Measurement of in vivo patella and achilles tendon forces during treadmill running

Groeneveld, Llewellyn Wallace (2020-03)

Thesis (MEng)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: Tendons are the connections that translate forces from muscles to bone and are essential to the musculoskeletal system movement during locomotion. The load experienced during running is believed to be a primary injury factor for tendinopathy (Malliaras et al., 2015). An individual’s running biomechanics influence the load experienced, and are risk factors for both Achilles (Chang et al., 2000; Moore et al., 2014; Moore et al., 2016) and patella (Kunimasa et al., 2014) tendinopathy. This study investigated the feasibility of using a fibre optic sensor to measure in vivo patella and Achilles tendon forces during running. The study also aimed to determine whether the sensor could detect differences in tendon loads as a function of intrinsic and extrinsic factors in running conditions. According to the author’s knowledge this was the first time a fiber optic sensor was used to measure tendon force during running. A light intensity based fibre optic sensor system capable of measuring in vivo tendon forces was designed, built and tested. The sensor was implemented in a pilot study with five participants to measure in vivo tendon forces during treadmill running tests while simultaneously measuring the muscle activity, kinematics and kinetics. The tests were conducted at the Neuromechanics Unit of Central Analytical Facilities at Stellenbosch University. The optic fiber was inserted into the patella and Achilles tendon by a surgeon with guidance of an ultrasound. The instrumented running tests consisted of six tests at variable conditions: level running at self-selected speed and stride frequency, level running at 110% stride frequency, level running at 90% stride frequency, level running at 10 km/h, 9% incline at 10 km/h and 9% decline at 10 km/h. The Achilles and patella tendon moment arms were determined using a scaled OpenSim model (Rajagopal et al., 2016). Attempts were made to calibrate the sensor, however these were considered to be inaccurate. Despite thereof, the sensor enabled detection of proportional changes in tendon force for quantitative comparison between running conditions. A fibre optic sensor can be used to measure in vivo patella tendon forces during running on an instrumented treadmill. The measurement of the Achilles tendon forces were difficult due to breakage of the fibre during the running tests. The breakage of optic fiber could be due to the high cyclic loading of tendons during running and influenced by a participants ground reaction force and height. The fibre optic sensor could also detect differences in tendon loads caused by intrinsic and extrinsic changes in running conditions. The running conditions that decreased peak tendon forces were the inclined and declined conditions for the Achilles tendon, and the increase in stride frequency and inclined conditions for the patella tendon. The sensor was found to affect a participant’s biomechanical parameters during running, for some of which of the effect sizes were substantial. It remains unclear how this should be accounted for in clinical interpretation of results, thus warrants further investigation.

AFRIKAANSE OPSOMMING: ʼn Tendon is die verbinding wat kragte tussen spiere en been oordra en is noodsaaklik vir die beweging van die muskuloskeletale stelsel tydens die liggaambeweging. Dit word geglo dat die las wat die tendon tydens die hardloopaksie ervaar, ʼn primêre beseringsfaktor is wat tendinopatie veroorsaak (Malliaras et al., 2015). ʼn Individu se hardloop biomeganika beïnvloed hierdie las en is ʼn riskofaktor vir beide Achilles (Chang et al., 2000; Moore et al., 2014; Moore et al., 2016) sowel as patella (Kunimasa et al., 2014) tendinopatie. Hierdie studie het die uitvoerbaarheid ondersoek van ʼn optiese vesel sensor om in vivo Achilles en patella tendonkragte te meet tydens ʼn hardloopaksie. Die studie wou ook vasstel of die sensor verskille in die laste kon aanwys as amp van intrinsieke en ekstrinsieke faktore in omstandighede waarin ʼn individue sal hardloop. Sover die skrywer se kennis strek is dit die eerste keer wat die optiese vesel sensor gebruik is om tendonkragte te meet tydens ʼn hardloopaksie. ʼn Ligintesiteit-gebasseerde optiese vesel sensorsisteem wat in vivo tendonkragte kan meet is ontwerp, gebou en getoets. Die sensor is tydens ʼn studie met vyf deelnemers gebruik om tendonkragte te meet tydens toetse waar deelnemers op ʼn trapmeul hardloop. Die spieraktiwiteit, kinematie sowel as die kinetika is ook tydens hierdie toetse gemeet. Die toetse is by die Neuromeganika Eenheid van die Sentrale Analitiese Fasiliteit (CAF) by die Universiteit van Stellenbosch uitgevoer. Die optiese vesel is deur ʼn chirurg deur die patella en Achilles tendons gevoer met behulp van ultrasoniese klankgolwe. Daar is ses hardlooptoetse uitgevoer, elk onder ander omstandighede: op ʼn gelyke oppervlak teen ʼn spoed en kadens wat deur die deelnemer bepaal is, op ʼn gelyke oppervlak teen 110% kadens, op ʼn gelyke oppervlak teen 90% kadens, op ʼn gelyke oppervlak teen 10 km/h, teen ʼn helling van 9% teen 10 km/h en teen ʼn afdraend van 9% teen 10 km/h. Die Achilles en patella tendon se hefboomarms is vasgestel deur gebruik te maak van ʼn OpenSim model (Rajagopal et al., 2016). Daar is pogings aangewend om die sensor te kalibreer, maar is egter onsuksevol bevind. Ten spyte hiervan kon die sensor toelaat dat proporsionele veranderinge uitgewys kon word in tendonkragte vir kwantitatiewe vergelyking tussen hardloopomstandighede. ʼn Optiese vesel-sensor kan gebruik word om in vivo patella tendon kragte te meet tydens ʼn hardloopaksie op ʼn trapmeul. Dit was uitdagend om die Achilles tendon se kragte te meet aangesien die vesel tydens die toetse gebreek het. Dit kon gebeur as gevolg van die hoë sikliese las in tendons tydens die hardloopaksie en kon beïnvloed word deur die deelnemer se grondreaksiekrag en lengte. Die optiese vesel kon ook verskille uitwys in tendonlaste wat deur intrinsieke en ekstrinsieke veranderinge in hardloopomstandighede veroorsaak is. Die opdraaed en afdraend hardloopkondisies is dié wat piek tendonkragte verminder het vir die Achilles tendon terwyl dit die kadens en afraendkondisies was vir die patella tendon. Dit is bevind dat die sensor die deelnemer se biomeganiese parameters tydens ʼn hardloopaksie beïnvloed. Vir sommige deelnemers was die invloed beduidend. Dit is steeds onduidelik hoe hierdie veranderinge motiveer kan word in die kliniese interpretasie van die resultate. Om hierdie rede word ʼn verdere ondersoek voorgestel.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/108104
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