Measurement of rectus femoris muscle velocities during patellar tendon jerk using vector tissue doppler imaging
Open accessAbstract
We have developed a vector tissue Doppler imaging (TDI) system based on a clinical scanner that can be used to measure muscle velocities independent of the direction of motion. This method overcomes the limitations of conventional Doppler ultrasound, which can only measure velocity components along the ultrasound beam. In this study, we utilized this method to investigate the rectus femoris muscle velocities during a patellar tendon jerk test. Our goal was to investigate whether the muscle elongation velocities during a brisk tendon tap fall within the normal range of velocities that are expected due to rapid stretch of limb segments. In a preliminary study, we recruited six healthy volunteers (three men and three women) following informed consent. The stretch reflex response to tendon tap was evaluated by measuring: (1) the tapping force using an accelerometer instrumented to the neurological hammer (2) the angular velocities of the knee extension and flexion using a electrogoniometer (3) reflex activation using electromyography (EMG) and (4) muscle elongation, extension and flexion velocities using vector TDI. The passive joint angular velocity was linearly related to the passive muscle elongation velocity (R(2)=0.88). The maximum estimated joint angular velocity corresponding to muscle elongation due to tendon tap was less than 8.25 radians/s. This preliminary study demonstrates the feasibility of vector TDI for measuring longitudinal muscle velocities and indicates that the muscle elongation velocities during a clinical tendon tap test are within the normal range of values for rapid limb stretch encountered in daily life. With further refinement, vector TDI could become a powerful method for quantitative evaluation of muscle motion in musculoskeletal disorders.
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- Findingown data
The maximum error was 16% for the vector Doppler method.
“The maximum error was 16%.”
Quote in the paperSubstantial claim - Findingown data
The maximum estimated joint angular velocity corresponding to muscle elongation due to tendon tap was less than 8.25 radians/s.
“The maximum estimated joint angular velocity corresponding to muscle elongation due to tendon tap was less than 8.25 radians/s.”
- Also stated in: § B. Estimation of elongation, reflex extension and passive flexion velocities · hedged
“The estimated joint angular velocity corresponding to the muscle elongation due to tendon tap was less than 8.25 radians/s (Fig. 3(B)).”
Quote in the paperSubstantial claim- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Also stated in: § B. Estimation of elongation, reflex extension and passive flexion velocities · hedged
- Findingown data
Mean absolute error was 9% in the velocity magnitude estimated using the vector Doppler method compared to the manufacturer specified velocity of the string.
“Mean absolute error was 9% in the velocity magnitude estimated using our method compared to the manufacturer specified velocity of the string.”
Quote in the paperSubstantial claim - Findingown data
The maximum error using conventional 1D Doppler ultrasound using the same transmit and receive aperture sizes with the string at 60° to the transducer was 22%.
“The maximum error using conventional 1D Doppler ultrasound using the same transmit and receive aperture sizes with the string at 60° to the transducer was 22%.”
Quote in the paperSubstantial claim - Findingreasoning
A vector tissue Doppler imaging (TDI) system based on a clinical scanner has been developed that can measure muscle velocities independent of the direction of motion.
“We have developed a vector tissue Doppler imaging (TDI) system based on a clinical scanner that can be used to measure muscle velocities independent of the direction of motion.”
- Also stated in: § I. Introduction · plain
“We have developed a vector TDI system by electronically splitting a linear array transducer into multiple sub-apertures that can be electronically steered to estimate motion in multiple directions and reconstruct both the velocity magnitude and direction in an angle-independent manner.”
- Also stated in: § V. CONCLUSION · plain
“We have developed a vector TDI system based on a clinical ultrasound scanner for measuring longitudinal muscle velocities.”
Quote in the paperSubstantial claim - Also stated in: § I. Introduction · plain
- Findingown data
The passive joint angular velocity was linearly related to the passive muscle elongation velocity (R2=0.88).
“The passive joint angular velocity was linearly related to the passive muscle elongation velocity (R2=0.88).”
- Also stated in: § B. Estimation of elongation, reflex extension and passive flexion velocities · plain
“The passive elongation velocity of the rectus femoris muscle measured using vector TDI correlated with the angular velocity of the knee joint measured using the electrogoniometer (Fig. 3(A), R2=0.88).”
Quote in the paperSubstantial claim - Also stated in: § B. Estimation of elongation, reflex extension and passive flexion velocities · plain
- Findingnone given
The third peak is the passive flexion of the knee returning to its original position.
“The third peak is the passive flexion of the knee returning to its original position.”
Quote in the paperSubstantial claim - Findingown data
The rectus femoris muscle velocities associated with the reflex response to a tendon tap have three peaks.
“The rectus femoris muscle velocities associated with the reflex response to a tendon tap has three peaks as shown in Figure 2(E).”
Quote in the paperSubstantial claim - Findingown data
The maximum joint angular velocity corresponding to tendon tap elongation is less than 8.5 radians/s.
“Our preliminary results indicate that the maximum joint angular velocity corresponding to tendon tap elongation is less than 8.5 radians/s”
Quote in the paperSubstantial claim- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Findingnone given
The muscle elongation velocity at the instant of passive flexion (νelpassive) coincides with the negative knee angular velocity ωelpassive.
“The muscle elongation velocity at this instant νelpassive coincides with the negative knee angular velocity ωelpassive.”
Quote in the paperSubstantial claim - Findingown data
Vector Doppler is capable of estimating longitudinal muscle velocities.
“We have successfully demonstrated that vector Doppler is capable of estimating longitudinal muscle velocities.”
Quote in the paperSubstantial claim - Interpretationown data
The muscle elongation velocities during a clinical tendon tap test are within the normal range of values for rapid limb stretch encountered in daily life.
“indicates that the muscle elongation velocities during a clinical tendon tap test are within the normal range of values for rapid limb stretch encountered in daily life.”
- Also stated in: § V. CONCLUSION · hedged
“Preliminary results indicate that the muscle elongation velocities during a clinical tendon tap test are within the normal range of values for rapid limb stretch encountered in daily life.”
Quote in the paperSubstantial claim- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Also stated in: § V. CONCLUSION · hedged
- Interpretationown data
This preliminary study demonstrates the feasibility of vector TDI for measuring longitudinal muscle velocities.
“This preliminary study demonstrates the feasibility of vector TDI for measuring longitudinal muscle velocities”
- Also stated in: § V. CONCLUSION · boosted
“This study demonstrates the feasibility of vector TDI for measuring longitudinal muscle velocities during a monosynaptic stretch reflex response.”
Quote in the paperSubstantial claim - Also stated in: § V. CONCLUSION · boosted
- Premisecitation
The normal range of angular velocities for the knee joint is up to 12 radians/s.
“normal range of angular velocities for the knee joint (up to 12 radians/s) [8]”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8]
Not checked in the free run.
- Interpretationcitation
The maximum joint angular velocity corresponding to tendon tap elongation is well within the normal range of angular velocities for the knee joint.
“which is well within the normal range of angular velocities for the knee joint (up to 12 radians/s) [8].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8]
Not checked in the free run.
- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Interpretationown data
Based on the maximum observed Doppler shifts for muscle elongation in this study, the maximum joint angular velocity equivalent to tendon tap is still within the normal range of angular velocities of the knee.
“However, based on the maximum observed Doppler shifts for muscle elongation in our study, we believe that the maximum joint angular velocity equivalent to tendon tap is still within the normal range of angular velocities of the knee.”
Quote in the paperSubstantial claim- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Premisecitation
Grubb et al. measured peak contraction velocities in the rectus femoris during a tendon tap test using TDI M-mode of 5.6±1.3 cm/s to 8.1±1.6 cm/s in five subjects.
“Grubb et. al. [5] measured the peak contraction velocities in the rectus femoris during a tendon tap test using the TDI M-mode available on conventional echocardiography systems. They measured peak contraction velocities of 5.6±1.3 cm/s to 8.1±1.6 cm/s in five subjects”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] source
Not checked in the free run.
- Interpretationreasoning
The Doppler method overcomes the limitations of B-mode fascicle tracking because it measures instantaneous velocity at a specified location without needing to visualize the entire fascicle.
“The Doppler method overcomes these limitations since we are measuring the instantaneous velocity at a specified location without any need to visualize the entire fascicle.”
Quote in the paperSubstantial claim - Interpretationown data
The direct measurement of muscle velocity during elongation enabled estimation of the joint angular velocity equivalent to the muscle stretch produced by the patellar tendon jerk.
“The direct measurement of the muscle velocity during elongation enabled us to estimate the joint angular velocity that is equivalent to the muscle stretch produced by the patellar tendon jerk.”
Quote in the paperSubstantial claim- Rests on an assumption: The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
- Study design and conductreasoning
The impact of relative motion between the knee joint and the ultrasound probe on the measurements was minimal.
“We believe that the impact of such relative motion on our measurements was minimal, since we are measuring instantaneous muscle velocity.”
Quote in the paperSubstantial claim - Study design and conductreasoning
It is possible that the muscle elongation velocities are somewhat underestimated in the present study.
“However, it is still possible that the muscle elongation velocities are somewhat underestimated in the present study.”
Quote in the paperNot a substantial claim - Study design and conductown data
The string phantom calibration at 45° and depth 12-16 mm corresponds to the experimental conditions for the in vivo studies.
“The velocity of the string was estimated for the receive beam steering angle of 45° and a region of interest at a depth of 12–16 mm which corresponds to the experimental conditions for our in vivo studies.”
Quote in the paperSubstantial claim - Interpretationcitation
The peak contraction velocities measured by Grubb et al. are comparable to the range of velocities measured in this study.
“which are comparable to the range of velocities measured in our study.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] source
Not checked in the free run.
- Interpretationreasoning
Vector TDI overcomes the limitation of conventional Doppler for estimating muscle velocities.
“Vector TDI overcomes this limitation.”
Quote in the paperSubstantial claim
- May combine two claims. 8
- Classified as probably not a substantial claim. 9
May combine two claims.
Findingnone givenThe second peak occurs after the EMG signal indicating activation of reflex extension and corresponds to the reflex muscle extension velocity (νshreflex).
“The second peak occurs after the EMG signal indicating activation of reflex extension and corresponds to the reflex muscle extension velocity (νshreflex).”
Quote in the paperSubstantial claimMay combine two claims.
Findingnone givenThe first velocity peak occurs immediately after the hammer impact and corresponds to the elongation of the muscle in response to the tendon tap (νeltap).
“The first velocity peak occurs immediately after the hammer impact and corresponds to the elongation of the muscle in response to the tendon tap (νeltap).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe direction of νelpassive is the same as νeltap and occurs predominantly in the lateral direction along the length of the rectus femoris.
“In Figure 2(E), note that the direction of νelpassive is the same as νeltap as expected, and occurs predominantly in the lateral direction (blue trace) along the length of the rectus femoris.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSensitivity to tendon tap varied across cases, with high correlation between muscle elongation and hammer acceleration for cases 4 and 5 (R2=0.71 and 0.96) and lower correlation for cases 1, 2, 3, and 6 (R2=0.03, 0.33, 0.25, and 0.56).
“Some cases had high sensitivity to tendon tap, with a high correlation between muscle elongation and hammer acceleration (R2 =0.71 and 0.96, for cases 4 and 5 respectively), whereas other cases had lower sensitivity (R2 =0.03, 0.33, 0.25 and 0.56, for cases 1,2,3 and 6 respectively).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisereasoningConventional Doppler ultrasound can only measure velocity components along the ultrasound beam, which limits its utility for estimating muscle velocities because muscle motion is often longitudinal along the skin surface.
“This method overcomes the limitations of conventional Doppler ultrasound, which can only measure velocity components along the ultrasound beam.”
- Also stated in: § I. Introduction · plain
“This poses a challenge for conventional Doppler methods, since they can only estimate the velocity component along the direction of the propagating ultrasound beam, which is perpendicular to the skin surface.”
- Also stated in: § IV. DISCUSSION · plain
“Conventional Doppler ultrasound can only estimate velocity components along the direction of propagation of the ultrasound beam.”
Quote in the paperSubstantial claim- Also stated in: § I. Introduction · plain
May combine two claims.
PremisecitationTissue Doppler imaging (TDI) is routinely used for estimating velocities of cardiac muscle and can potentially be used for estimating skeletal muscle velocities as well.
“Tissue Doppler imaging (TDI) is routinely used for estimating velocities of cardiac muscle and can potentially be used for estimating skeletal muscle velocities as well [4, 5].”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
PremisecitationThe vector Doppler method is based on estimating the velocity vector from measurements taken from two or more independent directions.
“The vector Doppler method is based on estimating the velocity vector from the measurements taken from two or more independent directions [7].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn response to tendon tap, both rectus femoris and vastus lateralis muscles are activated through monosynaptic networks.
“Previous studies have demonstrated that in response to tendon tap, both rectus femoris and vastus lateralis muscles are activated through monosynaptic networks [6].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone givenThe ultrasound data acquisition was synchronized with the instrumented neurological hammer, electrogoniometer and EMG using an external trigger output from the ultrasound system.
“The ultrasound data acquisition was synchronized with the instrumented neurological hammer, electrogoniometer and EMG using an external trigger output from the ultrasound system.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductnone givenThe ultrasound transducer was externally clamped and the subject was seated on a fixed surface to minimize relative motion between the knee joint and the ultrasound probe due to the knee jerk.
“In our studies, the ultrasound transducer was externally clamped and the subject was seated on a fixed surface to minimize relative motion between the knee joint and the ultrasound probe due to the knee jerk.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataSix healthy volunteers provided informed consent to participate in the study.
“Six healthy volunteers (three men and three women, age range 20–29 years) were recruited from the staff and students at George Mason University and provided informed consent to participate in the study.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningA variance correction term was included in the velocity estimate so that the velocity estimates were close to the maximum Doppler shift frequencies.
“We included a variance correction term in our velocity estimate, so that the velocity estimates were close to the maximum Doppler shift frequencies.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenB-mode imaging was used to ensure that the center of the rectus femoris muscle was approximately located at the expected beam overlap region.
“B-mode imaging was used to ensure that the center of the rectus femoris muscle was approximately located at the expected the beam overlap region (as shown in Figure 1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe velocity estimates were calibrated using a string phantom.
“The velocity estimates were calibrated using a string phantom (CIRS Inc. Norfolk, VA).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisereasoningThe B-mode ultrasound method for measuring fascicle stretch velocities has limitations because the entire fascicle length for many muscle groups is difficult to measure due to the limited field of view of ultrasound and the measurements are sensitive to any movement of the transducer.
“This method has several limitations since the entire fascicle length for many muscle groups is difficult to measure due to the limited field of view of ultrasound and the measurements are sensitive to any movement of the transducer.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe Institutional Review Board approved all the study procedures.
“Our Institutional Review Board approved all the study procedures.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationOther researchers have used ultrasound to measure fascicle stretch velocities during stretch reflex response.
“Other researchers have used ultrasound to measure fascicle stretch velocities during stretch reflex response [9] [10].”
Quote in the paperSubstantial claim0 of 2 sources checked
The paper relies on this without support.
The transfer function between passive knee angular velocity and passive rectus femoris elongation velocity applies to the muscle elongation produced by a tendon tap.
“We calculated the transfer function between (ωelpassive) and (νelpassive). The equivalent knee angular velocity (ωeltap) corresponding to the elongation of rectus femoris muscle during standard tendon tap can then be estimated from νeltap as follows: (1)ωelpassive=A×νelpassive+B⇒ωeltap=A×νeltap+B”
The paper relies on this without support.
Stimuli like the tendon tap are not encountered during normal movement activities.
“Stimuli like the tendon tap are not encountered during normal movement activities.”
The paper relies on this without support.
It is not known whether the muscle lengthening velocity during a tendon tap approaches or exceeds those produced by the rapid stretch of a limb segment, or how it compares to the range of knee angular velocities encountered during functional movements.
“It is not known whether the muscle lengthening velocity during a tendon tap approaches or exceeds those produced by the rapid stretch of a limb segment, or how it compares to the range of knee angular velocities encountered during functional movements.”
The paper relies on this without support.
Currently, there is no reliable method to directly measure the muscle elongation and activation velocities.
“Currently, there is no reliable method to directly measure the muscle elongation and activation velocities.”
Cites
Cross-beam vector Doppler ultrasound for angle-independent velocity measurements
Dunmire, B., Beach, K. W., Labs, K.-H., Plett, M., & Strandness, D. E. (2000) · Ultrasound in Medicine & Biology · doi:10.1016/s0301-5629(00)00287-8 · Cited by 272 · see citing works
MOVEMENT DEFICITS CAUSED BY HYPEREXCITABLE STRETCH REFLEXES IN SPASTIC HUMANS
CORCOS, D. M., GOTTLIEB, G. L., PENN, R. D., MYKLEBUST, B., & AGARWAL, G. C. (1986) · Brain · doi:10.1093/brain/109.5.1043 · Cited by 153 · see citing works
Skeletal muscle contraction in healthy volunteers: assessment with Doppler tissue imaging.
Grubb, N. R., Fleming, A., Sutherland, G. R., & Fox, K. A. (1995) · Radiology · doi:10.1148/radiology.194.3.7862989 · Cited by 50 · see citing works
Cronin, N. J., Peltonen, J., Ishikawa, M., Komi, P. V., Avela, J., Sinkjaer, T., & Voigt, M. (2008) · Journal of Applied Physiology · doi:10.1152/japplphysiol.90432.2008 · Cited by 49 · see citing works
Tissue Doppler imaging for detecting onset of muscle activity
Pulkovski, N., Schenk, P., Maffiuletti, N. A., & Mannion, A. F. (2008) · Muscle & Nerve · doi:10.1002/mus.20996 · Cited by 42 · see citing works
Role of peripheral afferents and spinal reflexes in normal and impaired human locomotion.
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Houston, M. E., Norman, R. W., & Froese, E. A. (1988) · European Journal of Applied Physiology and Occupational Physiology · doi:10.1007/bf00636595 · Cited by 36 · see citing works
Brooke, J. D., & McIlroy, W. E. (1990) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(90)90153-b · Cited by 12 · see citing works
Neural control: novel evaluation of stretch reflex sensitivity
Nakazawa, K., Yamamoto, S. ‐., Ohtsuki, T., Yano, H., & Fukunaga, T. (2001) · Acta Physiologica Scandinavica · doi:10.1046/j.1365-201x.2001.00868.x · Cited by 10 · see citing works
Restoring balance to the reflex actions of the muscle spindle: the secondary endings also matter
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Flagged first, then by citations
Cited by
Sorted by citations
Knee joint angular velocities and accelerations during the patellar tendon jerk
Lebiedowska, M. K., Sikdar, S., Eranki, A., & Garmirian, L. (2011) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2011.04.018 · Cited by 15 · see citing works
Self-citationThe effects of body position and muscle activation on patellar tendon reflex properties
Pope, Z. K., & DeFreitas, J. M. (2015) · Physiological Measurement · doi:10.1088/0967-3334/36/7/1429 · Cited by 8 · see citing works
- Authors
- Sikdar, S., Lebiedowska, M., Eranki, A., Garmirian, L., & Damiano, D.
- Affiliations
- George Mason University (US)
- National Institutes of Health (US)
- Venue
- 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society
- Publisher
- IEEE
- Published
- 2009-09
- Volume
- 143
- Pages
- 2963-2966
- ISSN
- 2375-7477 (ISSN-L)
- PMC
- PMC3576698
- OpenAlex
- W2129097239
- Cited by
- 13
- References
- 10
- Citations by year
- 2024: 1 · 2022: 1 · 2015: 1 · 2013: 3 · 2012: 1
- FWCI
- 6.05
- Type
- conference paper
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- NIH Clinical Center (ZIACL060017)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Keywords
- rectus femoris, muscle velocity, stretch reflex, knee angular velocity, passive joint motion, electromyography, musculoskeletal disorders
- MeSH terms
- Adult, Algorithms, Electromyography, Female, Humans, Image Processing, Computer-Assisted, Male, Neuromuscular Diseases, Reflex, Reflex, Stretch, Range of Motion, Articular, Patellar Ligament, Muscle, Skeletal, Ultrasonography, Doppler, Phantoms, Imaging
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