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Intratendon bioimpedance spectroscopy: a first step exploring reliability and sensitivity to change.
Patricia Beltrá1,2,3, Miguel Delicado Miralles1,4, Emilio Tomás-Muñoz1
1Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Alacant, Spain.
Peerj
|May 26, 2026
Summary
Intra-Tendon Bioimpedance Spectroscopy (IT-BIS) shows excellent short-term reliability for tendon assessment but needs standardization for longer-term use. This minimally invasive technique is sensitive to physiological changes and has minimal adverse effects, making it a promising tool.
Area of Science:
- Biomedical Engineering
- Musculoskeletal Imaging
- Biophysics
Background:
- Ultrasonography is the primary tool for macrostructural tendon evaluation.
- Microstructural tendon analysis currently requires invasive biopsies.
- A minimally invasive alternative is needed for detailed tendon assessment.
Purpose of the Study:
- To evaluate the reliability and sensitivity to change of Intra-Tendon Bioimpedance Spectroscopy (IT-BIS).
- To explore IT-BIS as a less invasive method for tendon microstructural evaluation.
- To assess the safety and efficacy of IT-BIS in healthy volunteers.
Main Methods:
- IT-BIS was performed on 40 healthy volunteers' patellar tendons using fine needles in a tetrapolar configuration.
- Measurements were taken twice per session, with two sessions separated by at least two weeks.
- Intra- and inter-session reliability were assessed using ICC, SEM, and MDC.
- Sensitivity to change was evaluated through needle insertion and percutaneous electrolysis.
Main Results:
- IT-BIS demonstrated excellent intra-session reliability (ICCs 0.927-0.999) but poor-to-moderate inter-session reliability (ICCs 0.087-0.528).
- The technique was sensitive to needle insertion effects at low frequencies and electrolysis effects at high frequencies.
- Minimal and transient adverse effects were reported, with a 4.63% pain occurrence rate.
Conclusions:
- IT-BIS is a reliable tool for short-term tendon assessment but requires methodological standardization for inter-session reliability.
- The technique shows promise as a safe, minimally invasive method for evaluating tendon microstructural changes.
- IT-BIS is sensitive to acute physiological alterations in tendon tissue.
