In vivo moment arm determination using B-mode ultrasonography.

The tendon excursion of the tibialis anterior (TA) muscle was measured in vivo using B-mode ultrasonography in seven subjects under three force levels (0, 30 and 60% maximal voluntary contraction, MVC). For each force level, the TA moment arm (m) was determined by calculating the derivative of the tendon excursion relative to the ankle angle (a). A dynamometer controlled the ankle angle while force levels were monitored. The parametric model proposed by Miller and Dennis (1996), m = R sin(a + delta), where R is the largest moment arm and delta represents the offset angle of R from 90 degrees, was used in a least-squares fit of the relationship between moment arm and ankle angle. The R values at 0% MVC were significantly smaller than those at 30 and 60% MVC. The values of calculated moment arm at 0% MVC were not considered adequate estimates of the TA moment arm because of the possible confounding effect of the slackness of the relaxed muscle-tendon unit in more dorsiflexed positions. The moment arm values at 30 and 60% MVC were believed to provide reliable estimates of those of TA since the application of tension probably reduced the effects of the slackness of the muscle-tendon unit and tendon elongation on tendon excursion measurement at these force levels. Since the ultrasonographic technique is an in vivo application of the tendon excursion technique and therefore takes the functional meaning into consideration, it can yield more significant moment arms than other in vivo or cadaver techniques.