SUMMARY OF REPLIES : How to measure tension in tissues in-vivo

[Feras Hakkak]

Dear Biomech-L list members,

 

I sent an email titled “How to measure tension in tissues
in-vivo” to seek your help regarding the methods of measuring tensions in human
soft tissues in vivo. Here I summarize the responses and thank very much all
who kindly responded and helped me in this regard.

 

Sincerely,

 

Feras Hakkak

PhD Student,

Biomed. Eng.
Dept.,

AmirKabir Univ. of
Tech.,

Tehran, Iran

 

 

 

My question was:

Dear Biomech-L list members

 

I am working on modeling the knee as my PhD project and I'm wondering
if there are any in vivo information about the amount of tension in tissues
around the knee, i.e. ligaments, menisci, and fascia. I would be
grateful if you can provide me with some references. Also I would be grateful
if you could advise me how we can do in-vivo experiments to find
out the tissue tensions. I have already found this paper in which it has
been suggested that we can use MRI machine to measure tissue stiffness. But how
can we measure the tension?

 

Jenkyn, T. R., R. L. Ehman, et al. (2003). "Noninvasive Muscle Tension
Measurement Using the Novel Technique of Magnetic
Resonance Elastography (MRE)." Journal of Biomechanics 36:
1917–1921.

 

ABSTRACT:

A novel method for direct measurement of the state of skeletal
muscle contraction is introduced called magnetic resonance elastography
(MRE). Such a technique is useful for avoiding the indeterminacy inherent in
most inverse dynamic models of the musculoskeletal system. Within a standard MRI scanner, mechanical vibration is applied to muscle via the skin,
creating shear waves that penetrate the tissue and propagate along muscle fibers. A gradient echo sequence is used with
cyclic motion-encoding to image the propagating shear waves using phase
contrast. Individual muscles of interest are identified and the shear
wavelength in each is measured. Shear wavelength increases with increasing
tissue stiffness and increasing tissue tension.

Several ankle muscles were tested simultaneously in normal subjects. Applied
ankle moment was isometrically resisted at several different foot positionsShear wavelengths in relaxed muscle in neutral
foot position was 2.34±0.47 cm for tibialis anterior
(TA) and 3.13±0.24 cm for lateral gastrocnemius (LG). Wavelength
increased in relaxed muscle when stretched (to 3.80±0.28 cm for TA in 45°
plantar-flexion and to 3.95±0.43 cm for LG in 20° dorsi-flexion). Wavelength
increased more significantly with contraction (to 7.71±0.97 cm in TA for 16Nm
dorsi-flexion effort and to 7.90±0.34 cm in LG for 48Nm plantar-flexion
effort).

MRE has been shown to be sensitive to both passive and active tension within
skeletal muscle making it a promising, noninvasive tool for biomechanical
analysis. Since it is based on MRI technology, any muscle, however deep, can be
interrogated using equipment commonly available in most health care facilities.

 

 

Jason Silver jason.i.silver@gmail.com :

Hey,



I don't know if this is much help, but you can measure tissue strains using
ultrasound as well. This may be a little more useful to you than MRE because
ultrasound systems are far more easy to come by. The technique is known as
sonoelastogrpahy. I have attached a paper that outlines one such method on leg
muscle tendons.



Hope this is of some help.



Sincerely,



Jason Silver

MaSc Student

Biomedical Engineering

Carleton University, Canada

 

Attachment:

Joe Farron, Tomy Varghese, and
Darryl G. Thelen (Jan. 2009) “Measurement of Tendon Strain During Muscle Twitch
Contractions Using Ultrasound Elastography”, IEEE Transactions on Ultrasonics,
Ferroelectrics, and Frequency Control, Vol. 56, No. 1, pp. 27-35.

Abstract: Abstract—A 2-D
strain estimation algorithm was used to estimate tendon strain from ultrasound
data collected during muscle twitch contractions. We first used speckle
tracking techniques to estimate frame-to-frame displacements of all pixels
within a rectangular region of interest (ROI) positioned over a tendon. A
weighted, least-squares approach was then solved for the displacements of the
ROI endpoints that best fit the pixel displacements. We summed endpoint
displacements across successive frames to determine the cumulative endpoint
motion, which was then used to estimate the cumulative strain along the
tendinous fibers. The algorithm was applied to ultrasound radiofrequency data,
acquired at 74 frames per second over the tibialis anterior (TA) musculotendon
junction (MTJ). The TA muscle was electrically stimulated with the subject
holding voluntary preloads of 0%, 10%, 20%, 30%, 40%, and 50% of a maximum voluntary
contraction (MVC). Peak tendon strains computed using elastography (0.06 to
0.80%) were slightly larger and occurred earlier (50–90 ms after stimulus) than
calculations based on visual analysis of B-mode images. This difference likely
reflected the more localized nature of the elastographic strain values.
Estimates of the tangential elastic modulus (192±58 MPa) were consistent with
literature values obtained using more direct approaches. It is concluded that
automated elastographic approaches for computing in vivo tendon strains could
provide new insights into musculotendon dynamics and function.

 

Ton van den Bogert BOGERTA@ccf.org :

 

Dear Feras,



Biological tissues often have nonlinear elastic properties, so stiffness
increases with load (tension).  Therefore if you can measure stiffness, it
will also be an indicator of tension.



One noninvasive method to measure stiffness is speed of
sound.  There is some interesting work by Philippe Pourcelot you
should include in your review.



Please share your findings in a posting to Biomch-L with a summary of all the
responses.



Ton van den Bogert



--



A.J. (Ton) van den Bogert, PhD

Department of Biomedical Engineering

Cleveland Clinic Foundation

http://www.lerner.ccf.org/bme/bogert/

 

 

Adam J. Bartsch bartsca@ccf.org :

 

Dear Feras-



I worked previously with a team at Ohio State
using miniature transducers called linear variable differential transducers
(LVDT) manufactured by MicroStrain, Inc. (www.microstrain.com) to
attempt to measure PCL elongation.  There are some studies where these
devices have been used in squatting/stepping experiments in vivo to measure ACL
elongation:



Beynnon, BD, Johnson, RJ, Fleming, BC,
Renstrom, P, Pope, MH, Haugh, LD.  (1994).  The measurement of
elongation of anterior cruciate ligament grafts
in vivo.  J Bone and Joint Surg, 76(4):520-531.



Cerulli, G, Benoit, DL, Lamontagne, M, Caraffa, A, Liti, A.  (2003). 
In vivo anterior cruciate ligament strain
behaviour during a rapid deceleration movement: case report.  Knee Surg
Sports Traumatol Arthrosc, 11:307-311.



Fleming, BC,
Beynnon, BD.  (2004).  In vivo measurement of ligament/tendon strains
and forces:  a review.  Annals of Biomedical
Engineering, 32(3):318-328.



Renstrom, P, Arms, SW, Stanwyck, TS, Johnson, RJ, Pope, M.  (1986). 
Strain within the anterior cruciate ligament during hamstring and quadriceps
activity.  Am J Sports Med, 14(1):83-87.



Stanwyck, TS, Arms, SW, Gilbertson, LG, Krag, MH, Pope, M.  (1985). 
In vivo measurement techniques for orthopaedic research.  Automedica,
6:99-118.



Yamamoto, K, Hirokawa, S, Kawada, T.  (1998).  Strain distribution in
the ligament using photoelasticity.  A direct application to the human
ACL.  Medical Engineering and Physics, 20:161-168.



Hope this helps!



Warm regards,

Adam

================================

Adam J. Bartsch, M.S.

Cleveland Clinic
Spine Research Laboratory

Lutheran Hospital,
2-C

1730 West 25th Street

Cleveland, OH  44113

216.363.5749

 

 

Ioannis Symeonidis isymeonidis@yahoo.com :

 

Dear Feras,

I am also a PhD student, so I cannot say I am a specialist on the field, I am
working on the neck musculature but from another mail converstation I had with
a colleague, I can send you the following link for the lower
limb:

http://isbweb.org/data/delp/index.html



check the muscle_input_file which have several parameters for lower limb
modeling, including the resting length of the muscle.



I hope this helped you,

cheers,

ioannis

 

 

Kevin Moerman kevinmoerman@hotmail.com :

Dear Feras,



If you can access the archive then I take it you probably also found the
summary of replies I received to my questions? If not let me know then I’ll try
and retrieve it for you. It seemed that very little is known about the
difference between passive living (with muscle tone)
and passive living without muscle tone. I was interested in the difference with
freshly dead tissue which might be comparable to the later. It’s quite obvious
that the muscle tone enhances stiffness of the muscle somewhat but I have not
found data quantifying this. There are papers on the role of muscle tone and
also on the how the activation of a muscle is enhanced to protect it self eg.
under violent extension. It is then proposed that muscle response to a certain
stretch/stretch rate to protect it self but I could not find any
stretch/stretch rate thresholds as such and again little quantified information
on the increased stiffness/tension is provided.  Also I could find no information
on the effect of (mild or violent) compression.

My project involves the validation/adaptation of a
constitutive model developed from experimental data on freshly dead porcine
(gluteus maximus) skeletal muscle tissue (see Van
Loocke et al.) for living human skeletal muscle
tissue.

We will use non-invasive imaging methods and inverse
iterative FE analysis to determine the parameters in this constitutive model
for living human skeletal muscle tissue. We explored the use of digital image correlation see here: http://dx.doi.org/10.1016/j.jbiomech.2009.02.016
which seemed a useful method for this. However in the future we aim to use
tagged Magnetic resonance imaging as this will
provide 3D deformation imaging throughout the muscle rather then just the
surface deformation.

…[snip]....

Good luck, I’d be interested in any information you may
find.

Kindest regards,



Kevin Moerman

K.M. Moerman M.Sc. B.Eng.

Research Student
Trinity Centre for Bioengineering
School of Engineering
Parsons Building
Trinity College
Dublin 2
Ireland

Tel: 00353 (0) 1 896 1976
Mobile: 00353 (0) 85 760 5144

www.tcd.ie/bioengineering