@inproceedings{IntziegianniCasselMuelleretal.2012,
  author    = {Intziegianni, Konstantina and Cassel, Michael and M{\"u}ller, Steffen and Mayer, Frank},
  title     = {Ultrasound evaluation of the patellar tendon cross-sectional area and its relation to maximum force},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {44},
  booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  pages     = {714 -- 714},
  year      = {2012},
  language  = {en}
}
@article{KoenigCasselIntziegiannietal.2014,
  author    = {K{\"o}nig, Niklas and Cassel, Michael and Intziegianni, Konstantina and Mayer, Frank},
  title     = {Inter-rater reliability and measurement error of sonographic muscle architecture assessments},
  series = {Journal of ultrasound in medicine},
  volume    = {33},
  journal   = {Journal of ultrasound in medicine},
  number    = {5},
  publisher = {American Institute of Ultrasound in Medicine},
  address   = {Laurel},
  issn      = {0278-4297},
  doi       = {10.7863/ultra.33.5.769},
  pages     = {769 -- 777},
  year      = {2014},
  abstract  = {Objectives-Sonography of muscle architecture provides physicians and researchers with information about muscle function and muscle-related disorders. Inter-rater reliability is a crucial parameter in daily clinical routines. The aim of this study was to assess the inter-rater reliability of sonographic muscle architecture assessments and quantification of errors that arise from inconsistent probe positioning and image interpretation. Results-Inter-rater reliability was good overall (ICC, 0.77-0.90; IRV, 9.0\%-13.4\%; bias LoA, 0.2 +/- 0.2-1.7 +/- 3.0). Superior and inferior pennation angles showed high systematic bias and LoA in all setups, ranging from 2.0 degrees +/- 2.2 degrees to 3.4 degrees +/- 4.1 degrees. The highest IRV was found for muscle thickness (13.4\%). "When the probe position was standardized, the SEM for muscle thickness decreased from 0.1 to 0.05 cm. Conclusions-Sonographic examination of muscle architecture of the medial gastrocnemius has good to high reliability. In contrast to pennation angle measurements, length measurements can be improved by standardization of the probe position.},
  language  = {en}
}
@inproceedings{HainCasselIntziegiannietal.2014,
  author    = {Hain, Gerrit and Cassel, Michael and Intziegianni, Konstantina and Mayer, Frank},
  title     = {Achilles tendon cross-sectional area changes during maximal voluntary isometric plantar-flexion contraction in healthy individuals.},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {46},
  booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  number    = {5},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  pages     = {47 -- 47},
  year      = {2014},
  language  = {en}
}
@inproceedings{IntziegianniCasselHainetal.2014,
  author    = {Intziegianni, Konstantina and Cassel, Michael and Hain, Gerrit and Fr{\"o}hlic, Katja and Mayer, Frank},
  title     = {Reliability of sonographic assessment of Achilles tendon cross-sectional area at rest and maximal voluntary contraction},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {46},
  booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  number    = {5},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  pages     = {47 -- 47},
  year      = {2014},
  language  = {en}
}
@inproceedings{ReschkeCasselIntziegiannietal.2014,
  author    = {Reschke, Antje and Cassel, Michael and Intziegianni, Konstantina and Mayer, Frank},
  title     = {Intra- and inter-rater reliability of sonographic cross-sectional area measurements in asymptomatic patella tendons},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {46},
  booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  number    = {5},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  pages     = {927 -- 928},
  year      = {2014},
  language  = {en}
}
@article{IntziegianniCasselRaufetal.2016,
  author    = {Intziegianni, Konstantina and Cassel, Michael and Rauf, S. and White, S. and Rector, Michael V. and Kaplick, Hannes and Wahmkow, Gunnar and Kratzenstein, S. and Mayer, Frank},
  title     = {Influence of Age and Pathology on Achilles Tendon Properties During a Single-leg Jump},
  series = {International journal of sports medicine},
  volume    = {37},
  journal   = {International journal of sports medicine},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0172-4622},
  doi       = {10.1055/s-0042-108198},
  pages     = {973 -- 978},
  year      = {2016},
  abstract  = {Prevalence of Achilles tendinopathy increases with age leading to a weaker tendon with predisposition to rupture. Conclusive evidence of the influence of age and pathology on Achilles tendon (AT) properties remains limited, as previous studies are based on standardized isometric conditions. The study investigates the influence of age and pathology on AT properties during single-leg vertical jump (SLVJ). 10 children (C), 10 asymptomatic adults (A), and 10 tendinopathic patients (T) were included. AT elongation [mm] from rest to maximal displacement during a SLVJ on a force-plate was sonographically assessed. AT compliance [mm/N]) and strain [\%] was calculated by dividing elongation by peak ground reaction force [N] and length, respectively. One-way ANOVA followed by Bonferroni post-hoc correction (=0.05) were used to compare C with A and A with T. AT elongation (p=0.004), compliance (p=0.001), and strain were found to be statistically significant higher in C (27 +/- 3mm, 0.026 +/- 0.006[mm/N], 13 +/- 2\%) compared to A (21 +/- 4mm, 0.017 +/- 0.005[mm/N], 10 +/- 2\%). No statistically significant differences (p0.05) was found between A and T (25 +/- 5mm, 0.019 +/- 0.004[mm/N], 12 +/- 3\%). During SLVJ, tendon responded differently in regards to age and pathology with children having the most compliant AT. Higher compliance found in healthy tendons might be considered as a protective factor against load-related injuries.},
  language  = {en}
}
@inproceedings{IntziegianniCasselKoenigetal.2013,
  author    = {Intziegianni, Konstantina and Cassel, Michael and K{\"o}nig, Niklas and Mayer, Frank},
  title     = {Reliability of variables defining mechanical and material properties of the achilles tendon},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {45},
  booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  number    = {5},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  pages     = {238 -- 239},
  year      = {2013},
  language  = {en}
}
@article{IntziegianniCasselKoenigetal.2015,
  author    = {Intziegianni, Konstantina and Cassel, Michael and K{\"o}nig, Niklas and M{\"u}ller, Steffen and Fr{\"o}hlich, Katja and Mayer, Frank},
  title     = {Ultrasonography for the assessment of the structural properties of the Achilles tendon in asymptomatic individuals: An intra-rater reproducibility study},
  series = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  volume    = {23},
  journal   = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  number    = {4},
  publisher = {IOS Press},
  address   = {Amsterdam},
  issn      = {0959-3020},
  doi       = {10.3233/IES-150586},
  pages     = {263 -- 270},
  year      = {2015},
  abstract  = {BACKGROUND: Reproducible measurements of tendon structural properties are a prerequisite for accurate diagnosis of tendon disorders and for determination of their mechanical properties. Despite the widely used application of Ultrasonography (US) in musculoskeletal assessment, its operator dependency and lack of standardization influences the consistency of the measurement. OBJECTIVE: To evaluate the intra-rater reproducibility of a standardized US method assessing the structural properties of the Achilles tendon (AT). METHODS: Sixteen asymptomatic participants were positioned prone on an isokinetic dynamometer with the knee extended and ankle at 90. flexion. US was used to assess AT-length, cross-sectional area (CSA), and AT-elongation during isometric plantarflexion contraction. The intra-rater reproducibility was assessed by ICC (2.1), Test-Retest Variability (TRV, \%), Bland-Altman analyses (Bias +/- LoA [1.96*SD]), and Standard-Error of Measurement (SEM). RESULTS: Measurements of AT-length demonstrated an ICC of 0.93, TRV of 4.5 +/- 3.9\%, Bias +/- LoA of -2.8 +/- 25.0 mm and SEM of 6.6 mm. AT-CSA showed an ICC of 0.79, TRV of 8.7 +/- 9.6\%, Bias +/- LoA of 1.7 +/- 19.4 mm(2) and SEM of 5.3 mm(2). AT-elongation revealed an ICC of 0.92, TRV of 12.9 +/- 8.9\%, Bias +/- LoA of 0.3 +/- 5.7 mm and SEM of 1.5 mm. CONCLUSIONS: The presented methodology allows a reproducible assessment of Achilles tendon structural properties when performed by a single rater.},
  language  = {en}
}
@article{KellisEllinoudisIntziegianni2017,
  author    = {Kellis, Eleftherios and Ellinoudis, Athanasios and Intziegianni, Konstantina},
  title     = {Reliability of sonographic assessment of biceps femoris distal tendon strain during passive stretching},
  series = {Ultrasound in Medicine \& Biology},
  volume    = {43},
  journal   = {Ultrasound in Medicine \& Biology},
  publisher = {Elsevier},
  address   = {New York},
  issn      = {0301-5629},
  doi       = {10.1016/j.ultrasmedbio.2017.04.018},
  pages     = {1769 -- 1779},
  year      = {2017},
  abstract  = {The purpose of this study was to determine the intra-rater, inter-examiner and inter-observer reliability of biceps femoris long head (BFlh) tendon strain using ultrasound imaging. Nineteen patients (age: 20.4 +/- 0.35 y) were tested twice with a 1-wk interval. Each session included passive stretching from three different hip positions. Tests were performed independently by two examiners while BFlh tendon displacement (mm) and strain (\%) were manually extracted from ultrasound video footages by two observers. Intra-rater comparisons revealed an intra-class correlation coefficient (ICC2,1) range of 0.87 to 0.98 and a variability less than 4.74\%. Interexaminer comparisons revealed an ICC2,1 range of 0.83 to 0.99 and less than 4.69\% variability. Inter-observer ICCs ranged from 0.93 to 0.97 with variability less than 4.89\%. Using a well-defined scanning protocol, two experienced examiners attained high levels of intra-rater agreement, with similarly excellent results for inter-rater and inter-observer reliability for BFlh tendon displacement and strain. (E-mail: ekellis@phed-sr.auth.gr) (C) 2017 World Federation for Ultrasound in Medicine \& Biology.},
  language  = {en}
}
@article{RectorIntziegianniMuelleretal.2017,
  author    = {Rector, Michael V. and Intziegianni, Konstantina and M{\"u}ller, Steffen and Mayer, Frank and Cassel, Michael},
  title     = {Reproducibility of an ankle joint rotation correction method for assessment of Achilles tendon elongation},
  series = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  volume    = {25},
  journal   = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  number    = {1},
  publisher = {IOS Press},
  address   = {Amsterdam},
  issn      = {0959-3020},
  doi       = {10.3233/IES-160644},
  pages     = {47 -- 52},
  year      = {2017},
  abstract  = {BACKGROUND: The Achilles tendon (AT) requires optimal material and mechanical properties to function properly. Calculation of these properties depends on accurate measurement of input parameters (i.e. tendon elongation). However, the measurement of AT elongation with ultrasound during maximum voluntary isometric contraction (MVIC) is overestimated by ankle joint rotation (AJR). Methods to correct the influence of this rotation on AT elongation exist, yet their reproducibility in clinical settings is unknown. OBJECTIVE: To evaluate the test-retest reproducibility of AT elongation during MVIC after AJR correction. METHODS: Ten participants attended test and retest measurements where they performed plantar-flexion MVIC on a dynamometer. Simultaneously, ultrasound recorded AT elongation as the displacement of the medial gastrocnemius-myotendinous junction, while an electrogoniometer measured AJR. The ankle was then passively rotated to the AJR achieved during MVIC and AT elongation again determined. Elongation was corrected by subtracting this passive AT elongation from the total AT elongation during MVIC. Reproducibility was evaluated using ICC (2.1), test-retest variability (TRV, \%), Bland-Altman analyses (Bias +/- LoA [1.96*SD]) and standard error of the measurement (SEM). RESULTS: Corrected AT elongation reproducibility exhibited an ICC = 0.79, SEM = 0.2 cm and TRV = 20 +/- 19\%. Bias +/- LoA were determined to be 0.0 +/- 0.8 cm. CONCLUSIONS: Using this ultrasound and electrogoniometer-based method, corrected AT elongation can be assessed reproducibly.},
  language  = {en}
}