Longitudinal Changes in Achilles Tendon and Medial Gastrocnemius Muscle Architecture During a 156-km Ultradistance Trail Running Event (Trailstiff)

This study aimed to assess the longitudinal changes in triceps surae muscle-tendon architecture to an ultra distance trail running. Experienced trail runners (N=55, 78% men, age: 45.2 [13.5] years) participated in a 156-km trail run (6000m climbing) consisting in six 26-km laps. The resting architectural properties of triceps surae muscle-tendon were measured using ultrasound imaging for Achille tendon cross-sectional area (AT CSA), medial gastrocnemius muscle pennation angle, thickness, length and fiber length. Measurements were performed the day before the race (Baseline), at 52-km (T1), at 104-km (T2), at 156-km (T3) and 12 hours after the race (H12).

Study Overview

• Status: Completed
• Conditions: Achilles Tendinopathy; Sport Injury; Lower Limb Injury; Calf Injury
• Intervention / Treatment: Diagnostic test: Ultrasound measurement of triceps surae muscle-tendon architecture

• Study Type: Observational
• Enrollment (Actual): 55

Contacts and Locations

Study Locations

• France
  • Caen, France, 14000
    • CHU Caen Normandie

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

All the participants engaged in the First Trail Scientifique de Clécy 2021(https://pubmed.ncbi.nlm.nih.gov/35704381/)

Description

Inclusion criteria

• Experienced runners voluntarily participating in the Trail Scientifique de Clécy (156 km/6000 D+)
• Participants who had already completed 2 ultratrail races (+160 km and -160 km), at least one of them in the past 24 months; the participants had to justify their events and rankings
• Participants affiliated with a social security system or those who were a beneficiary of such a system
• Participants who could speak and read the French language
• Participants with the ability to physically participate in the ultraendurance race
• Participants with the ability to provide written consent for participation in the study

Exclusion criteria

• Participants with cardiac or extracardiac contraindications to intense physical activity
• Participants who had run a mountain ultramarathon (160 km) after September 2, 2021
• Pregnant or breastfeeding women
• Minor participants
• Participants included in another biomedical research protocol during this study
• Participants with recent muscular and orthopedic injuries, limiting running for <15 days
• Participants with a history of ankle joint surgery (eg, arthrodesis)
• Participants with a history of foot or ankle surgery
• Participants with lower-limb pathology or trauma

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Experienced long-distance trail runners; All the participants of the First 'Trail Scientifique de Clécy 2021". This was a multidisciplinary protocol to investigate the mechanisms that contribute to performance during an ultradistance trail race (156-km)

Diagnostic test: Ultrasound measurement of triceps surae muscle-tendon architecture; The resting plantar-flexors MTU architecture assessment was performed using a conventional B-mode and extended-field-of-view (EFOV) ultrasound imaging. Achille tendon cross-sectionnal area, Medial gastrocnemius thickness, pennation angle, fascicle length and muscle length were collected on the dominant lower limb.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Achille tendon cross sectional area	Mid-portion Achille tendon cross sectional area was measured (in mm²) using B mode ultrasound imaging	Five time points: (1) at baseline, the day before the 156-km race, (2) during the race, at 52-km, (3) during the race, at 104-km, (4) immediately after the race, at 156-km and (5) at 12-hours after arrival.
Medial gastrocnemius thickness	Medial gastrocnemius thickness was measured at the inferior third of muscle llength (in mm) using B mode ultrasound imaging	Five time points: (1) at baseline, the day before the 156-km race, (2) during the race, at 52-km, (3) during the race, at 104-km, (4) immediately after the race, at 156-km and (5) at 12-hours after arrival.
Medial gastrocnemius pennation angle	Medial gastrocnemius pennation angle was measured at the inferior third of muscle llength (in °) using B mode ultrasound imaging	Five time points: (1) at baseline, the day before the 156-km race, (2) during the race, at 52-km, (3) during the race, at 104-km, (4) immediately after the race, at 156-km and (5) at 12-hours after arrival.
Medial gastrocnemius fascicle length	Medial gastrocnemius fascicle length was calculated under the assumption of linearity as Fascicle Lnegth = Muscle Thickness / sin (Pennation angle) measured at the inferior third of muscle length (calculated in mm) using B mode ultrasound imaging	Five time points: (1) at baseline, the day before the 156-km race, (2) during the race, at 52-km, (3) during the race, at 104-km, (4) immediately after the race, at 156-km and (5) at 12-hours after arrival.
Medial gastrocnemius muscle length	Medial gastrocnemius muscle length was measured using an extended-field-of-view (EFOV) ultrasound imaging	Five time points: (1) at baseline, the day before the 156-km race, (2) during the race, at 52-km, (3) during the race, at 104-km, (4) immediately after the race, at 156-km and (5) at 12-hours after arrival.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Finisher status	Participants were classifioed as "Finishers" or "Did not finish" whether they completed the 156-km race, or not	One time point, after the race
Average speed	Average speed was calculated using the time per lap and distance for each lap	Four time point (1) during the race, at 52-km, (2) during the race, at 104-km, (3) during the race, at 156-km and (4) for the whole race.

Collaborators and Investigators

• Sponsor: University Hospital, Caen

Publications and helpful links

General Publications

• Mauvieux B, Hingrand C, Drigny J, Hodzic A, Baron P, Hurdiel R, Jouffroy R, Vauthier JC, Pessiglione M, Wiehler A, Degache F, Pavailler S, Heyman E, Plard M, Noirez P, Dubois B, Esculier JF, Nguyen AP, Van Cant J, Roy Baillargeon O, Pairot de Fontenay B, Delaunay PL, Besnard S. Study of the Kinetics of the Determinants of Performance During a Mountain Ultramarathon: Multidisciplinary Protocol of the First Trail Scientifique de Clecy 2021. JMIR Res Protoc. 2022 Jun 15;11(6):e38027. doi: 10.2196/38027.

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2021
• Primary Completion (Actual): November 13, 2021
• Study Completion (Actual): February 1, 2024

Study Registration Dates

• First Submitted: February 19, 2024
• First Submitted That Met QC Criteria: February 28, 2024
• First Posted (Actual): March 7, 2024

Study Record Updates

• Last Update Posted (Estimated): March 26, 2025
• Last Update Submitted That Met QC Criteria: March 24, 2025
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Muscular Diseases; Tendon Injuries; Wounds and Injuries; Athletic Injuries; Tendinopathy; Leg Injuries
• Other Study ID Numbers: Trailstiff

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No