim...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-84202-9 |
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| author | Alessia Funaro Vickie Shim Ine Mylle Benedicte Vanwanseele |
| author_facet | Alessia Funaro Vickie Shim Ine Mylle Benedicte Vanwanseele |
| author_sort | Alessia Funaro |
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| description | Abstract The treatment of Achilles tendinopathy is challenging, as 40% of patients do not respond to existing rehabilitation protocols. These protocols neglect individual Achilles tendon (AT) characteristics, which are crucial for healing of the tendon tissue. Although prior studies suggest an optimal strain for AT regeneration (6% tendon strains), it is unclear if current protocols meet this condition. Our study aimed to analyse the impact of a selection of rehabilitation exercises on tendon strains in patients with Achilles tendinopathy, using subject-specific finite element (FE) models of the free AT. Second, this study aimed to explain the influence of muscle forces and material properties on AT strains. The 21 FE models of the AT included the following subject-specific features: geometry estimated from 3D freehand ultrasound images, Elastic modulus estimated from the experimental stress‒strain curve, and muscle forces estimated using a combination of 3D motion capture and musculoskeletal modelling. Exercises were ranked based on strain progression, starting from concentric and eccentric exercises, and going to more functional exercises, which impose a greater load on the AT. There was no significant difference between the unilateral heel drop and walking, and both exercises fell within the optimal strain range. However, when examining individual strains, it became evident that there was diversity in exercise rankings among participants, as well as exercises falling within the optimal strain range. Muscle forces notably affected strains more than material properties. Our findings indicate the importance of tailored rehabilitation protocols that account for individual morphological, material, and muscle characteristics. |
| format | Article |
| id | doaj-art-4633d43bd83e434da30b195ae6ae3210 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-4633d43bd83e434da30b195ae6ae32102025-01-12T12:21:46ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-024-84202-9Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathyAlessia Funaro0Vickie Shim1Ine Mylle2Benedicte Vanwanseele3Human Movement Biomechanics Research Group, Department of Movement Sciences, KU LeuvenAuckland Bioengineering Institute, University of AucklandHuman Movement Biomechanics Research Group, Department of Movement Sciences, KU LeuvenHuman Movement Biomechanics Research Group, Department of Movement Sciences, KU LeuvenAbstract The treatment of Achilles tendinopathy is challenging, as 40% of patients do not respond to existing rehabilitation protocols. These protocols neglect individual Achilles tendon (AT) characteristics, which are crucial for healing of the tendon tissue. Although prior studies suggest an optimal strain for AT regeneration (6% tendon strains), it is unclear if current protocols meet this condition. Our study aimed to analyse the impact of a selection of rehabilitation exercises on tendon strains in patients with Achilles tendinopathy, using subject-specific finite element (FE) models of the free AT. Second, this study aimed to explain the influence of muscle forces and material properties on AT strains. The 21 FE models of the AT included the following subject-specific features: geometry estimated from 3D freehand ultrasound images, Elastic modulus estimated from the experimental stress‒strain curve, and muscle forces estimated using a combination of 3D motion capture and musculoskeletal modelling. Exercises were ranked based on strain progression, starting from concentric and eccentric exercises, and going to more functional exercises, which impose a greater load on the AT. There was no significant difference between the unilateral heel drop and walking, and both exercises fell within the optimal strain range. However, when examining individual strains, it became evident that there was diversity in exercise rankings among participants, as well as exercises falling within the optimal strain range. Muscle forces notably affected strains more than material properties. Our findings indicate the importance of tailored rehabilitation protocols that account for individual morphological, material, and muscle characteristics.https://doi.org/10.1038/s41598-024-84202-9Achilles tendonTwisting sub-tendon morphologySubject-specific 3D modelsTendon strainsFinite element modellingRehabilitation exercises |
| spellingShingle | Alessia Funaro Vickie Shim Ine Mylle Benedicte Vanwanseele Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy Scientific Reports Achilles tendon Twisting sub-tendon morphology Subject-specific 3D models Tendon strains Finite element modelling Rehabilitation exercises |
| title | Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy |
| title_full | Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy |
| title_fullStr | Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy |
| title_full_unstemmed | Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy |
| title_short | Subject-specific biomechanics influences tendon strains in patients with Achilles tendinopathy |
| title_sort | subject specific biomechanics influences tendon strains in patients with achilles tendinopathy |
| topic | Achilles tendon Twisting sub-tendon morphology Subject-specific 3D models Tendon strains Finite element modelling Rehabilitation exercises |
| url | https://doi.org/10.1038/s41598-024-84202-9 |
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