{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T21:15:13Z","timestamp":1652994913205},"reference-count":62,"publisher":"Human Kinetics","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:p>Shear wave elastography imaging of the ulnar collateral ligament (UCL) is used to help understand changes in material properties of the ligament. Ensuring that the wrist flexors are relaxed is essential as muscle contractions can alter the alignment of the medial elbow. The purpose of this study was to determine how the structural and material properties of the medial elbow respond to various elbow torques. The medial elbows of 20 healthy adults, free from upper extremity disorders, were imaged in 3 of the following torque conditions: (1)\u00a0neutral relaxed, (2)\u00a0passive valgus, and (3)\u00a0active varus. Structural properties (ulnohumeral gap and UCL length) using B-mode and material properties (UCL and flexor muscle stiffness) using shear wave were measured. Passive valgus torque opened the ulnohumeral gap (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and increased UCL (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and wrist flexor stiffness (<jats:italic>P<\/jats:italic>\u2009=\u2009.001), compared with the neutral condition. Under an active varus contraction, the gap returned back to the neutral position, but UCL (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.008) and wrist flexor stiffness (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.004) remained elevated compared with neutral, meaning low-intensity torques can influence structural and material properties of the medial elbow. Therefore, effort should be taken to minimize muscle activation during imaging in order to accurately measure medial elbow properties.<\/jats:p>","DOI":"10.1123\/jab.2020-0095","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T06:51:51Z","timestamp":1608533511000},"page":"52-58","source":"Crossref","is-referenced-by-count":0,"title":["Material Properties of the Medial Elbow During Passive Valgus and Self-Initiated Varus Torques"],"prefix":"10.1123","volume":"37","author":[{"given":"Brian J.","family":"Diefenbach","sequence":"first","affiliation":[{"name":"1East Carolina University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony S.","family":"Kulas","sequence":"additional","affiliation":[{"name":"1East Carolina University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Curran","sequence":"additional","affiliation":[{"name":"1East Carolina University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick M.","family":"Rider","sequence":"additional","affiliation":[{"name":"1East Carolina University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"100","reference":[{"key":"ref151","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/0363546513516592","article-title":"Stress sonography of the ulnar collateral ligament of the elbow in professional baseball pitchers: a 10-year study","volume":"42","author":"Ciccotti","year":"2014","journal-title":"Am J Sports Med"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/cpf.12315","article-title":"Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography","volume":"37","author":"Chino","year":"2017","journal-title":"Clin Physiol Funct Imaging"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00256-013-1695-3","article-title":"\u201cSoft, hard, or just right?\u201d Applications and limitations of axial-strain sonoelastography and shear-wave elastography in the assessment of tendon injuries","volume":"43","author":"Ooi","year":"2014","journal-title":"Skeletal Radiol"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2325967115S00163","article-title":"Strength of dynamic stabilizers of the elbow in professional baseball pitchers decreases during baseball season","volume":"3","author":"Toby","year":"2015","journal-title":"Orthop J Sport Med"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1152\/jn.1986.56.5.1225","article-title":"Characteristics of synergic relations during isometric contractions of human elbow muscles","volume":"56","author":"Buchanan","year":"1986","journal-title":"J Neurophysiol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/cpf.12315","article-title":"Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography","volume":"37","author":"Chino","year":"2017","journal-title":"Clin Physiol Funct Imaging"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5435\/00124635-200103000-00004","article-title":"Medial elbow problems in the overhead-throwing athlete","volume":"9","author":"Chen","year":"2001","journal-title":"J Am Acad Orthop Surg"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1148\/radiol.2271020288","article-title":"Radiology dynamic US of the anterior band of the ulnar collateral asymptomatic major league","volume":"227","author":"Nazarian","year":"2003","journal-title":"Radiology"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1177\/03635465010290050601","article-title":"Valgus laxity of the ulnar collateral ligament of the elbow in collegiate athletes","volume":"29","author":"Singh","year":"2001","journal-title":"Am J Sports Med"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1177\/03635465010290050601","article-title":"Valgus laxity of the ulnar collateral ligament of the elbow in collegiate athletes","volume":"29","author":"Singh","year":"2001","journal-title":"Am J Sports Med"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1002\/mus.21723","article-title":"Real-time visualization of muscle stiffness distribution with ultrasound shear wave imaging during muscle contraction","volume":"42","author":"Shinohara","year":"2010","journal-title":"Muscle Nerve"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"449","DOI":"10.7863\/jum.2013.32.3.449","article-title":"Shear wave elastographic characterization of normal and torn Achilles tendons: a pilot study","volume":"32","author":"Chen","year":"2013","journal-title":"J Ultrasound Med"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1148\/radiol.14140434","article-title":"Viscoelasticity in Achilles tendonopathy: quantitative assessment by using real-time shear-wave elastography","volume":"274","author":"Aubry","year":"2015","journal-title":"Radiology"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0363546518755149","article-title":"Medial elbow joint space increases with valgus stress and decreases when cued to perform a maximal grip contraction","volume":"46","author":"Pexa","year":"2018","journal-title":"Am J Sports Med"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1080\/00140139.2013.799235","article-title":"Placement of forearm surface EMG electrodes in the assessment of hand loading in manual tasks","volume":"56","author":"Takala","year":"2013","journal-title":"Ergonomics"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1148\/radiol.2015150908","article-title":"Quantitative shear-wave US elastography of the supraspinatus muscle: reliability of the method and relation to tendon integrity and muscle quality","volume":"278","author":"Rosskopf","year":"2016","journal-title":"Radiology"},{"key":"ref521","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/03635465980260031301","article-title":"Medial elbow joint laxity in professional baseball pitchers: a bilateral comparison using stress radiography","volume":"26","author":"Ellenbecker","year":"1998","journal-title":"Am J Sports Med"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1152\/japplphysiol.01323.2009","article-title":"Muscle shear elastic modulus measured using supersonic shear imaging is highly related to muscle activity level","volume":"108","author":"Nordez","year":"2010","journal-title":"J Appl Physiol"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00256-019-3162-2","article-title":"Shear-wave elastography of the ulnar collateral ligament of the elbow in healthy volunteers: a pilot study","volume":"48","author":"Gupta","year":"2019","journal-title":"Skeletal Radiol"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"95","DOI":"10.7863\/ultra.15.07041","article-title":"Shear wave ultrasound elastographic evaluation of the rotator cuff tendon","volume":"36","author":"Hou","year":"2017","journal-title":"J Ultrasound Med"},{"key":"ref481","doi-asserted-by":"crossref","first-page":"011004","DOI":"10.1115\/1.4038259","article-title":"Ultrasound shear wave elastography of the elbow ulnar collateral ligament: reliability test and a preliminary case study in a baseball pitcher","volume":"1","author":"Lin","year":"2017","journal-title":"J Eng Sci Med Diagnostics Ther"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1037\/1040-3590.6.4.284","article-title":"Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology","volume":"6","author":"Cicchetti","year":"1994","journal-title":"Psychol Assess"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1148\/radiol.2015150908","article-title":"Quantitative shear-wave US elastography of the supraspinatus muscle: reliability of the method and relation to tendon integrity and muscle quality","volume":"278","author":"Rosskopf","year":"2016","journal-title":"Radiology"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s00421-016-3509-5","article-title":"Shear wave elastography reveals different degrees of passive and active stiffness of the neck extensor muscles","volume":"117","author":"Dieterich","year":"2017","journal-title":"Eur J Appl Physiol"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1037\/1040-3590.6.4.284","article-title":"Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology","volume":"6","author":"Cicchetti","year":"1994","journal-title":"Psychol Assess"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"371","DOI":"10.7863\/ultra.34.3.371","article-title":"Reliability and precision of stress sonography of the ulnar collateral ligament","volume":"34","author":"Bica","year":"2015","journal-title":"J Ultrasound Med"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"011004","DOI":"10.1115\/1.4038259","article-title":"Ultrasound shear wave elastography of the elbow ulnar collateral ligament: reliability test and a preliminary case study in a baseball pitcher","volume":"1","author":"Lin","year":"2017","journal-title":"J Eng Sci Med Diagnostics Ther"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1259\/bjr\/93042867","article-title":"Ultrasound elastography for musculoskeletal applications","volume":"85","author":"Drakonaki","year":"2012","journal-title":"Br J Radiol"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00256-013-1695-3","article-title":"\u201cSoft, hard, or just right?\u201d Applications and limitations of axial-strain sonoelastography and shear-wave elastography in the assessment of tendon injuries","volume":"43","author":"Ooi","year":"2014","journal-title":"Skeletal Radiol"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/0363546513516592","article-title":"Stress sonography of the ulnar collateral ligament of the elbow in professional baseball pitchers: a 10-year study","volume":"42","author":"Ciccotti","year":"2014","journal-title":"Am J Sports Med"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1148\/radiol.14140434","article-title":"Viscoelasticity in Achilles tendonopathy: quantitative assessment by using real-time shear-wave elastography","volume":"274","author":"Aubry","year":"2015","journal-title":"Radiology"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00256-017-2846-8","article-title":"Reproducibility of shear wave elastography measuresof the Achilles tendon","volume":"47","author":"Payne","year":"2018","journal-title":"Skeletal Radiol"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1152\/japplphysiol.01323.2009","article-title":"Muscle shear elastic modulus measured using supersonic shear imaging is highly related to muscle activity level","volume":"108","author":"Nordez","year":"2010","journal-title":"J Appl Physiol"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/mus.24104","article-title":"Muscle shear modulus measured with ultrasound shear-wave elastography across a wide range of contraction intensity","volume":"50","author":"Yoshitake","year":"2014","journal-title":"Muscle Nerve"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"2325967118788847","DOI":"10.1177\/2325967118788847","article-title":"Using stress ultrasonography to understand the risk of UCL injury among professional baseball pitchers based on ligament morphology and dynamic abnormalities","volume":"6","author":"Shanley","year":"2018","journal-title":"Orthop J Sport Med"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0363546518755149","article-title":"Medial elbow joint space increases with valgus stress and decreases when cued to perform a maximal grip contraction","volume":"46","author":"Pexa","year":"2018","journal-title":"Am J Sports Med"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s00421-016-3509-5","article-title":"Shear wave elastography reveals different degrees of passive and active stiffness of the neck extensor muscles","volume":"117","author":"Dieterich","year":"2017","journal-title":"Eur J Appl Physiol"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"565","DOI":"10.7863\/ultra.16.03032","article-title":"Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon","volume":"36","author":"Ta\u015f","year":"2017","journal-title":"J Ultrasound Med"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/mus.24104","article-title":"Muscle shear modulus measured with ultrasound shear-wave elastography across a wide range of contraction intensity","volume":"50","author":"Yoshitake","year":"2014","journal-title":"Muscle Nerve"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"371","DOI":"10.7863\/ultra.34.3.371","article-title":"Reliability and precision of stress sonography of the ulnar collateral ligament","volume":"34","author":"Bica","year":"2015","journal-title":"J Ultrasound Med"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/036354659402200105","article-title":"Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography: evaluation in 25 baseball players with surgical confirmation","volume":"22","author":"Timmerman","year":"1994","journal-title":"Am J Sports Med"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00256-017-2846-8","article-title":"Reproducibility of shear wave elastography measuresof the Achilles tendon","volume":"47","author":"Payne","year":"2018","journal-title":"Skeletal Radiol"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1148\/rg.2017160116","article-title":"Shear-wave elastography: basic physics and musculoskeletal applications","volume":"37","author":"Taljanovic","year":"2017","journal-title":"Radiographics"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"2325967118788847","DOI":"10.1177\/2325967118788847","article-title":"Using stress ultrasonography to understand the risk of UCL injury among professional baseball pitchers based on ligament morphology and dynamic abnormalities","volume":"6","author":"Shanley","year":"2018","journal-title":"Orthop J Sport Med"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1080\/00140139.2013.799235","article-title":"Placement of forearm surface EMG electrodes in the assessment of hand loading in manual tasks","volume":"56","author":"Takala","year":"2013","journal-title":"Ergonomics"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"95","DOI":"10.7863\/ultra.15.07041","article-title":"Shear wave ultrasound elastographic evaluation of the rotator cuff tendon","volume":"36","author":"Hou","year":"2017","journal-title":"J Ultrasound Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"449","DOI":"10.7863\/jum.2013.32.3.449","article-title":"Shear wave elastographic characterization of normal and torn Achilles tendons: a pilot study","volume":"32","author":"Chen","year":"2013","journal-title":"J Ultrasound Med"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00256-019-3162-2","article-title":"Shear-wave elastography of the ulnar collateral ligament of the elbow in healthy volunteers: a pilot study","volume":"48","author":"Gupta","year":"2019","journal-title":"Skeletal Radiol"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/036354659402200105","article-title":"Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography: evaluation in 25 baseball players with surgical confirmation","volume":"22","author":"Timmerman","year":"1994","journal-title":"Am J Sports Med"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5435\/00124635-200103000-00004","article-title":"Medial elbow problems in the overhead-throwing athlete","volume":"9","author":"Chen","year":"2001","journal-title":"J Am Acad Orthop Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1148\/rg.2017160116","article-title":"Shear-wave elastography: basic physics and musculoskeletal applications","volume":"37","author":"Taljanovic","year":"2017","journal-title":"Radiographics"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.2106\/00004623-198668080-00004","article-title":"Reconstruction of the ulnar collateral ligament in athletes","volume":"68","author":"Jobe","year":"1986","journal-title":"J Bone Joint Surg Am"},{"key":"ref241","author":"Curran","year":"2017","journal-title":"Changes in the structural properties of the UCL in collegiate baseball pitchers."},{"key":"ref271","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1148\/radiol.2271020288","article-title":"Radiology dynamic US of the anterior band of the ulnar collateral asymptomatic major league","volume":"227","author":"Nazarian","year":"2003","journal-title":"Radiology"},{"key":"ref611","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2325967115S00163","article-title":"Strength of dynamic stabilizers of the elbow in professional baseball pitchers decreases during baseball season","volume":"3","author":"Toby","year":"2015","journal-title":"Orthop J Sport Med"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.2106\/00004623-198668080-00004","article-title":"Reconstruction of the ulnar collateral ligament in athletes","volume":"68","author":"Jobe","year":"1986","journal-title":"J Bone Joint Surg Am"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/03635465980260031301","article-title":"Medial elbow joint laxity in professional baseball pitchers: a bilateral comparison using stress radiography","volume":"26","author":"Ellenbecker","year":"1998","journal-title":"Am J Sports Med"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1152\/jn.1986.56.5.1225","article-title":"Characteristics of synergic relations during isometric contractions of human elbow muscles","volume":"56","author":"Buchanan","year":"1986","journal-title":"J Neurophysiol"},{"key":"ref551","author":"Curran","year":"2017","journal-title":"Changes in the structural properties of the UCL in collegiate baseball pitchers."},{"key":"ref101","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1002\/mus.21723","article-title":"Real-time visualization of muscle stiffness distribution with ultrasound shear wave imaging during muscle contraction","volume":"42","author":"Shinohara","year":"2010","journal-title":"Muscle Nerve"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1259\/bjr\/93042867","article-title":"Ultrasound elastography for musculoskeletal applications","volume":"85","author":"Drakonaki","year":"2012","journal-title":"Br J Radiol"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"565","DOI":"10.7863\/ultra.16.03032","article-title":"Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon","volume":"36","author":"Ta\u015f","year":"2017","journal-title":"J Ultrasound Med"}],"container-title":["Journal of Applied Biomechanics"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jab\/37\/1\/article-p52.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jab\/37\/1\/article-p52.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T20:30:31Z","timestamp":1652992231000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jab\/37\/1\/article-p52.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,1]]},"references-count":62,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.1123\/jab.2020-0095","relation":{},"ISSN":["1065-8483","1543-2688"],"issn-type":[{"value":"1065-8483","type":"print"},{"value":"1543-2688","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,1]]}}}