Ultrasound assessment of talar cartilage thickness measurements in asymptomatic subjects with pes planus and its relationship with anthropometric parameters.

INTRODUCTION: Individuals with pes planus may have alterations in talar cartilage thickness due to changes in lower extremity alignment. The aim of this study was to measure the talar cartilage thickness of subjects with pes planus and compare the results with those of healthy controls. Another aim of the present study was to evaluate its relationship with anthropometric foot parameters. METHODS: This cross-sectional study included 48 individuals (16 males and 32 females) in the pes planus group and 48 individuals in the healthy control group (14 males and 34 females) based on the Navicular Drop (ND) test and the Foot Posture Index (FPI). Talar cartilage thickness (TCT) was measured with ultrasound. Anthropometric foot parameters of the individuals, such as foot length and foot width, were evaluated using a podoscope. RESULTS: TCT was higher in participants with pes planus compared to the control group (dominant side, p = 0.006; non-dominant side, p = 0.002). Foot width and length were similar in both groups for the dominant and non-dominant feet (p > 0.05). TCT on the dominant foot was positively correlated with the FPI score (r = 0.205, p = 0.045), ND score (r = 0.297, p = 0.003), foot width (r = 0.244, p = 0.017) and foot length (r = 0.253, p = 0.013). On the other hand, TCT on the non-dominant side was positively correlated with the FPI score (r = 0.235, p = 0.021), ND score (r = 0.363, p < 0.001), foot width (r = 0.270, p = 0.008) and length (r = 0.303, p = 0.003). CONCLUSION: The talar cartilage of patients with pes planus seems to be thicker, and this is generally related to body weight, body mass index, foot anthropometrics, and posture characteristics. LEVEL OF EVIDENCE: Level III, diagnostic comparative study.

Muscle and tendon stiffness of lower extremity in older adults with fall history: Stiffness effect on physical performance and fall risk.

Changes in muscle and tendon stiffness may lead to falls in older adults by affecting joint stability and muscle function. This study aims to investigate the changes in stiffness in lower extremity muscles and tendons in the older adults with a fall history. A cross-sectional research design was followed. 25 older adults with a fall history and 26 older adults without fall history were recruited study. Stiffness of the lower extremity muscles and tendons was measured using a MyotonPRO device. Balance and functional ability of the participants were evaluated. The stiffness of all the selected muscles and tendon was lower in the older adults with a history of fall compared to controls (p<0.05). The obtained results suggest the decrease in the stiffness of the lower extremity muscles and tendon may negatively affect muscle function and joint stability/ control, and it may increase the predisposition to falling in older adults.

The Relationship of Depression Level and Physical Activity with Postural Control in Geriatric Individuals.

Introduction: The aim of this study was to investigate the relationships between functional performance, physical activity level, and depression level with postural control in older adults. Methods: Data were collected from 48 community-dwelling subjects aged ≥65 years. As measurement parameters, Sway mobile balance application for postural control, Sit - Stand Test for lower extremity muscle strength, SenseWear armband for physical activity level, Mini-Mental Test for mental status and Beck Depression Inventory (BDI) for depression level were used. Results: Sway score was positively correlated with total energy expenditure (TEE) (r=0.28, p=0.04) and number of steps (r=0.30, p=0.03) and negatively correlated with BDI (r=-0.33, p=0.03). The BDI score was negatively correlated with all physical activity parameters. While lower extremity strength, which indicates functional performance, showed moderate-good correlation with physical activity parameters, it showed moderate negative correlation with BDI (r=-0.63, p<0.001). Body mass index value positively correlated with TEE (r=0.34, p=0.01). Conclusions: The results of this study showed a significant correlation between postural control, physical activity, and depression level. A sufficient level of physical activity is important for the maintenance and improvement of depression level and postural control system. The relationship between physical activity, depression level and postural control should not be ignored in healthy aging.

The Immediate Effect of Cumulative Transverse Strain via Exercise on the Achilles Tendon in Individuals with and Without Flat Feet.

BACKGROUND: Flat feet change lower extremity alignment, and it may change the load distribution on Achilles tendon during exercise. The purpose of the present study was to investigate the immediate effect of cumulative transverse strain via resistive ankle plantarflexion exercise on the Achilles tendon in individuals with flat feet. METHODS: Fourteen individuals with flat feet and 14 age-matched individuals with normal foot posture were enrolled in the present study. Achilles tendon thickness was measured by an ultrasonography device with a linear probe at 3 points: 1 cm (AT-1), 2 cm (AT-2), and 3 cm (AT-3) proximal to the superior aspect of the calcaneus. Ultrasonography measurements were performed before and after participants completed 90 repetitions of double-leg calf raise exercises which included moving the foot from full ankle dorsiflexion to full ankle plantarflexion. RESULTS: Achilles tendon thickness at all points measured was thinner in the flat feet group at both pre- and post-exercise conditions compared with that of the control group (p<0.05). Achilles tendon thickness at AT-1, AT-2, and AT-3 decreased after the exercise in both groups (p<0.001). The differences in Achilles tendon thickness at all points measured between pre- and post-exercise conditions were lower in individuals with flat feet than those of the control group (p<0.05). CONCLUSION: There was a significant decrease in Achilles tendon thickness after exercise in both groups; however, the tendon thickness markedly diminished in individuals with normal foot posture. The results are thought to result from changes in tendon structure and in load distribution on the Achilles tendon.

The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders.

OBJECTIVE: To determine the reliability and diagnostic accuracy of the Turkish version of the Fonseca anamnestic index (FAI-T). METHODS: The cultural equivalence of the FAI was established according to the International Network for Orofacial Pain and Related Disorders Methodology. The test-retest reliability, internal consistency, and diagnostic accuracy of the FAI-T was carried out in a sample of 66 controls and 139 patients with TMD. Diagnostic accuracy of the FAI-T was evaluated against the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS: Internal consistency analysis resulted in a Cronbach's alpha coefficient of 0.805. The intraclass correlation coefficient (ICC) values of each index question ranged from 0.739 to 0.897. FAI had a high level of accuracy (area under the ROC curve of 0.928). CONCLUSION: The results provide considerable evidence that the FAI-T can be used as a screening tool for the identification of TMD in Turkish-speaking populations.

Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults.

BACKGROUND: Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage. METHODS: This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device. RESULTS: The Achilles tendon thickness at 2 cm (P = .009) and 3 cm (P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area (P = .005) and medial condyle (P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups. CONCLUSION: The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage. LEVEL OF EVIDENCE: Level III, diagnostic comparative study.

Pulmonary Functions in Patients With Chronic Neck Pain: A Case-Control Study.

OBJECTIVE: The purpose of the study was to investigate pulmonary functions of patients with chronic neck pain and compare them with those of asymptomatic controls. METHODS: This case-control study was conducted with 25 patients with chronic neck pain (age, 26.84 ± 7.89 years) and 27 age-matched asymptomatic controls (age, 25.96 ± 7.13 years). Pulmonary function tests were performed using spirometry (Quark PFT, COSMED, Rome, Italy). Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% to 75% vital capacity, peak expiratory flow, maximum voluntary ventilation, and the FEV1/FVC ratio were measured and are expressed as (%) predicted value for patients with chronic neck pain and asymptomatic controls. RESULTS: The chronic neck pain group had lower FEV1 (P = .015), FVC (P = .029), forced expiratory flow at 25% to 75% vital capacity (P = .040), and maximum voluntary ventilation (P = .042) compared with asymptomatic controls; however, FEV1/FVC (P = .470) and peak expiratory flow (P = .183) were similar in both groups. CONCLUSION: These results demonstrated that dynamic lung volumes were lower in patients with chronic neck pain compared with asymptomatic controls.

Passive mechanical properties of extrinsic foot muscles and Achilles tendon in adults with and without pes planus.

The purpose of the present study was to investigate the changes in stiffness, tone, and elasticity of extrinsic foot muscles and Achilles tendon in adults with pes planus at rest and during standing. The study was conducted with 59 participants, 29 with pes planus and 30 with normal foot posture. The oscillation frequency (indicator of tone), dynamic stiffness (indicator of stiffness), and logarithmic decrement (related to elasticity) of the Achilles tendon, peroneus longus, tibialis anterior, and medial and lateral gastrocnemius muscles were measured with a myotonometer (MyotonPRO, Myoton AS, Estonia). The passive mechanical properties of the selected muscles and tendon were measured at rest and during standing. The oscillation frequency, dynamic stiffness, and logarithmic decrement of the peroneus longus, tibialis anterior, and medial and lateral gastrocnemius muscles were similar in individuals with and without pes planus (p < 0.05). Individuals with pes planus had higher dynamic stiffness of the Achilles tendon at rest (p = 0.042; d = 0.431), whereas they had lower dynamic stiffness of the Achilles tendon with a moderate effect size during standing compared to controls (p = 0.028; d = 0.640). The logarithmic decrement of the Achilles tendon in individuals with pes planus was significantly lower with a large effect size during standing (p = 0.025; d = 0.945). The results obtained suggest that pes planus is not related to the passive mechanical properties of the foot extrinsic muscles. A decrease in stiffness and an increase in elasticity during standing, and an increase in stiffness at rest in the Achilles tendon were found in individuals with pes planus.

Temporomandibular dysfunction affects aerobic capacity in females: A preliminary study.

Objective: The purpose of this study was to investigate the aerobic capacity in patients with temporomandibular dysfunction (TMD) and to compare the results with those of the asymptomatic individuals.Methods: The TMD group included a total of 31 females between the ages of 18 and 25 years. The control group consisted of 31 asymptomatic females with an age range of 18 to 27 years. A graded exercise test was performed using an electronically braked arm crank ergometer. An indirect calorimeter system was used to calculate the peak oxygen consumption (VO2peak). In addition, peak heart rate (HRpeak) and respiratory quotient were calculated for each participant.Results: The TMD group had lower VO2peak (p= 0.017) and HRpeak (p= 0.012) in aerobic capacity tests; however, respiratory quotient was similar in both groups (p= 0.446).Discussion: The TMD group had lower aerobic capacity compared to the asymptomatic individuals.

An investigation of the changes in mechanical properties of the orofacial and neck muscles between patients with myogenous and mixed temporomandibular disorders.

Objective: To investigate the possible changes in the mechanical properties of the orofacial and neck muscles in patients with temporomandibular disorders (TMD).Methods: The study included a total of 98 females. Females were divided into three groups as myogenous TMD, mixed TMD, and healthy controls. The frequency (indicator of muscle tone), stiffness, and decrement (related to muscle elasticity) values of the sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were measured using a portable myotonometer.Results: The frequency, stiffness, and decrement values of the masseter muscle were higher in the mixed and myogenous TMD groups than those of the control group (p < 0.017). The mixed TMD group had higher frequency and stiffness values in the upper trapezius muscle compared with the control group (p < 0.017).Discussion: The results suggest that the mechanical properties of the oral and neck muscles may be affected in patients with TMD.

An investigation of the factors that influence functional improvement in stroke rehabilitation

Background/aim: The purpose of this study was to determine effect of age, sex, affected extremity, disability severity, treatment type, cerebrovascular accident (CVA) etiology, number of treatment sessions, and CVA duration on the functional improvement of the stroke patients who participated in a physical medicine and rehabilitation program. Materials and methods: The research sample consisted of 322 stroke patients. Clinical and demographic features including age, sex, affected extremity, disability severity, treatment type, CVA etiology, number of treatment sessions, and CVA duration were recorded. Functional status was evaluated retrospectively by using the functional independence measure (FIM) at admission and discharge. Results: It was detected that discharge FIM score of the patients exhibited an increase of significance level (p < 0.05). It was found that age, number of treatment sessions, CVA duration and FIM admission score were determinative parameters in FIM gain level (p < 0.05) while sex, affected extremity, and CVA etiology were not effective in FIM gain level (p > 0.05). Conclusion: Results show that functional improvement after rehabilitation was better in the younger ages, shorter CVA durations and moderate functional disturbances. The findings obtained may be useful for stroke rehabilitation triage.

Interrater and Intrarater Reliability of a Handheld Myotonometer in Measuring Mechanical Properties of the Neck and Orofacial Muscles.

OBJECTIVE: The purpose this study was to investigate the reliability of a handheld myotonometer in measuring the mechanical properties of the neck and orofacial muscles in asymptomatic individuals. METHODS: The study included 16 healthy participants. The mechanical properties (frequency, decrement, stiffness, relaxation time, and creep) of the selected muscles were measured with a MyotonPRO myotonometer (Mumeetria Ltd, Tallinn, Estonia). The sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were selected to determine the reliability of the device. Measurements were performed by 2 examiners to determine interrater reliability; for intrarater reliability, an examiner repeated the measurements 1 week after the first measurements. RESULTS: The results revealed moderate to excellent intrarater and interrater reliability (intraclass correlation coefficients: 0.50-0.95) in measuring muscle mechanic properties. The standard error of measurement in the tested muscles ranged from 0.3 to 0.8 Hz for frequency, from 7.4 to 20.9 N/m for stiffness, from 0.1 to 0.2 for decrement, and from 0.8 to 1.4 ms for relaxation time. The minimum detectable change ranged from 0.8 to 2.2 Hz for frequency, from 20.5 to 57.9 N/m for stiffness, from 0.2 to 0.6 for decrement, from 2.2 to 3.9 ms for relaxation time, and from 0.2 to 0.3 for creep. In addition, the coefficients of variation were below 9.1% for all the assessed parameters. CONCLUSION: The obtained results demonstrate that the MyotonPRO device is a reliable and repeatable tool to quantify the frequency, stiffness, decrement, relation time, and creep of the neck and orofacial muscles in asymptomatic individuals.

Effects of hyperlipidemia on patellar tendon stiffness: A shear wave elastography study.

BACKGROUND: Recent studies presented that increased adiposity and hyperlipidemia may cause tendon pathology. The aim of this study was to evaluate the effect of hyperlipidemia on the patellar tendon stiffness by shear wave elastography. METHODS: A total of 51 participants (19 female, 32 male) were included. Participants were divided into two groups, according to their low-density lipoprotein levels, as the study group (hyperlipidemia, n = 24) and the control group (non-hyperlipidemia, n = 27). The patellar tendon and rectus femoris muscle shear wave velocities were measured by shear wave elastography. FINDINGS: Patellar tendon shear wave velocities was 5.02 (SD: 0.78) m/s in the control group and 5.98 (SD: 1.19) m/s in the hyperlipidemia group (ES = 0.95, P = .001). There was a positive moderate statistically significant correlation between patellar tendon shear wave velocity and low-density lipoprotein (r = 0.432, p < .002). In the multiple linear regression analysis, only low-density lipoprotein was found as a significant predictor of patellar tendon shear wave velocity (CI: 0.005-0.028, P = .007). INTERPRETATION: We evaluated the effects of hyperlipidemia and body mass index on patellar tendon mechanical properties with shear wave elastography. We found that the blood low-density lipoprotein level had an impact on patellar tendon stiffness independently of body mass index. Accordingly, it is important to evaluate individuals' low-density lipoprotein levels when examining risk factors for tendon pathology.

Thickness, cross-sectional area, and stiffness of intrinsic foot muscles affect performance in single-leg stance balance tests in healthy sedentary young females.

The purpose of this study was to investigate the effect of thickness, cross-sectional area and stiffness of intrinsic foot muscles on performance in single-leg stance balance tasks in healthy sedentary young females. This study included a total of 40 healthy sedentary young females between the ages of 19 and 35 years. Single-leg stance balance assessments were carried out using Biodex Balance Systems (Biodex Medical Systems, Shirley, NY, USA). Performance in the single-leg stance balance tests was assessed using the overall stability index (OSI), mediolateral stability index (MLSI) and the anteroposterior stability index (APSI). Lower scores indicated better postural stability. Stiffness, thickness and cross-sectional area measurements of the abductor hallucis (AbH), flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB) muscles were performed using an ultrasonography device. Larger AbH and FHB muscles were correlated with higher OSI, APSI, and MLSI (r = 0.31-0.46, p < 0.05), whereas larger FDB muscle was correlated with higher OSI and MLSI (r = 0.28-0.38, p < 0.05). Higher stiffness of the AbH and FHB muscles were correlated with lower OSI, APSI, and MLSI (r = -0.32 to 0.58, p < 0.05), but stiffness of the FDB muscle was not significantly correlated with OSI, APSI, and MLSI (r = 0.03-0.22, p Ëƒ 0.05). These results suggest that larger AbH, FDB and FHB muscles are related to reduced performance in single-leg stance balance tests, whereas higher AbH and FHB stiffness are related to better performance in single-leg stance balance tests in healthy sedentary young females.

Knee muscle and tendon stiffness in professional soccer players: a shear-wave elastography study.

BACKGROUND: It is well known that several risk factors such as fatigue, previous injury, muscle strength deficit or imbalance are related to a higher incidence of knee injuries in professional soccer players. Knee muscle and tendon stiffness may be another factor that is related to knee injuries in professional soccer players. Therefore, the aim of the present study was to investigate the differences between professional soccer players and healthy sedentary males in terms of the stiffness of patellar tendon (PT), quadriceps tendon (QT), and rectus femoris muscle (RF) and vastus medialis muscle (VM). METHODS: The study group was comprised of 17 professional male soccer players in age range of 24-37 years. The control group was comprised of 22 healthy sedentary males in an age range of 21-36 years. Shear-Wave Velocity (SWV) measurements of the selected muscles and tendons were performed using an ultrasonography device with a lineal probe. RESULTS: The professional soccer players had lower SWV of PT (P=0.024) and QT (P<0.001) in the dominant leg compared to the control group; however, SWV of PT (P=0.455) and QT (P=0.827) in the non-dominant leg were similar in both groups. SWV of RF was higher in both dominant and non-dominant legs in professional soccer players compared to the control group (P<0.05); however, SWV of VM was similar in both groups (P>0.05). CONCLUSIONS: Professional soccer players had lower PT and QT stiffness. On the other hand, they had higher RF stiffness compared to sedentary individuals. Furthermore, VM stiffness was similar in both groups.

An investigation of the sex-related differences in the stiffness of the Achilles tendon and gastrocnemius muscle: Inter-observer reliability and inter-day repeatability and the effect of ankle joint motion.

PURPOSE: The purpose of the present study was to investigate sex-related differences in the stiffness of the Achilles tendon and gastrocnemius muscle at rest and tensioned state. Another purpose of the study was to investigate the inter-observer reliability and inter-day repeatability of MyotonPRO, a portable myotonometer, in measuring tendon and muscle stiffness. METHODS: The study included 73 healthy participants (19 males for the reliability and repeatability study; 24 males and 30 females for the experimental study) with an age range of 19-27 years. The stiffness of the Achilles tendon and medial gastrocnemius muscle was measured with a portable myotonometer (MyotonPRO). The stiffness measurements of the Achilles tendon and medial gastrocnemius muscle were performed at 0° and 10° of ankle joint dorsiflexion. The stiffness measurements were performed by two physiotherapists to determine the inter-observer reliability of the device. For the inter-day repeatability (or between-day precision), the same individuals were reassessed by the same examiner after a 3-day interval. RESULTS: It was found that MyotonPRO has excellent inter-observer reliability and inter-day repeatability in measuring the stiffness of the Achilles tendon and medial gastrocnemius muscle (ICC=0.83-0.98). The stiffness of the Achilles tendon and gastrocnemius muscle at neutral and 10° joint dorsiflexion was higher in males compared to females (p<0.05); however, the stiffness value of difference between neutral and 10° joint dorsiflexion for the Achilles tendon and gastrocnemius muscle was similar in both groups (p>0.05). DISCUSSION: The obtained results suggest that MyotonPRO is a reliable and repeatable device in measuring the stiffness of the Achilles tendon and gastrocnemius muscle. Furthermore, males have stiffer Achilles tendon and gastrocnemius muscle, compared to females; however, the change in the stiffness of the assessed tissues caused by joint motion was similar in both sexes.

An investigation of the relationship between plantar pressure distribution and the morphologic and mechanic properties of the intrinsic foot muscles and plantar fascia.

BACKGROUND: The purpose of this study was to investigate the relationship between plantar pressure distribution and the stiffness, thickness, and cross-sectional area of the plantar fascia (PF) and abductor hallucis (AbH), flexor hallucis brevis (FHB), and flexor digitorum brevis (FDB) muscles. METHODS: The present study included a total of 41 healthy females between the ages of 20 and 34 years. Plantar pressure during static standing position was measured using a pedobarography system (MatScan, Tekscan, Inc., South Boston, Massachusetts, USA). Peak pressure, mean pressure, maximum force (Max-F), contact area (Con-A), pressure time integral, and force time integral (FTI) were measured. The thickness, cross-sectional area and stiffness of the intrinsic foot muscles and PF were measured using an ACUSON S3000 Ultrasound System and a 9L4 probe (4-9 MHz) (Siemens Medical Solution, Mountain View, CA, USA). Shear Wave Velocity (SWV) of the intrinsic foot muscles and PF was measured using a customized software program (Virtual Touch Imaging and Quantification; Siemens Medical Solution). RESULTS: Con-A had a moderate correlation with the thickness and cross-sectional area of PF, AbH, FHB, and FDB. A fair to moderate correlation was found between heel Max-F and the thickness and cross-sectional area of PF, AbH, FHB, and FDB. There is no significant correlation between the SWV of the assessed tissues and plantar pressure distribution parameters. Body mass and BMI had a fair to good correlation with Mean-P, Con-A, heel Max-F, midfoot Max-F, metatarsal Max-F, FTI, thickness, and cross-sectional area of the PF and assessed muscles SIGNIFICANCE: The results suggest that abnormal force, contact area, and higher body mass may cause hypertrophy of the PF and foot intrinsic muscles.

Mechanical properties and morphologic features of intrinsic foot muscles and plantar fascia in individuals with hallux valgus.

BACKGROUND: The aim of the present study was to investigate the morphologic features and mechanical properties of plantar fascia (PF), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and abductor hallucis (AbH) muscles in individuals with halluks valgus (HV) and to compare the results with individuals without HV. METHODS: A total of 30 participants (27 female, 3 male) between the ages of 19-58 years with HV deformity and 30 individuals without HV (27 female, 3 male) between the ages of 20-58 years were included in the study. AbH, PF, FHB, and FDB thickness, cross-sectional area and stiffness were measured with an ultrasonography device. For stiffness measurements, Shear Wave Velocity (SWV) of the assessed soft tissues was calculated using a customized software program. RESULTS: Mean and standard deviation of SWV of PF, AbH, FHB, FDB, and thickness of PF, AbH, FHB, FDB, and cross-sectional area of AbH, FHB, FDB in individuals with HV were 7.6 ± 1.0 m/sec, 2.8 ± 0.3 m/sec, 2.6 ± 0.4 m/sec, and 3.4 ± 0.2 m/sec, 3.3 ± 0.5 mm, 11.4 ± 2.2 mm, 16.5 ± 1.9 mm, 8.9 ± 1.8 mm, 2.4 ± 0.5 cm2, 2.7 ± 0.5 cm2, 1.9 ± 0.6 cm2, respectively. Mean and standard deviation of SWV of PF, AbH, FHB, FDB and thickness of PF, AbH, FHB, FDB, and cross-sectional area of AbH, FHB, FDB in controls groups were 7.6 ± 1.2 m/sec, 2.3 ± 0.3 m/sec, 2.3 ± 0.4 m/sec, and 3.4 ± 0.4 m/sec, 3.3 ± 0.5 mm, 9.7 ± 2.1 mm, 14.5 ± 1.4 mm, 9.7 ± 1.2 mm, 2.1 ± 0.3 cm2, 2.3 ± 0.4 cm2, 2.1 ± 0.4 cm2, respectively. Individuals with HV had lower AbH and FHB thickness, cross-sectional area and SWV, however FDB thickness and cross-sectional area were higher in individuals with HV compared to that of individuals without HV (p < 0.05). PF thickness (p = 0.273), SWV of PF (p = 0.979) and FDB (p = 0.295) were similar in both groups. CONCLUSION: Our results suggest that individuals with HV had lower AbH and FHB stiffness, however PF and FDB stiffness were similar in HV and control group. In addition, AbH and FHB thickness and cross-sectional area were lower in individuals with HV; however, FDB thickness and cross-sectional area were higher in individuals with HV compared to that of individuals without HV. LEVEL OF EVIDENCE: Level III, Diagnostic Study.

Neck Muscle Stiffness in Participants With and Without Chronic Neck Pain: A Shear-Wave Elastography Study.

OBJECTIVES: The purpose of the present study was to investigate differences in neck muscle stiffness between patients with chronic neck pain and asymptomatic control group. METHODS: Thirty-five patients with chronic neck pain and 35 age-matched asymptomatic participants enrolled in the study. Shear wave velocity (SWV) of upper trapezius, levator scapulae, splenius capitis, and sternocleidomastoid muscles were obtained using an ACUSON S3000 Ultrasonography Device (Siemens Medical Solutions, Mountain View, California). In patients with chronic neck pain, pain intensity was measured by Numerical Rating Scale and disability level was measured by Neck Disability Index. RESULTS: The SWV of splenius capitis was similar in both groups (P = .985); however, SWV of upper trapezius (P = .001), levator scapulae (P = .038), and sternocleidomastoid (P = .001) of the patients with chronic neck pain were higher compared with the asymptomatic controls groups. Numerical Rating Scale and Neck Disability Index scores did not correlate with the SWV of the selected muscles (P > .05). CONCLUSIONS: Stiffness of upper trapezius, levator scapulae, and sternocleidomastoid muscles in patients with neck pain were higher compared to asymptomatic participants. In addition, severity of pain and disability did not correlate to stiffness of these muscles in patient with chronic neck pain.

Effects of morphological and mechanical properties of plantar fascia and heel pad on balance performance in asymptomatic females.

INTRODUCTION: Personal differences in morphological and mechanical properties of plantar fascia and heel fat pad may be an important parameter regarding an individual's balance performance. The purpose of this study was to investigate the effect of thickness and stiffness of heel fat pad and plantar fascia on balance performance in asymptomatic sedentary females. MATERIALS AND METHODS: This study was carried out on 37 asymptomatic sedentary females between the ages of 19 and 35 years. Balance assessments during single-leg standing were carried out using Biodex Balance Systems (Biodex Medical Systems, Shirley, NY, USA). In this study, the individuals' balance performance was assessed using the center of balance (COB) parameters, which were the standard deviation of the COB amplitude in the anterior-posterior (AP_SD) and medial-lateral (ML_SD) directions. Stiffness and thickness measurements of heel fat pad and plantar fascia were performed using an ACUSON S3000 Ultrasound System and a 9L4 probe (4-9MHz) (Siemens Medical Solution, Mountain View, CA, USA). RESULTS: AP_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.46, p=0.004) and heel pad stiffness (r=0.41, p=0.011), and a fair correlation with plantar fascia thickness (r=0.34, p=0.038) and plantar fascia stiffness (r=0.38, p=0.021). ML_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.41, p=0.013) and heel pad stiffness (r=0.53, p=0.001), and a fair correlation with plantar fascia thickness (r=0.40, p=0.015). CONCLUSION: It was found that higher plantar fascia and heel fat pad stiffness and thickness are related to higher postural sway in anterior-posterior and medial-lateral directions based on the single-leg balance tests. These results suggest that the morphological and mechanical properties of plantar fascia and heel fat pad play an important role in balance performance.