@misc{RischStollSchomoelleretal.2021,
  author    = {Risch, Lucie and Stoll, Josefine and Schom{\"o}ller, Anne and Engel, Tilman and Mayer, Frank and Cassel, Michael},
  title     = {Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-54286},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-542865},
  pages     = {1 -- 8},
  year      = {2021},
  abstract  = {Objective: This study investigated intraindividual differences of intratendinous blood flow (IBF) in response to running exercise in participants with Achilles tendinopathy. Design: This is a cross-sectional study. Setting: The study was conducted at the University Outpatient Clinic. Participants: Sonographic detectable intratendinous blood flow was examined in symptomatic and contralateral asymptomatic Achilles tendons of 19 participants (42 ± 13 years, 178 ± 10 cm, 76 ± 12 kg, VISA-A 75 ± 16) with clinically diagnosed unilateral Achilles tendinopathy and sonographic evident tendinosis. Intervention: IBF was assessed using Doppler ultrasound "Advanced Dynamic Flow" before (Upre) and 5, 30, 60, and 120 min (U5-U120) after a standardized submaximal constant load run. Main Outcome Measure: IBF was quantified by counting the number (n) of vessels in each tendon. Results: At Upre, IBF was higher in symptomatic compared with asymptomatic tendons [mean 6.3 (95\% CI: 2.8-9.9) and 1.7 (0.4-2.9), p < 0.01]. Overall, 63\% of symptomatic and 47\% of asymptomatic Achilles tendons responded to exercise, whereas 16 and 11\% showed persisting IBF and 21 and 42\% remained avascular throughout the investigation. At U5, IBF increased in both symptomatic and asymptomatic tendons [difference to baseline: 2.4 (0.3-4.5) and 0.9 (0.5-1.4), p = 0.05]. At U30 to U120, IBF was still increased in symptomatic but not in asymptomatic tendons [mean difference to baseline: 1.9 (0.8-2.9) and 0.1 (-0.9 to 1.2), p < 0.01]. Conclusion: Irrespective of pathology, 47-63\% of Achilles tendons responded to exercise with an immediate acute physiological IBF increase by an average of one to two vessels ("responders"). A higher amount of baseline IBF (approximately five vessels) and a prolonged exercise-induced IBF response found in symptomatic ATs indicate a pain-associated altered intratendinous "neovascularization."},
  language  = {en}
}
@article{RischStollSchomoelleretal.2020,
  author    = {Risch, Lucie and Stoll, Josefine and Schom{\"o}ller, Anne and Engel, Tilman and Mayer, Frank and Cassel, Michael},
  title     = {Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons},
  series = {Frontiers in physiology},
  volume    = {12},
  journal   = {Frontiers in physiology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne, Schweiz},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2021.617497},
  pages     = {1 -- 8},
  year      = {2020},
  abstract  = {Objective: This study investigated intraindividual differences of intratendinous blood flow (IBF) in response to running exercise in participants with Achilles tendinopathy. Design: This is a cross-sectional study. Setting: The study was conducted at the University Outpatient Clinic. Participants: Sonographic detectable intratendinous blood flow was examined in symptomatic and contralateral asymptomatic Achilles tendons of 19 participants (42 ± 13 years, 178 ± 10 cm, 76 ± 12 kg, VISA-A 75 ± 16) with clinically diagnosed unilateral Achilles tendinopathy and sonographic evident tendinosis. Intervention: IBF was assessed using Doppler ultrasound "Advanced Dynamic Flow" before (Upre) and 5, 30, 60, and 120 min (U5-U120) after a standardized submaximal constant load run. Main Outcome Measure: IBF was quantified by counting the number (n) of vessels in each tendon. Results: At Upre, IBF was higher in symptomatic compared with asymptomatic tendons [mean 6.3 (95\% CI: 2.8-9.9) and 1.7 (0.4-2.9), p < 0.01]. Overall, 63\% of symptomatic and 47\% of asymptomatic Achilles tendons responded to exercise, whereas 16 and 11\% showed persisting IBF and 21 and 42\% remained avascular throughout the investigation. At U5, IBF increased in both symptomatic and asymptomatic tendons [difference to baseline: 2.4 (0.3-4.5) and 0.9 (0.5-1.4), p = 0.05]. At U30 to U120, IBF was still increased in symptomatic but not in asymptomatic tendons [mean difference to baseline: 1.9 (0.8-2.9) and 0.1 (-0.9 to 1.2), p < 0.01]. Conclusion: Irrespective of pathology, 47-63\% of Achilles tendons responded to exercise with an immediate acute physiological IBF increase by an average of one to two vessels ("responders"). A higher amount of baseline IBF (approximately five vessels) and a prolonged exercise-induced IBF response found in symptomatic ATs indicate a pain-associated altered intratendinous "neovascularization."},
  language  = {en}
}
@article{CasselRischIntziegiannietal.2018,
  author    = {Cassel, Michael and Risch, Lucie and Intziegianni, Konstantina and Mueller, Juliane and Stoll, Josefine and Brecht, Pia and Mayer, Frank},
  title     = {Incidence of achilles and patellar tendinopathy in adolescent elite athletes},
  series = {International journal of sports medicine},
  volume    = {39},
  journal   = {International journal of sports medicine},
  number    = {9},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0172-4622},
  doi       = {10.1055/a-0633-9098},
  pages     = {726 -- 732},
  year      = {2018},
  abstract  = {The study investigated the incidence of Achilles and patellar tendinopathy in adolescent elite athletes and non-athletic controls. Furthermore, predictive and associated factors for tendinopathy development were analyzed. The prospective study consisted of two measurement days (M1/M2) with an interval of 3.2 +/- 0.9 years. 157 athletes (12.1 +/- 0.7 years) and 25 controls (13.3 +/- 0.6 years) without Achilles/patellar tendinopathy were included at Ml. Clinical and ultrasound examinations of both Achilles (AT) and patellar tendons (PT) were performed. Main outcome measures were incidence tendinopathy and structural intratendinous alterations (hypo-/hyperechogenicity, vascularization) at M2 [\%]. Incidence of Achilles tendinopathy was 1\% in athletes and 0\% in controls. Patellar tendinopathy was more frequent in athletes (13 \%)than in controls (4\%). Incidence of intratendinous alterations in ATs was 1-2\% in athletes and 0 \% in controls, whereas in PTs it was 4-6 \% in both groups (p >0.05). Intratendinous alterations at M2 were associated with patellar tendinopathy in athletes (p <= 0.01). Intratendinous alterations at M1, anthropometric data, training amount, sports or sex did not predict tendinopathy development (p>0.05). Incidence often dinopathy and intratendinous alterations in adolescent athletes is low in ATs and more common in PTs. Development of intratendinous alterations in PT is associated with tend in opathy. However, predictive factors could not be identified.},
  language  = {en}
}
@article{CasselStollMayer2015,
  author    = {Cassel, Michael and Stoll, Josefine and Mayer, Frank},
  title     = {Tendinopathies of the Lower Extremities in Sport - Diagnostics and Therapy},
  series = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation},
  volume    = {29},
  journal   = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation},
  number    = {2},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0932-0555},
  doi       = {10.1055/s-0034-1399668},
  pages     = {87 -- 98},
  year      = {2015},
  abstract  = {Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment.},
  language  = {de}
}