-
Sex differences in the kinematics and kinetics of the foot and plantar aponeurosis during drop-jump.Scientific Reports Aug 2023Plantar fasciitis is one of the most common musculoskeletal injuries in runners and jumpers, with a higher incidence in females. However, mechanisms underlying...
Plantar fasciitis is one of the most common musculoskeletal injuries in runners and jumpers, with a higher incidence in females. However, mechanisms underlying sex-associated differences in its incidence remain unclear. This study investigated the possible differences in landing and jumping kinematics and kinetics of the foot between sexes during drop-jump activities. Twenty-six participants, including 13 males and 13 females, performed drop-jumps from a platform onto force plates. Nineteen trials including ten males and nine females were selected for inverse dynamics analysis. The patterns of stretch and tensile force generated by the plantar aponeurosis (PA) were estimated using a multi-segment foot model incorporating the PA. Our results demonstrated that dorsiflexion, angular velocity, and normalized plantarflexion moment of the midtarsal joint right after the heel landed on the floor were significantly larger in females than in males. Consequently, the PA strain rate and tensile stress tended to be larger in females than in males. Such differences in the kinematics and kinetics of the foot and the PA between sexes could potentially lead to a higher prevalence of foot injuries such as plantar fasciitis in females.
Topics: Humans; Female; Male; Aponeurosis; Biomechanical Phenomena; Kinetics; Fasciitis, Plantar; Sex Characteristics
PubMed: 37563188
DOI: 10.1038/s41598-023-39682-6 -
Medicine Mar 2020Conventional levator aponeurosis plication is a widely accepted technique for correction of mild to moderate ptosis. However, this method is associated with a high...
Conventional levator aponeurosis plication is a widely accepted technique for correction of mild to moderate ptosis. However, this method is associated with a high recurrence rate. The objective of this study was to investigate the clinical efficacy of levator aponeurosis posterior layer plication technique for correction of mild to moderate ptosis.A convenience sampling approach was used to recruit 450 patients with mild to moderate blepharoptosis at the Guangzhou Eye-Nose-Face Aesthetic Plastic Surgery Hospital between August, 2015 and December, 2017. All participants were treated with levator aponeurosis posterior layer plication technique. The primary outcome was the postoperative change in marginal reflex distance 1 (MRD1). The paired t test was used to determine the clinical efficacy. Outcomes were assessed at 1 week, 1 month, 3 months, and 6 months after surgery.The mean preoperative MRD1 was 1.7 ± 0.5 mm, and the mean postoperative MRD1 at 6-month follow-up was 3.7 ± 0.4 mm (P < .0001). According to the postoperative survey, 427 (94.9%) patients were satisfied with surgical outcomes.This modified levator aponeurosis plication technique is a simple and effective procedure for correction of mild to moderate blepharoptosis. It results in good MRD1 and high patient satisfaction.
Topics: Adolescent; Adult; Aponeurosis; Blepharoptosis; Female; Humans; Male; Middle Aged; Ophthalmologic Surgical Procedures; Severity of Illness Index; Young Adult
PubMed: 32195929
DOI: 10.1097/MD.0000000000019038 -
Journal of the Mechanical Behavior of... Oct 2020Aponeuroses are stiff sheath-like components of the muscle-tendon unit that play a vital role in force transmission and thus locomotion. There is clear importance of the...
Aponeuroses are stiff sheath-like components of the muscle-tendon unit that play a vital role in force transmission and thus locomotion. There is clear importance of the aponeurosis in musculoskeletal function, but there have been relatively few studies of aponeurosis material properties to date. The goals of this work were to: 1) perform tensile stress-relaxation tests, 2) perform planar biaxial tests, 3) employ computational modeling to the data from 1 to 2, and 4) perform scanning electron microscopy to determine collagen fibril organization for aponeurosis tissue. Viscoelastic modeling and statistical analysis of stress-relaxation data showed that while relaxation rate differed statistically between strain levels (p = 0.044), functionally the relaxation behavior was nearly the same. Biaxial testing and associated modeling highlighted the nonlinear (toe region of ~2-3% strain) and anisotropic (longitudinal direction linear modulus ~50 MPa, transverse ~2.5 MPa) tensile mechanical behavior of aponeurosis tissue. Comparisons of various constitutive formulations showed that a transversely isotropic Ogden approach balanced strong fitting (goodness of fit 0.984) with a limited number of parameters (five), while damage modeling parameters were also provided. Scanning electron microscopy showed a composite structure of highly aligned, partially wavy collagen fibrils with more random collagen cables for aponeurosis microstructure. Future work to expand microstructural analysis and use these data to inform computational modeling would benefit this work and the field.
Topics: Anisotropy; Aponeurosis; Collagen; Stress, Mechanical; Tendons
PubMed: 32957196
DOI: 10.1016/j.jmbbm.2020.103889 -
Actas Dermo-sifiliograficas Dec 2017
Topics: Aged; Aponeurosis; Biopsy; Calcinosis; Female; Fibroblasts; Fibroma; Forearm; Humans; Neoplasms, Connective Tissue; Subcutaneous Tissue; Ultrasonography
PubMed: 28108007
DOI: 10.1016/j.ad.2016.05.023 -
Zhongguo Gu Shang = China Journal of... Jan 2022To investigate the clinical effect of scar tissue suture at the broken end of Achilles tendon after gastrocnemius aponeurosis release in the treatment of chronic...
OBJECTIVE
To investigate the clinical effect of scar tissue suture at the broken end of Achilles tendon after gastrocnemius aponeurosis release in the treatment of chronic Achilles tendon rupture.
METHODS
The clinical data of 17 patients with old achilles tendon rupture treated from January 2017 to December 2019 were analyzed retrospectively, including 15 males and 2 females, aged 26 to 53 years with an average of (35.2±11.6) years old, and the time from injury to operation was 37 to 92 days with an average of (49.3±13.3) days. Myerson's classification included 6 cases of typeⅡ and 11 cases of typeⅢ. The defect of the broken end of Achilles tendon was 2 to 5 cm with an average of(4.1±1.5) cm after partial scar tissue was removed. All patients were treated with gastrocnemius aponeurosis, appropriate excision of scar tissue at the broken end of Achilles tendon and direct suture. The continuity and healing of Achilles tendon were evaluated by color Doppler ultrasound 3 months after operation. The ankle plantar flexor strength was measured by ankle plantar flexor strength tester before operation and 1 year after operation. American Orthopaedic Foot and Ankle Society ankle hindfoot score (AOFAS) and Achilles tendon rupture score were used before operation and 1 year after operation Achilles tendon total fracture score (ATRS) was used to evaluate the clinical rehabilitation of Achilles tendon rupture.
RESULTS
All patients were followed up for 12 to 18 months with an average of(13.6±1.8) months. The surgical incision healed in stageⅠ. Color Doppler ultrasound showed good continuity of Achilles tendon, local Achilles tendon slightly thickened and irregular fiber direction. The ankle plantar flexor force (92.2±3.9) N at 1 year after operation was significantly higher than that before operation (29.5±4.2) N (<0.05);One year after operation, the AOFAS(91.20±3.30) was significantly higher than that before operation (42.20±4.40)(<0.05);the ATRS (90.70±3.00) was significantly higher than that before operation(40.00±2.90)(<0.05).
CONCLUSION
The gastrocnemius aponeurosis release combined with scar suture of Achilles tendon end is an effective technique for the treatment of chronic Achilles tendon rupture, avoid injury to hallux flexor longus or flexor digitorum longus, with the plantar flexor muscle strength of the ankle was recovered well, is an effective method to treat chronic Achilles tendon rupture.
Topics: Achilles Tendon; Adult; Aponeurosis; Cicatrix; Female; Humans; Male; Middle Aged; Retrospective Studies; Rupture; Sutures; Treatment Outcome; Young Adult
PubMed: 35130593
DOI: 10.12200/j.issn.1003-0034.2022.01.004 -
Clinical Anatomy (New York, N.Y.) Apr 2023The bicipital aponeurosis (BA) is the distal aponeurosis of the biceps brachii which usually covers the median nerve (MN), and the brachial artery (BrA) and sometimes...
The bicipital aponeurosis (BA) is the distal aponeurosis of the biceps brachii which usually covers the median nerve (MN), and the brachial artery (BrA) and sometimes causes compression of these structures. Since these situations are rarely reported in the literature, BA frequently does not come to mind as a cause of such compression. Therefore, the diagnosis may be delayed. In this study, we aimed to investigate the morphometry of BA and its relationship with the surrounding neurovascular structures and to draw attention to BA as a structure that can cause entrapment of the MN and rarely, the BrA. We examined the MRIs of the elbow of 279 patients (107 women, 172 men) aged between 18 and 72 years. We measured the thickness, length and width of BA, and investigated the anatomical relationship between BA, BrA, and MN. The respective median thickness, width, and length of BA were 0.7 (0.4-1.8 mm), 18.0 (6.0-34.0 mm), and 32.0 (18.0-50.0 mm), respectively. In all sections examined, the BA covered the BrA and MN, and was located immediately anterior to the BrA. In 225 (80.6%) of 279 MRIs, the BrA was located anterior to the MN and posterior to the BA. In the remaining 54 (19.4%) MRIs, the MN was located anterior to the BrA and posterior to the BA. The respective median thickness, width, and length of the BA were 0.7 mm, 18.0 mm, and 32.0 mm, respectively. It covered the BrA and MN and was located immediately anterior to the BrA. The BA sometimes causes compression syndromes of these structures, therefore, for physicians, it is important to understand the anatomy of the BA.
Topics: Male; Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Elbow; Aponeurosis; Tendons; Muscle, Skeletal; Magnetic Resonance Imaging
PubMed: 35384071
DOI: 10.1002/ca.23876 -
Journal of Biomechanics Feb 2002Two questions were addressed in this study: (1) how much strain of the superficial aponeurosis of the human medial gastrocnemius muscle (MG) was obtained during...
Two questions were addressed in this study: (1) how much strain of the superficial aponeurosis of the human medial gastrocnemius muscle (MG) was obtained during voluntary isometric contractions in vivo, (2) whether there existed inhomogeneity of the strain along the superficial aponeurosis. Seven male subjects, whose knees were extended and ankles were flexed at right angle, performed isometric plantar flexion while elongation of superficial aponeurosis of MG was determined from the movements of the intersections made by the superficial aponeurosis and fascicles using ultrasonography. The strain of the superficial aponeurosis at the maximum voluntary contraction, estimated from the elongation and length data, was 5.6+/-1.2%. There was no significant difference in strain between the proximal and distal parts of the superficial aponeurosis. Based on the present result and that of our previous study for the same subjects (J. Appl. Physiol 90 (2001) 1671), a model was formulated for a contracting uni-pennate muscle-tendon unit. This model, which could be applied to isometric contractions at other angles and therefore of wide use, showed that similar strain between superficial and deep aponeuroses of MG contributed to homogeneous fascicle length change within MG during contractions. These findings would contribute to clarifying the functions of the superficial aponeurosis and the effects of the superficial aponeurosis elongation on the whole muscle behavior.
Topics: Adult; Humans; Male; Models, Biological; Muscle Contraction; Muscle, Skeletal; Stress, Mechanical; Tendons; Ultrasonography
PubMed: 11784540
DOI: 10.1016/s0021-9290(01)00196-8 -
Foot & Ankle International Oct 1994Material properties of the plantar aponeurosis were determined by a two-dimensional video tracking method to simultaneously measure the aponeurosis deformation. Failure...
Material properties of the plantar aponeurosis were determined by a two-dimensional video tracking method to simultaneously measure the aponeurosis deformation. Failure loads averaged 1189 +/- 244 N and were higher in men. Average stiffness of the intact fascia was 203.7 +/- 50.5 N/mm at a loading rate of 11.12 N/sec and it did not vary significantly for the loading rates of 11.12 to 1112 N/sec. The high tensile loads required for failure were consistent with clinical and biomechanical studies and indicated the importance of the aponeurosis in foot function and arch stability.
Topics: Aged; Aged, 80 and over; Biomechanical Phenomena; Biophysics; Cadaver; Fascia; Female; Foot; Humans; Male; Middle Aged; Weight-Bearing
PubMed: 7834064
DOI: 10.1177/107110079401501007 -
BMC Musculoskeletal Disorders Jul 2020The objective of this study was to explore the relationships between claw toe deformity, peripheral neuropathy, intrinsic muscle volume, and plantar aponeurosis...
BACKGROUND
The objective of this study was to explore the relationships between claw toe deformity, peripheral neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness using computed tomography (CT) images of diabetic feet in a cross-sectional analysis.
METHODS
Forty randomly-selected subjects with type 2 diabetes were selected for each of the following four groups (n = 10 per group): 1) peripheral neuropathy with claw toes, 2) peripheral neuropathy without claw toes, 3) non-neuropathic with claw toes, and 4) non-neuropathic without claw toes. The intrinsic muscles of the foot were segmented from processed CT images. Plantar aponeurosis thickness was measured in the reformatted sagittal plane at 20% of the distance from the most inferior point of the calcaneus to the most inferior point of the second metatarsal. Five measurement sites in the medial-lateral direction were utilized to fully characterize the plantar aponeurosis thickness. A linear mixed-effects analysis on the effects of peripheral neuropathy and claw toe deformity on plantar aponeurosis thickness and intrinsic muscle volume was performed.
RESULTS
Subjects with concurrent neuropathy and claw toes had thicker mean plantar aponeurosis (p < 0.006) and may have had less mean intrinsic muscle volume (p = 0.083) than the other 3 groups. The effects of neuropathy and claw toes on aponeurosis thickness were synergistic rather than additive. A similar pattern may exist for intrinsic muscle volume, but results were not as conclusive. A negative correlation was observed between plantar aponeurosis thickness and intrinsic muscle volume (R = 0.323, p < 0.001).
CONCLUSIONS
Subjects with concurrent neuropathy and claw toe deformity were associated with the smallest intrinsic foot muscle volumes and the thickest plantar aponeuroses. Intrinsic muscle atrophy and plantar aponeurosis thickening may be related to the development of claw toes in the presence of neuropathy.
Topics: Aponeurosis; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Foot; Hammer Toe Syndrome; Humans; Peripheral Nervous System Diseases; Toes
PubMed: 32703177
DOI: 10.1186/s12891-020-03503-y -
Journal of Applied Physiology... May 2019This review, the first in a series of minireviews on the passive mechanical properties of skeletal muscles, seeks to summarize what is known about the muscle... (Review)
Review
This review, the first in a series of minireviews on the passive mechanical properties of skeletal muscles, seeks to summarize what is known about the muscle deformations that allow relaxed muscles to lengthen and shorten. Most obviously, when a muscle lengthens, muscle fascicles elongate, but this is not the only mechanism by which muscles change their length. In pennate muscles, elongation of muscle fascicles is accompanied by changes in pennation and changes in fascicle curvature, both of which may contribute to changes in muscle length. The contributions of these mechanisms to change in muscle length are usually small under passive conditions. In very pennate muscles with long aponeuroses, fascicle shear could contribute substantially to changes in muscle length. Tendons experience moderate axial strains even under passive loads, and, because tendons are often much longer than muscle fibers, even moderate tendon strains may contribute substantially to changes in muscle length. Data obtained with new imaging techniques suggest that muscle fascicle and aponeurosis strains are highly nonuniform, but this is yet to be confirmed. The development, validation, and interpretation of continuum muscle models informed by rigorous measurements of muscle architecture and material properties should provide further insights into the mechanisms that allow relaxed muscles to lengthen and shorten.
Topics: Aponeurosis; Humans; Muscle Contraction; Muscle, Skeletal; Tendons
PubMed: 30571291
DOI: 10.1152/japplphysiol.00673.2018