BACKGROUND: The relationship between ankle plantar flexor biomechanical properties and gait pattern following surgery for acute rupture of the Achilles tendon has not yet been fully investigated. METHODS: Forty-nine young adults (27 men and 22 women) who underwent surgical repair of a complete Achilles tendon rupture were evaluated at 3, 6, 12 and 24 months by clinical assessment, biomechanical evaluation and gait analysis. FINDINGS: Ankle range of motion, plantar flexor passive stiffness and concentric strength were recovered within 12 months. Gait abnormalities related to these factors took longer to disappear owing to the presence of anomalous muscle patterns. At 24 months, a deficit in calf-muscle eccentric strength was still present, determining adaptive changes in gait strategy that involved ankle motion and coordinated muscular activity. INTERPRETATION: Improvement of gait pattern is slower than recovery of plantar flexor mechanical properties. Persisting mechanical impairment resulting in gait adaptations may be detrimental to the healing structures by increasing stress on the Achilles tendon. Restoration of calf-muscle eccentric strength and coordinated antagonist muscle activity should be key points in postoperative rehabilitation following surgical repair of Achilles tendon rupture.
BACKGROUND: The relationship between ankle plantar flexor biomechanical properties and gait pattern following surgery for acute rupture of the Achilles tendon has not yet been fully investigated. METHODS: Forty-nine young adults (27 men and 22 women) who underwent surgical repair of a complete Achilles tendon rupture were evaluated at 3, 6, 12 and 24 months by clinical assessment, biomechanical evaluation and gait analysis. FINDINGS: Ankle range of motion, plantar flexor passive stiffness and concentric strength were recovered within 12 months. Gait abnormalities related to these factors took longer to disappear owing to the presence of anomalous muscle patterns. At 24 months, a deficit in calf-muscle eccentric strength was still present, determining adaptive changes in gait strategy that involved ankle motion and coordinated muscular activity. INTERPRETATION: Improvement of gait pattern is slower than recovery of plantar flexor mechanical properties. Persisting mechanical impairment resulting in gait adaptations may be detrimental to the healing structures by increasing stress on the Achilles tendon. Restoration of calf-muscle eccentric strength and coordinated antagonist muscle activity should be key points in postoperative rehabilitation following surgical repair of Achilles tendon rupture.
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Authors: Mathias Wulf; Mihir Shanker; Michael Schuetz; Michael Lutz; Christian M Langton; Sue L Hooper; James E Smeathers; Torsten Brauner; Scott C Wearing Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-28 Impact factor: 4.342
Authors: Carlos I De la Fuente; Roberto Peña Y Lillo; Rodrigo Ramirez-Campillo; Pablo Ortega-Auriol; Mauricio Delgado; Joel Alvarez-Ruf; Gabriel Carreño Journal: J Athl Train Date: 2016-12-06 Impact factor: 2.860
Authors: Karin Grävare Silbernagel; Katarina Nilsson-Helander; Roland Thomeé; Bengt I Eriksson; Jón Karlsson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-08-19 Impact factor: 4.342
Authors: Stephen M Suydam; Thomas S Buchanan; Kurt Manal; Karin Gravare Silbernagel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-04-23 Impact factor: 4.342