Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation

Knee osteoarthritis (OA) is a prevalent joint condition associated with disability, pain, and stiffness in the muscles surrounding the knee. Myofascial and massage techniques are employed to alleviate these symptoms. Unclear is whether muscle stiffness is measurably increased in the painful muscles,...

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Main Authors: Angela V. Dieterich, Katrin Skerl, Filip Paskali, Leonardo Gizzi, Mehrin Azan, Gabriela F. Carvalho, Matthias Kohl, Andreas Haueise
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2025.1593851/full
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author Angela V. Dieterich
Katrin Skerl
Filip Paskali
Leonardo Gizzi
Leonardo Gizzi
Mehrin Azan
Gabriela F. Carvalho
Matthias Kohl
Andreas Haueise
Andreas Haueise
author_facet Angela V. Dieterich
Katrin Skerl
Filip Paskali
Leonardo Gizzi
Leonardo Gizzi
Mehrin Azan
Gabriela F. Carvalho
Matthias Kohl
Andreas Haueise
Andreas Haueise
author_sort Angela V. Dieterich
collection DOAJ
description Knee osteoarthritis (OA) is a prevalent joint condition associated with disability, pain, and stiffness in the muscles surrounding the knee. Myofascial and massage techniques are employed to alleviate these symptoms. Unclear is whether muscle stiffness is measurably increased in the painful muscles, and how measured muscle stiffness relates to perceived stiffness, pain, and functional impairment. Given muscle anisotropy, stiffness changes may occur in the longitudinal plane parallel to muscle fibers or perpendicularly in the transverse plane. Shear wave velocity (SWV) was measured in both scanning planes in 21 individuals with diagnosed knee OA, 21 sex- and age-matched controls, and 20 young controls, focusing on the gastrocnemius medialis and vastus lateralis muscles under four conditions: (a) resting state, (b) holding the shank against gravity, (c) double-leg stance, and (d) single-leg stance. Median stiffness measures, the ratio of longitudinal-to-transverse stiffness, and the ratio of single-leg stance-to-baseline stiffness were compared between groups using the Kruskal- Wallis and Pairwise Asymptotic Wilcoxon rank sum tests. Correlations with the Knee Injury and Osteoarthritis Outcome Score and the Tampa Scale of Kinesiophobia were examined. Longitudinal stiffness of the gastrocnemius medialis muscle was significantly lower in the OA group at double-leg (P = 0.033) and single-leg stance (P = 0.019), with tendencies toward lower median stiffness in both muscles across most tasks. Transverse stiffness of the vastus lateralis muscle was significantly higher in the OA group at baseline (P = 0.027), with tendencies toward higher median stiffness in both muscles across most tasks. Significant moderate to excellent correlations support the clinical relevance of both longitudinal and transverse stiffness measurements. Measured and perceived stiffness were not correlated. Study results suggest that knee OA may differentially affect muscle stiffness in the longitudinal and transverse planes and that transverse stiffness measures may have clinical relevance.
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spelling doaj-art-a1dcf6ca50414a4aa20b1a7231f9e7ef2025-08-20T03:12:24ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-05-011610.3389/fphys.2025.15938511593851Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensationAngela V. Dieterich0Katrin Skerl1Filip Paskali2Leonardo Gizzi3Leonardo Gizzi4Mehrin Azan5Gabriela F. Carvalho6Matthias Kohl7Andreas Haueise8Andreas Haueise9Ultrasound Lab, Department of Physiotherapy, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Freiburg, GermanyInstitute of Technical Medicine, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Furtwangen, GermanyInstitute of Precision Medicine, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Villingen-Schwenningen, GermanyFraunhofer Institute for Production Engineering and Automation, Department of Biomechatronics, Stuttgart, GermanyInstitute for Modelling and Simulation of Biomechanical Systems IMSB, University of Stuttgart, Stuttgart, GermanyInstitute of Technical Medicine, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Furtwangen, GermanyUltrasound Lab, Department of Physiotherapy, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Freiburg, GermanyInstitute of Precision Medicine, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Villingen-Schwenningen, GermanyUltrasound Lab, Department of Physiotherapy, Faculty of Health, Medical, and Life Sciences, Furtwangen University, Freiburg, GermanyDepartment of Sport and Sport Science, University of Freiburg, Freiburg, GermanyKnee osteoarthritis (OA) is a prevalent joint condition associated with disability, pain, and stiffness in the muscles surrounding the knee. Myofascial and massage techniques are employed to alleviate these symptoms. Unclear is whether muscle stiffness is measurably increased in the painful muscles, and how measured muscle stiffness relates to perceived stiffness, pain, and functional impairment. Given muscle anisotropy, stiffness changes may occur in the longitudinal plane parallel to muscle fibers or perpendicularly in the transverse plane. Shear wave velocity (SWV) was measured in both scanning planes in 21 individuals with diagnosed knee OA, 21 sex- and age-matched controls, and 20 young controls, focusing on the gastrocnemius medialis and vastus lateralis muscles under four conditions: (a) resting state, (b) holding the shank against gravity, (c) double-leg stance, and (d) single-leg stance. Median stiffness measures, the ratio of longitudinal-to-transverse stiffness, and the ratio of single-leg stance-to-baseline stiffness were compared between groups using the Kruskal- Wallis and Pairwise Asymptotic Wilcoxon rank sum tests. Correlations with the Knee Injury and Osteoarthritis Outcome Score and the Tampa Scale of Kinesiophobia were examined. Longitudinal stiffness of the gastrocnemius medialis muscle was significantly lower in the OA group at double-leg (P = 0.033) and single-leg stance (P = 0.019), with tendencies toward lower median stiffness in both muscles across most tasks. Transverse stiffness of the vastus lateralis muscle was significantly higher in the OA group at baseline (P = 0.027), with tendencies toward higher median stiffness in both muscles across most tasks. Significant moderate to excellent correlations support the clinical relevance of both longitudinal and transverse stiffness measurements. Measured and perceived stiffness were not correlated. Study results suggest that knee OA may differentially affect muscle stiffness in the longitudinal and transverse planes and that transverse stiffness measures may have clinical relevance.https://www.frontiersin.org/articles/10.3389/fphys.2025.1593851/fullshear wave elastographymusclestiffnessknee osteoarthritisanisotropyage
spellingShingle Angela V. Dieterich
Katrin Skerl
Filip Paskali
Leonardo Gizzi
Leonardo Gizzi
Mehrin Azan
Gabriela F. Carvalho
Matthias Kohl
Andreas Haueise
Andreas Haueise
Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
Frontiers in Physiology
shear wave elastography
muscle
stiffness
knee osteoarthritis
anisotropy
age
title Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
title_full Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
title_fullStr Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
title_full_unstemmed Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
title_short Longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
title_sort longitudinal and transverse muscle stiffness change differently with knee osteoarthritis and do not align with stiffness sensation
topic shear wave elastography
muscle
stiffness
knee osteoarthritis
anisotropy
age
url https://www.frontiersin.org/articles/10.3389/fphys.2025.1593851/full
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