title: Gastrocnemius muscle contracture after spinal cord injury: a longitudinal study.
abstract: OBJECTIVE
  The aim of this study was to examine changes in passive length and stiffness of the gastrocnemius muscle-tendon unit in people after spinal cord injury.
  
  
  METHODS
  In a prospective longitudinal study, eight wheelchair-dependent participants with severe paralysis were assessed 3 and 12 mos after spinal cord injury. Passive torque-angle data were obtained as the ankle was slowly rotated through range at six knee angles. Differences in passive ankle torque-angle data recorded at different knee angles were used to derive passive length-tension curves of the gastrocnemius muscle-tendon unit. Ultrasound imaging was used to determine fascicle and tendon contributions to the muscle-tendon unit length-tension curves.
  
  
  RESULTS
  The participants had ankle contractures (mean [SD] maximum passive ankle dorsiflexion angle, 88 [9] degrees) 3 mos after spinal cord injury. Ankle range did not worsen significantly during the subsequent 9 mos (mean change, -5 degrees; 95% confidence interval, -16 to 6 degrees). There were no changes in the mean slack length or the stiffness of the gastrocnemius muscle-tendon unit or in the slack lengths of the fascicles or the tendon between 3 and 12 mos after spinal cord injury. There were no consistent patterns of the change in slack length or stiffness with the changes in ankle range in the data from the individual participants.
  
  
  CONCLUSIONS
  This study, the first longitudinal study of muscle length and stiffness after spinal cord injury, showed that the length and the stiffness of the gastrocnemius did not change substantially between 3 and 12 mos after injury.
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Joanna
authors.initials: J
authors.lastname: Diong
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Harvey
authors.forename: Li Khim
authors.initials: LK
authors.lastname: Kwah
authors.forename: Jillian L
authors.initials: JL
authors.lastname: Clarke
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Bilston
authors.forename: Simon C
authors.initials: SC
authors.lastname: Gandevia
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena; D003286:Contracture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue; D009129:Muscle Tonus / Q000502:physiology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis; D013710:Tendons / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018608:Ultrasonography, Doppler; D055815:Young Adult