Novel tools for the evaluation of Achilles tendon mechanical properties

Schneebeli, Alessandro ORCID: 0000-0002-8411-2012 (2025). Novel tools for the evaluation of Achilles tendon mechanical properties. University of Birmingham. Ph.D.

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Abstract

Tendon mechanical properties have been frequently investigated in recent years in order to evaluate tendon adaptations to training and to pathology. With the development of different technologies able to measure tendon mechanical properties, highly heterogeneous values have emerged in the literature, sometimes even contradicting one another. The overall aim of this thesis was to assess the available technologies for evaluating the mechanical properties of the Achilles tendon (AT) to understand their clinimetric properties and determine their ability to assess tendons during loaded tasks. This thesis consists of nine studies. A systematic review identified that strain elastography (SE) and shear wave elastography (SWE) have highly variable reliability results between studies with a high risk of bias within the individual studies. Furthermore, six observational studies using different technologies (SE, SWE, myotonometry and shear wave tensiometry) reported the clinimetric properties and the capability of the technologies to detect loading changes. Finally, two observational studies describe the implementation of a novel technology, shear wave tensiometry, to assess the AT in patients after Achilles tendon rupture (ATR). The results showed that shear wave tensiometry is a reliable tool and is able to detect changes between the ruptured and uninjured AT in both patients treated surgically and conservatively. Implementing shear wave tensiometry in clinical settings could be helpful to understand the behaviour of pathological tendon during load.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):