A wide number of trials is required to achieve acceptable reliability for measurement patellar tendon elongation in vivo

The purpose of the current study was to examine the reproducibility of patellar tendon elongation measurements using brightness-mode ultrasonography (BMU) during isometric knee extension contractions. We hypothesized that the measurement of the patellar tendon elongation during only one maximal voluntary isometric knee extension contractions would not provide reliable results and that a wide number of trials is required to achieve acceptable reliability. Ten participants (eight male and two female) performed 10 isometric knee extension contractions on two separate days (5 trials on each day). Using a modified knee brace, the ultrasound probe was firmly adjusted in the sagittal plane overlying the patellar tendon. The registered ultrasound images were analyzed by three different but equally trained observers. The reproducibility was examined by the calculation of the within-day, between-day and overall coefficient of multiple correlations (wCMC, bCMC and oCMC). The Spearman-Brown prophecy formula was use to estimate the required trials to achieve the desired reliability. The wCMC, bCMC and oCMC were in average 0.824, 0.798 and 0.770, respectively, suggesting a rather moderate reproducibility of patellar tendon elongation measurements. For a high reliability (≥0.95) of tendon elongation measurements 5-6 trials are required. Finally, the results revealed an independence of the measurements from days and observers.