Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction: IABP use

Fascicle length, pennation angle, and tendon elongation of the human tibialis anterior were measured in vivo by ultrasonography. Subjects (n = 9) were requested to develop isometric dorsiflexion torque gradually up to maximal at the ankle joint angle of 20 degrees plantarflexion from the anatomic position. Fascicle length shortened from 90 +/- 7 to 76 +/- 7 (SE) mm, pennation angle increased from 10 +/- 1 to 12 +/- 1 degrees, and tendon elongation increased up to 15 +/- 2 mm with graded force development up to maximum. The tendon stiffness increased with increasing tendon force from 10 N/mm at 0-20 N to 32 N/mm at 240-260 N. Young's modulus increased from 157 MPa at 0-20 N to 530 MPa at 240-260 N. It can be concluded that, in isometric contractions of a human muscle, mechanical work, some of which is absorbed by the tendinous tissue, is generated by the shortening of muscle fibers and that ultrasonography can be used to determine the stiffness and Young's modulus for human tendons.