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[Resumen] El músculo tibial posterior es el mayor estabilizador dinámico del arco longitudinal interno y principal supinador del pie. Los afectados de disfunción del tendón tibial posterior manifiestan sintomatología dolorosa, hinchazón en el recorrido del tendón, colapso del arco longitudinal medial, eversión del talón en posición relajada de calcáneo en apoyo y abducción del antepié en relación con el retropié. El objetivo principal de la propuesta de investigación es determinar la prevalencia de la disfunción del tendón tibial posterior en la población adulta. También se pretende: valorar las variables y la comorbilidad asociadas a la disfunción del tendón tibial posterior, determinar cómo la disfunción del tendón tibial posterior altera la calidad de vida de los pacientes y evaluar cómo la disfunción del tendón tibial posterior limita las actividades físicas diarias del paciente. Se llevará a cabo un estudio observacional transversal de prevalencia descriptivo en la Clínica Universitaria de Podología de la Universidad de la Coruña, [Resumo] O músculo tibial posterior e o maior estabilizador dinámico do arco lonxitudinal interno e principal supinador do pé. Os afectados de disfunción do tendón manifestan sintomatoloxía dolorosa, inchazón no percorrido do tendón, colapso do arco lonxitudinal medial, eversión do talón na posición relaxada de calcáneo en apoio e abducción do antepé en relación co retropé. O obxectivo principal da proposta de investigación e determinar o predominio da disfunción do tendón tibial posterior na poboación adulta. Tamén se pretende: valorar as variables e a comorbilidade asociada a disfunción do tendón tibial posterior, determinar como a disfunción do tendón tibial posterior altera a calidade de vida dos pacientes e avaliar como a disfunción do tendón tibial posterior limita as actividades físicas diarias do paciente. Levarase a cabo un estudo observacional trasversal de predominio descriptivo na Clínica Universitaria de Podoloxía da Universidade da Coruña., [Abstract] The posterior tibial muscle is the largest dynamic stabilizer of the longitudinal internal arch and primary supinator of the foot. Those affected by posterior tibial tendon dysfunction manifest painful symptoms, tendon swelling, medial longitudinal arch collapse, heel eversion in standing Disfunción del tendón tibial posterior y variables asociadas a su presencia en población adulta 7 relaxed calcaneus position and abduction of the forefoot in relation to the hindfoot. The main objective of this research proposal is to determine the prevalence of posterior tibial tendon dysfunction in the adult population. It is also intended to assess the variables and comorbidity associated with posterior tibial tendon dysfunction, to determine how dysfunction of the posterior tibial tendon alters patient´s quality of life, and to assess how posterior tibial tendon dysfunction alters the daily physical activity of the patient. A cross-sectional observational study of descriptive prevalence will be carried out at the “Clínica Universitaria de Podología” at the “Universidade da Coruña”

Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, it could be used to quantify the severity of tendonosis and help determine the appropriate treatment. Ultrasound elasticity imaging (UEI) is a real-time, noninvasive technique to objectively measure mechanical properties in soft tissue. It consists of acquiring a sequence of ultrasound frames and applying speckle tracking to estimate displacement and strain at each pixel. The goals of my dissertation were to 1) use acoustic simulations to investigate the performance of UEI during tendon deformation with different geometries; 2) develop and validate UEI as a potentially noninvasive technique for quantifying tendon mechanical properties in human cadaver experiments; 3) design a platform for UEI to measure mechanical properties of the PTT in vivo and determine whether there are detectable and quantifiable differences between healthy and diseased tendons. First, ultrasound simulations of tendon deformation were performed using an acoustic modeling program. The effects of different tendon geometries (cylinder and curved cylinder) on the performance of UEI were investigated. Modeling results indicated that UEI accurately estimated the strain in the cylinder geometry, but underestimated in the curved cylinder. The simulation also predicted that the out-of-the-plane motion of the PTT would cause a non-uniform strain pattern within incompressible homogeneous isotropic material. However, to average within a small region of interest determined by principal component analysis (PCA) would