Ultrasonography.  2020 Apr;39(2):114-120. 10.14366/usg.19032.

Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation

Affiliations
  • 1Department of Physical Therapy, School of Health Professions, University of North Texas Health Science Center, Ft. Worth, TX, USA
  • 2Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
  • 3Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), TroisRivières, Québec, Canada
  • 4Centre Hospitalier Affilié Universitaire Régional, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), Trois-Rivières, Québec, Canada
  • 5Département de Chimie, Biochimie et Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
  • 6Département d’Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
  • 7Texas Tech University Health Sciences Center, Lubbock, TX, USA
  • 8Unité de Recherche en Anatomie Clinique et Fonctionnelle (URACEF), Trois-Rivires, Québec, Canada

Abstract

Purpose
The purpose of this study was to investigate changes in the mechanical properties of capsular tissue using shear wave elastography (SWE) and a durometer under various tensile loads, and to explore the reliability and correlation of SWE and durometer measurements to evaluate whether SWE technology could be used to assess tissue changes during capsule tensile loading.
Methods
The inferior glenohumeral joint capsule was harvested from 10 fresh human cadaveric specimens. Tensile loading was applied to the capsular tissue using 1-, 3-, 5-, and 8-kg weights. Blinded investigators measured tissue stiffness and hardness during loading using SWE and a durometer, respectively. Intraobserver reliability was established for SWE and durometer measurements using intraclass correlation coefficients (ICCs). The Pearson product-moment correlation was used to assess the associations between SWE and durometer measurements.
Results
The ICC3,5 for durometer measurements was 0.90 (95% confidence interval [CI], 0.79 to 0.96; P<0.001) and 0.95 (95% CI, 0.88 to 0.98; P<0.001) for SWE measurements. The Pearson correlation coefficient values for 1-, 3-, and 5-kg weights were 0.56 (P=0.095), 0.36 (P=0.313), and -0.56 (P=0.089), respectively. When the 1- and 3-kg weights were combined, the ICC3,5 was 0.72 (P<0.001), and it was 0.62 (P<0.001) when the 1-, 3-, and 5-kg weights were combined. The 8-kg measurements were severely limited due to SWE measurement saturation of the tissue samples.
Conclusion
This study suggests that SWE is reliable for measuring capsular tissue stiffness changes in vitro at lower loads (1 and 3 kg) and provides a baseline for the non-invasive evaluation of effects of joint loading and mobilization on capsular tissues in vivo.

Keyword

Joint capsule; Elasticity; Hardness; Elastography; Reliability
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