Wei-Chen Peng1,2, Yuan-Hung Chao1,2, Amy S N Fu3, Shirley S M Fong4, Christer Rolf5, Hongsen Chiang6, Shiyi Chen7, Hsing-Kuo Wang1,2. 1. 1 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, China. 2. 2 Center of Physical Therapy, National Taiwan University Hospital, China. 3. 3 Department of Rehabilitation Science, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. 4. 4 School of Public Health, University of Hong Kong, Pokfulam, Hong Kong, China. 5. 5 Department of Orthopaedics, Clintec, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 6. 6 Department of Orthopaedic Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, China. 7. 7 Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Abstract
BACKGROUND: The purpose of the study was to compare the morphomechanical and functional characteristics during maximal isometric, concentric, and eccentric contractions in the legs of patients that underwent unilateral Achilles tendon repair with those in their noninjured control legs. METHODS: Twenty participants (median age = 38.2 years; range, 21.1-57.3 years) who underwent Achilles repair between 3 and 12 months ago were recruited with the following measures: (1) mechanical stiffness of the aponeurosis and (2) electromyography and medial gastrocnemius fascicle angle and length, standing muscle and tendon length, and height of heel rise with isometric contraction. RESULTS: Compared to the noninjured legs, the repaired legs showed less resting fascicle length, standing muscle length, isometric plantarflexion torque, and heel raise distance ( Ps ranged between .044 and <.001). During the concentric and eccentric phases of the raising and lowering test, the repaired legs demonstrated less fascicle length ( P ≤ .028) but greater tendinous tissue length ( Ps ranged between .084 and <.001) and fascicle angle ( Ps ranged between .247 and .008) and fewer change magnitudes of the fascicle length and tendinous tissue length ( P ≤ .003). The change magnitudes of the morphological characteristics showed correlations with the torque or distance. CONCLUSION: Selecting the appropriate surgical repair and rehabilitation for Achilles tendon ruptures is recommended for restoring the length and mechanical strength of the muscle-tendon unit of plantar-flexion muscles. LEVEL OF EVIDENCE: Level III, comparative study.
BACKGROUND: The purpose of the study was to compare the morphomechanical and functional characteristics during maximal isometric, concentric, and eccentric contractions in the legs of patients that underwent unilateral Achilles tendon repair with those in their noninjured control legs. METHODS: Twenty participants (median age = 38.2 years; range, 21.1-57.3 years) who underwent Achilles repair between 3 and 12 months ago were recruited with the following measures: (1) mechanical stiffness of the aponeurosis and (2) electromyography and medial gastrocnemius fascicle angle and length, standing muscle and tendon length, and height of heel rise with isometric contraction. RESULTS: Compared to the noninjured legs, the repaired legs showed less resting fascicle length, standing muscle length, isometric plantarflexion torque, and heel raise distance ( Ps ranged between .044 and <.001). During the concentric and eccentric phases of the raising and lowering test, the repaired legs demonstrated less fascicle length ( P ≤ .028) but greater tendinous tissue length ( Ps ranged between .084 and <.001) and fascicle angle ( Ps ranged between .247 and .008) and fewer change magnitudes of the fascicle length and tendinous tissue length ( P ≤ .003). The change magnitudes of the morphological characteristics showed correlations with the torque or distance. CONCLUSION: Selecting the appropriate surgical repair and rehabilitation for Achilles tendon ruptures is recommended for restoring the length and mechanical strength of the muscle-tendon unit of plantar-flexion muscles. LEVEL OF EVIDENCE: Level III, comparative study.
Authors: Dong Sun; Gusztáv Fekete; Julien S Baker; Qichang Mei; Bíró István; Yan Zhang; Yaodong Gu Journal: Int J Environ Res Public Health Date: 2020-06-28 Impact factor: 3.390