Immobility Response, Tonic, Rupture of Achilles Tendon, Rupture, Spontaneous
Conditions
Keywords
Achilles tendon rupture, Rehabilitation, Immobilization, Muscle architecture, Functionality, Neuromuscular parameters, Weight-Bearing
Brief summary
The purpose of this study is to evaluate the effects of early mobilization versus traditional immobilization rehabilitation programs after surgical Achilles tendon repair on the mechanical (torque-angle and torque-velocity relationships) and electrical (neuromuscular activation) properties of the plantar- and dorsiflexor muscles, gastrocnemius medialis morphology (muscle architecture), functional performance, and the mechanical and material properties (force-elongation and stress-strain relationships) of the injured and uninjured Achilles tendon. The hypothesis is that the early mobilization could reduce the deleterious effects of the joint immobilization and improve the tendon healing.
Detailed description
Participants were allocated into one of two intervention groups (traditional immobilization or early mobilization). Traditional immobilization group (45 days of plaster cast immobilization; after the immobilization period, subjects received instructions on how to perform a home-based exercise program) Early mobilization (six weeks of physical therapy program; three times per week; one to two hours of exercises for regaining range of motion and muscular endurance) Control group (subjects had no history of lower limb injury, and were matched in age and anthropometric measurements to subjects that performed physical rehabilitation and to subjects that remained immobilized.
Interventions
OTHERTraditional Immobilization
After surgery subjects were immobilized in a plaster cast, with the ankle positioned in gravitational equinus; weight bearing was not allowed. Two weeks post-operatively, the cast was removed and the patient was immobilized with a new plaster cast, with the ankle in the same position. Four weeks post-operatively, the ankle was plastered in neutral position (i.e. with the sole of the foot perpendicular to the shank), and weight bearing was encouraged. Six weeks post-operatively, the plaster cast was removed The home exercise program consisted of active exercises and stretches to improve ankle range of motion, and resistance and balance exercises
OTHEREarly Mobilization
The physical therapy started two weeks after the surgery and lasted six weeks, during which a removable brace was used. Therapy sessions, three times per week in the six-week period, included one to two hours of exercises for regaining range of motion and muscular endurance.
Sponsors
Federal University of Rio Grande do Sul
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Eligibility
Sex/Gender
MALE
Age
30 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Male * Achilles tendon rupture
Exclusion criteria
* arterial insufficiency * diabetes * autoimmune disease * patients who used systemic antibiotics or steroids or showed any other clinical contraindication to perform maximum voluntary contractions on a dynamometer.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Heel rise test (HRT) | Heel rise height was measured 3 times during the study: three, six and more than 12 months after surgical repair. | Heel rise height is an expression of ankle plantarflexor functional performance and was assessed using the HRT. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscular torque change | Torque was measured 3 times during the study: three, six and more than 12 months after surgical repair. | Torque is an expression of the muscular strength and was assessed by dynamometry |
| Ankle range of motion change | Ankle range of motion was measured 5 times during the study: 15 days, 45 days, three, six and more than 12 months after surgical repair. | Ankle range of motion was assessed by goniometry during active and passive dorsiflexion and plantar flexion. |
| Muscular architecture change | Muscle architecture was measured 4 times during the study: 45 days, three, six and more than 12 months after surgical repair. | Muscular architecture (muscle thickness, pennation angle and fascicle length) was assessed by ultrasonography |
| Plantarflexor muscle volume change | Plantarflexor muscle volume was assessed 4 times during the study: 45 days, three, six and more than 12 months after surgical repair. | Plantarflexor muscle volume was estimated from calf muscle thickness and limb length using the equation proposed by Miyatani et al. 2004. |
Countries
Brazil
Contacts
PRINCIPAL_INVESTIGATORMarco A Vaz, PhD
Federal University of Rio Grande do Sul
Outcome results
None listed