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Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons

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Abstract

Objective

To establish the test–retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system.

Materials and Methods

Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC2.k) and Bland–Altman plot were used to assess test–retest reliability.

Results

The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC2.k of 0.84 (95 % CI: 0.64–0.92) for reference material, 0.91 (95 % CI: 0.83–0.95) for Achilles tendons and 0.95 (95 % CI: 0.91–0.97) for Kager fat pads (KFP). The ICC2.k value for skin was 0.30 (95 % CI: –0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC2.k of 0.93 (95 % CI: 0.87–0.96) for reference material, 0.72 (95 % CI: 0.50–0.84) for skin, 0.93 (95 % CI: 0.87–0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66–0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC2.k of 0.87 (95 % CI: 0.75–0.93), and in the contracted state, it was very high with an ICC2.k of 0.94 (95 % CI: 0.90–0.97).

Conclusion

Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.

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Acknowledgements

We thank the staff and students at the University of Applied Sciences and Arts of Southern Switzerland (SUPSI) for taking part in the study. We especially thank the Thim van der Laan Foundation, Landquart, Switzerland for financial support.

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Authors and Affiliations

  1. Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland

    Alessandro Schneebeli, Corrado Cescon & Marco Barbero

  2. Servizio di Radiologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland

    Filippo Del Grande & Gabriele Vincenzo

  3. Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland

    Ron Clijsen

  4. Thim van der Laan AG, University College Physiotherapy, Landquart, Switzerland

    Ron Clijsen

  5. Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium

    Ron Clijsen

  6. ESAOTE S.p.A., Genoa, Italy

    Fulvio Biordi

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  1. Alessandro Schneebeli
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  2. Filippo Del Grande
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Correspondence to Alessandro Schneebeli.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki (and its later amendments) or comparable ethical standards.

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Schneebeli, A., Del Grande, F., Vincenzo, G. et al. Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons. Skeletal Radiol 45, 1045–1052 (2016). https://doi.org/10.1007/s00256-016-2382-y

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  • DOI: https://doi.org/10.1007/s00256-016-2382-y

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