Sports Applications

Until now the metabolism of stressed muscles could only be assessed by biopsies. This procedure can be expensive, time-consuming and is potentially painful for the patient. Using the musculoskeletal modules of the Diagnostic Pedal, the muscle metabolism of patients, amateur sportsmen, athletes and astronauts can be assessed in an easy, effective and non-invasive manner without the application of contrast media. By adopting this approach, endurance and strength athletes can be discriminated and the intramuscular recruitment pattern for the evaluation of the risk of muscle injuries in athletes and amateur sportsmen, e.g. soccer players can be determined. Another field of interest is the assessment of the training progress of athletes and amateur sportsmen and of exercise responses to gravity-independent training in astronauts.

Furthermore, the Diagnostic Pedal Cardio Step provides the investigation of heart muscle metabolism, morphologic and functional changes in hearts of sportsmen, the assessment of training progress and of responses to gravity-independent training.

Application fields of Ergospect Modules

Trispect:

Functional Specification:

  • calf muscles, muscles of the planta pedis, tendons of the extensor muscles, Achilles tendon, ankle for loaded MRI
Indications:
  • changes in lactate metabolism
  • assessment of muscle fiber type composition (MFTC) of athletes (non-invasive discrimination between endurance and strength athletes),
  • determination of the intramuscular recruitment pattern for the evaluation of the risk of calf muscle injuries in athletes and amateur sportsmen (e.g.: soccer players),
  • Achilles tendon re-ruptures after surgical fixation,
  • assessment of training progress in patients (e.g. peripheral arterial disease (PAD)),
  • exercise responses of athletes, amateur sportsmen and patients,
  • exercise responses to gravity-independent training
Parameters:
  • 31P MRS, 13C MRS: determination of mitochondrial function, anaerobic and aerobic capacity and glycogen metabolism
  • 1H-MRS: lipid metabolism and deoxymyoglobin: tracking of intra- and extra-myocellular lipids and myoglobin
  • LATEST: lactate chemical exchange saturation transfer (CEST) to image lactate in vivo
  • blood oxygen level dependency (BOLD): monitoring of the oxygen supply within the tissue
  • perfusion MRI: microcirculation within the exercising muscle
  • phase-contrast MRI: assessment of blood flow or changes in tissue elasticity (Achilles tendon, calf muscles)
  • CINE MRI: real-time imaging of calf muscles, tendons and ankle during exercise testing
  • relaxometry: determination of oedema or water content in different tissues during exercise testing (tendons, calf muscles)
  • elastography: elasticity testing and evaluation of re-ruptures after surgical fixation
  • mfMRI: T2-imaging of the flexor muscles to determine intramuscular water content changes under strain
  • conventional loaded MRI: investigation of anatomical structures under isometric strain
Target:
  • angiologists, gerontologists, interventional radiologists, neurologists, orthopaedists, paediatricians, physiologists, plastic surgeons, radiologists, sports physicians, training facilities for astronauts and athletes, traumatologists, vascular physicians/surgeons
Tibiospect:

Functional Specification:

  • extensor muscles of the lower leg, tendons of the flexor muscles, Achilles tendon, ankle for loaded MRI
Indications:
  • changes in lactate metabolism
  • assessment of muscle fiber type composition (MFTC) of athletes (non-invasive discrimination between endurance and strength athletes),
  • Achilles tendon re-ruptures after surgical fixation,
  • exercise responses of athletes, amateur sportsmen and patients,
  • exercise responses to gravity-independent training
Parameters:
  • 31P MRS, 13C MRS: determination of mitochondrial function, anaerobic and aerobic capacity and glycogen metabolism
  • 1H-MRS: lipid metabolism and deoxymyoglobin: tracking of intra- and extra-myocellular lipids and myoglobin
  • LATEST: lactate chemical exchange saturation transfer (CEST) to image lactate in vivo
  • perfusion MRI: microcirculation within the exercising muscle
  • phase-contrast MRI: assessment of blood flow or changes in tissue elasticity
  • CINE MRI: real-time imaging of the extensor muscles of the lower leg, the tendons of the flexor muscles, the Achilles tendon and the ankle during exercise testing
  • relaxometry: determination of oedema or water content within the extensor muscles under stress
  • elastography: elasticity testing and evaluation of re-ruptures after surgical fixation
  • conventional loaded MRI: investigation of anatomical structures under isometric strain
Target:
  • neurologists, gerontologists, orthopaedists, paediatricians, physiologists, plastic surgeons, radiologists, sports physicians, training facilities for astronauts and athletes, traumatologists
Quadspect:

Functional Specification:

  • extensor muscles of the thigh, quadriceps and patellar tendon, internal knee structures for loaded MRI
Indications:
  • changes in lactate metabolism (cancer, diabetes mellitus (DM)),
  • assessment of muscle fiber type composition (MFTC) of athletes (non-invasive discrimination between endurance and strength athletes),
  • determination of the intramuscular recruitment pattern for the evaluation of the risk of muscle injuries in athletes and amateur sportsmen (e.g.: soccer players),
  • ligament, tendon and meniscal tears and re-ruptures after surgical fixation,
  • exercise responses of athletes, amateur sportsmen and patients,
  • exercise responses to gravity-independent training
Parameters:
  • 31P MRS, 13C MRS: determination of mitochondrial function, anaerobic and aerobic capacity and glycogen metabolism
  • 1H-MRS: lipid metabolism and deoxymyoglobin: tracking of intra- and extra-myocellular lipids and myoglobin
  • LATEST: lactate chemical exchange saturation transfer (CEST) to image lactate in vivo
  • Perfusion MRI: microcirculation within the exercising muscle
  • Phase-contrast MRI: assessment of blood flow or changes in tissue elasticity (ligaments, tendons, menisci, cartilage, thigh muscles)
  • CINE MRI: real-time imaging of the extensor muscles of the thigh, the tendons and the internal structures of the knee during exercise testing
  • relaxometry: determination of oedema or water content under stress (ligaments, tendons, menisci, cartilage, thigh muscles)
  • elastography: quadriceps and patellar tendon elasticity testing and evaluation of re-ruptures after surgical fixation
  • mfMRI: T2-imaging of the flexor muscles to determine intramuscular water content changes under strain
  • Conventional loaded MRI: investigation of anatomical structures under isometric strain
Target:
  • gerontologists, neurologists, orthopaedists, paediatricians, physiologists, plastic surgeons, radiologists, sports physicians, training facilities for astronauts and athletes, traumatologists

Ischiospect:

Functional Specification:

  • flexor muscles of the thigh, internal structures of hip and knee for loaded MRI
Indications:
  • changes in lactate metabolism (cancer, diabetes mellitus (DM)),
  • assessment of muscle fiber type composition (MFTC) of athletes (non-invasive discrimination between endurance and strength athletes),
  • assessment of the intramuscular recruitment pattern for the evaluation of the risk of hamstring injuries in athletes and amateur sportsmen (e.g.: soccer players),
  • exercise responses of athletes, amateur sportsmen and patients,
  • exercise responses to gravity-independent training
Parameters:
  • 31P MRS, 13C MRS: determination of mitochondrial function, anaerobic and aerobic capacity and glycogen metabolism
  • 1H-MRS: lipid metabolism and deoxymyoglobin: tracking of intra- and extra-myocellular lipids and myoglobin
  • LATEST: lactate chemical exchange saturation transfer (CEST) to image lactate in vivo
  • perfusion MRI: microcirculation within the exercising muscle
  • phase-contrast MRI: assessment of blood flow or changes in tissue elasticity (ligaments, cartilage, flexor muscles)
  • CINE MRI: real-time imaging of the flexor muscles of the thigh, the tendons and the internal structures of hip and knee during exercise testing
  • relaxometry: determination of oedema or water content under stress (ligaments, cartilage, flexor muscles)
  • elastography: elasticity testing and evaluation of re-ruptures after surgical fixation
  • mfMRI: T2-imaging of the flexor muscles to determine intramuscular water content changes under strain
  • Conventional loaded MRI: investigation of anatomical structures under isometric strain
Target:
  • gerontologists, neurologists, orthopaedists, paediatricians, physiologists, plastic surgeons, radiologists, sports physicians, training facilities for astronauts and athletes, traumatologists

Cardio Step:

Functional Specification:

  • stress MRI of heart and circulation, cerebral blood flow
Indications:
  • evaluation of morphologic and functional changes in hearts of sports men and patients,
  • evaluation of aortic (e.g. aortic aneurysms, aortic coarctation), coronary arterial, pulmonary and cerebral blood flow during exercise,
  • investigation of heartmuscle metabolism of patients, athletes and amateur sportsmen,
  • evaluation of the effects of aerobic exercise on ventricular remodelling in patients (MI),
  • assessment of training progress in patients (e.g. chronic obstructive pulmonary disease (COPD), peripheral arterial disease (PAD), chronic heart failure), athletes and amateur sports men,
  • exercise responses to gravity-independent training
Parameters:
  • 31P MRS, 13C MRS: determination of mitochondrial function, anaerobic and aerobic capacity and glycogen metabolism
  • 1H-MRS: lipid metabolism and deoxymyoglobin: tracking of intra- and extra-myocellular lipids and myoglobin
  • Functional MRI (fMRI) of the brain: inversion time (TI) pulsed arterial spin labelling (PASL): measurement of relative CBF before, during and after exercise
  • perfusion MRI: microcirculation within the myocardium or changes in myocardial tissue elasticity
  • phase-contrast MRI: assessment of blood flow
  • CINE MRI: real-time imaging of cardiac action
  • relaxometry: determination of oedema or water content in the myocardium under stress
Target:
  • angiologists, cardiologists, gerontologists, heart surgeons, paediatricians, physiologists, pulmonologists, radiologists, sports physicians, training facilities for astronauts and athletes, vascular physicians/surgeons
In Development

Neurospect:

Functional Specification:

  • brain, spinal cord for loaded MRI
Indications:
  • evaluation of cerebral blood flow and neuronal activity during exercise testing protocols,
  • assessment of the effects of exercise on brain, cognition, mood (e.g. overweight children and adults, elder patients, patients with mental disorders)
Parameters:
  • Functional MRI (fMRI) of the brain:
  1. blood oxygen level dependency (BOLD): monitoring of the oxygen supply within the tissue, non-invasive tool for the detection of areas of increased neuronal activity during exercise, evaluation of spinal cord integrity and neuronal response after spinal injuries
  2. inversion time (TI) pulsed arterial spin labeling (PASL): measurement of relative CBF before, during and after exercise
  • perfusion MRI: microcirculation within the brain
  • phase-contrast MRI: assessment of cerebral blood flow
  • conventional loaded MRI of brain and spinal cord
Target:
  • gerontologists, neurologists, neurosurgeons, neuroscientists, paediatricians, physiologists, radiologists, sports physicians, traumatologists
Genuspect:

Functional Specification:

  • internal structures of the knee for loaded MRI
Indications:
  • evaluation of anterior cruciate ligament (ACL) integrity and tears, ACL changes and re-ruptures after surgical repair, osteochondral injuries, peripheral meniscal tears and patellar dislocation during the Lachman-test,
  • assessment of lateral collateral ligament (LCL), anterior and posterior cruciate ligament (ACL and PCL) integrity and tears during varus stress testing in full extension and at 30° of flexion of the knee,
  • investigation of medial collateral ligament (MCL) and anterior cruciate ligament (ACL) integrity and tears, meniscal tears, chondral injuries, patellar subluxation, distal femoral physeal fracture and pes tendinitis during valgus stress testing in full extension and at 30° of flexion of the knee,
  • evaluation of medial meniscus integrity and tears during abduction and external rotation of lower leg and foot,
  • assessment of lateral meniscus integrity and tears during abduction and internal rotation of lower leg and foot,
  • evaluation of articular cartilage degeneration (e.g. osteoarthritis, osteochondritis dissecans) and injuries,
  • follow-up after reparative and reconstructive surgery of traumatic and degenerative cartilaginous damage,
  • monitoring of the effects of potentially chondroprotective agents
Parameters:

conventional loaded MRI of the knee:

  1. coronal, sagittal and axial fat suppressed 2D fast SE proton-density (PD)-weighted images for the assessment of ligaments, articular cartilage and menisci before and during load
  2. coronal, sagittal and axial fat suppressed 2D fast SE T2-weighted images for the examination of ligaments, articular cartilage, menisci and associated bone bruise lesions or fracture lines before and during load
  3. coronal and sagittal fat suppressed 2D fast SE Intermediate-weighted sequences (TE 33-60msec) for the assessment of articular cartilage and differentiation between cartilage and subchondral bone
  • relaxometry: determination of oedema or water content under stress (ligaments, cartilage, menisci)
  • T2 mapping for the assessment of articular cartilage composition (e.g. osteoarthritis, after anterior cruciate ligament repair, monitoring of cartilage repair)
  • dGEMRIC: T1 mapping after intravenous administration of Gd-DTPA allows quantitative assessment of articular cartilage composition

Target:

  • gerontologists, orthopaedists, paediatricians, physiologists, radiologists, sports physicians, traumatologists