Quantifying the Stiffness of Achilles Tendon: Intra- and Inter-Operator Reliability and the Effect of Ankle Joint Motion

Chun Long Liu, Ya Peng Li, Xue Qiang Wang, Zhi Jie Zhang, Chun Long Liu, Ya Peng Li, Xue Qiang Wang, Zhi Jie Zhang

Abstract

BACKGROUND The objectives of the present study were to examine the intra- and inter-operator reliability of the MyotonPRO device in quantifying the stiffness of the Achilles tendon and the device's ability to examine the modulation in stiffness of the Achilles tendon during ankle joint flexion. MATERIAL AND METHODS Twenty asymptomatic participants (10 males and 10 females; mean age: 25.0±3.1 years) were recruited for this study. The stiffness of the Achilles tendon was quantified using the MyotonPRO device. RESULTS The results revealed excellent intra- and inter-operator reliability for quantifying Achilles tendon stiffness with the ankle joint in a neutral position and detected a 13.9% increase in stiffness of the Achilles tendon between 0° and 30° of ankle joint flexion. The minimal detectable change (MDC) in tendon stiffness was 45 Newton/meter (N/m). CONCLUSIONS Our findings indicated that the MyotonPRO device is a feasible method to quantify the stiffness of the Achilles tendon and monitor its changes. Thus, it is an essential tool to use to examine the modulation in the stiffness of the Achilles tendon due to pathology or interventions for future studies.

Conflict of interest statement

Conflict of interests

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Schematic of stiffness measurement of Achilles tendon using a portable MyotonPRO device.
Figure 2
Figure 2
Bland and Altman plots of intra- and inter-operator reliability of tendon stiffness. The difference in tendon stiffness between day 1 and day 5 is plotted against mean tendon stiffness (average of the 2 days for operator 1) for each participant in the dominate leg (A) and non-dominate leg (B). The difference in tendon stiffness between operator 1 and operator 2 is plotted against mean tendon stiffness (average of the 2 operators) for each participant in the dominate leg (C) and non-dominate leg (D). In each panel, the continuous line is the mean difference and the dotted lines represent 2 SD above and below the mean difference.
Figure 3
Figure 3
Comparisons of the stiffness index of the Achilles tendon between 0° and 30° of ankle joint dorsiflexion.

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