Impact of Physiotherapy on the Calf Muscle Torque Variability after Achilles Tendon Rupture

It has been established that muscle torque variability determines movement stability during the task [1]. Calf muscle weakness, ankle range of motion reduction and postural misbalance are common pathological limitations after Achilles tendon rupture (ATR). Most studies analyse rehabilitation influence for muscle strength and body balance, but there is a lack of information about calf muscle torque variability. The aim of the study was to determine ankle plantar flexion and dorsal flexion muscle maximal voluntary contraction torque and variability Q. Organization and methods. We measured five males, (aged 29 ± 6) after 6.5 – week surgery of ATR. Participants performed isometric ankle flexion and extension force with injured and non-injured legs. Muscles maximal voluntary contraction (MVC) torque and torque variability were measured at –15°; 0°; 15° angles. The variability of target force was 20% of MVC torque. Rehabilitation programme consisted of balance, muscle strength and stretching exercises. Calf muscle MVC torque and variability were observed before and after 8-week rehabilitation. The results of the research. We determined that after physiotherapy the injured and the non-injured leg isometric ankle flexion and extension muscle MVC torque increased and muscle torque variability decreased.Keywords: muscle torque variability, isometric maximal voluntary contraction torque, rehabilitation suformavimas.

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Recovery of Calf Muscle Strength Following Acute Achilles Tendon Rupture Treatment

Foot & Ankle Specialist ◽

10.1177/1938640009348338 ◽

2009 ◽

Vol 2 (5) ◽

pp. 219-226 ◽

Cited By ~ 15

Author(s):

Roderik Metz ◽

Geert J. M. G. van der Heijden ◽

Egbert-Jan M. M. Verleisdonk ◽

Rob Tamminga ◽

Christiaan van der Werken

Keyword(s):

Muscle Strength ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Calf Muscle

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Changes in Tendon Elongation and Muscle Atrophy Over Time After Achilles Tendon Rupture Repair: A Prospective Cohort Study on the Effects of Early Functional Mobilization

The American Journal of Sports Medicine ◽

10.1177/0363546520956677 ◽

2020 ◽

Vol 48 (13) ◽

pp. 3296-3305 ◽

Cited By ~ 1

Author(s):

Susanna Aufwerber ◽

Gunnar Edman ◽

Karin Grävare Silbernagel ◽

Paul W. Ackermann

Keyword(s):

Patient Outcome ◽

Cohort Study ◽

Achilles Tendon ◽

Muscle Atrophy ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Calf Muscle ◽

Control Group ◽

Tendon Elongation ◽

Over Time

Background: Early functional mobilization (EFM) may improve patient outcome after Achilles tendon rupture (ATR). However, whether EFM affects patient outcome via changes in tendon elongation, thickening, or calf muscle atrophy is unknown. Purpose: To analyze differences in tendon and muscle morphology recovery over time between groups treated with EFM or standard treatment after ATR repair. Study Design: Cohort study; Level of evidence, 2. Methods: This prospective cohort study included 86 patients (20 women) with ATR repair who had a mean (SD) age of 39.3 (8.2) years and were part of a larger prospective randomized controlled trial. Patients were postoperatively randomized to immediate postoperative weightbearing and ankle motion (EFM group) or to immobilization in a below-knee plaster cast for 2 weeks (control group). Patient-reported and functional outcomes were assessed at 6 and 12 months with the Achilles Tendon Total Rupture Score and the heel-rise test for endurance. At 2 and 6 weeks and 6 and 12 months postoperatively, B-mode ultrasound imaging was performed to assess the length and cross-sectional area (CSA) of the Achilles tendon, the gastrocnemius CSA, as well as the thickness of soleus. Results: The Achilles Tendon Total Rupture Score for the EFM and control groups were 65.8 (18.7) and 56.8 (20.1; P = .045), respectively, at 6 months and 79.6 (15.8) and 78.9 (17.2; P = .87), respectively, at 12 months. At 2 weeks, tendon elongation was significantly more pronounced in the EFM group as compared with the control group (mean side-to-side difference, 1.88 cm vs 0.71 cm; P = .005). Subsequently, tendon elongation increased in the control group while it decreased in the EFM group so that at 6 and 12 months no significant differences between groups were found. Mean Achilles tendon elongation at 1 year was 1.73 (1.07) cm for the EFM group (n = 55) and 1.67 (0.92) cm for the control group (n = 27), with a mean difference of 0.06 cm (95% CI, 0.54 to –0.42; P = .80). Achilles tendon CSA and calf muscle atrophy displayed no significant differences between the groups; however, significant changes were demonstrated over time ( P ≤ .001) in both groups. Conclusion: EFM results in more Achilles tendon elongation at early healing, but this difference subsides over time. EFM does not seem to affect patient outcome via changes in tendon elongation, thickening, or calf muscle atrophy. Registration: NCT02318472 (ClinicalTrials.gov identifier).

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Calf Muscle Atrophy and Achilles Tendon Elongation After Acute Achilles Tendon Rupture

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2017.08.153 ◽

2017 ◽

Vol 33 (10) ◽

pp. e129-e130 ◽

Cited By ~ 3

Author(s):

Juuso Heikkinen ◽

Iikka Lantto ◽

Tapio Flinkkila ◽

Pertti Siira ◽

Vesa Laine ◽

...

Keyword(s):

Achilles Tendon ◽

Muscle Atrophy ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Calf Muscle ◽

Tendon Elongation

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Factors Associated With Calf Muscle Endurance Recovery 1 Year After Achilles Tendon Rupture Repair

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2010.3204 ◽

2010 ◽

Vol 40 (6) ◽

pp. 345-351 ◽

Cited By ~ 52

Author(s):

Geoff P. Bostick ◽

Nadr M. Jomha ◽

Amar A. Suchak ◽

Lauren A. Beaupré

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Calf Muscle ◽

Muscle Endurance ◽

Factors Associated

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Dependence of Muscle Torque of Ankle Plantar and Dorsal Flexors on Different Ankle Angles

Baltic Journal of Sport and Health Sciences ◽

10.33607/bjshs.v1i80.343 ◽

2018 ◽

Vol 1 (80) ◽

Author(s):

Rima Solianik ◽

Vaida Aleknavičiūtė ◽

Zita Andrijauskaitė ◽

Algimantas Putramentas ◽

Gintarė Dargevičiūtė ◽

...

Keyword(s):

Electrical Stimulation ◽

Maximal Voluntary Contraction ◽

Plantar Flexion ◽

Muscle Length ◽

Voluntary Contraction ◽

Calf Muscle ◽

Muscle Torque ◽

Ankle Angle ◽

O 15 ◽

The Relationship

Research background and hypothesis. There is much research information about the relationship between the knee joint angle and the quadriceps muscle torque (Mohamed et al., 2002), but still we lack evidence about the relationship between ankle angle and calf muscle torque. Research aim. The purpose of this research was to establish the dependence of maximal voluntary contraction (MVC) and electrical stimulation (ES)-evoked torque and calf muscle electrical activity (EMG) on different ankle plantar and dorsal ﬂ exion angles. We hypothesized that the calf muscle MVC and ES-evoked torque as well as muscle EMG amplitude would increase with increasing muscle length (i. . increasing ankle angle).Research methods. The subjects in the research were ten non-trained men. Calf plantar and dorsal ﬂ exors muscle ES and MVC torque were tested at eight different ankle angles (–25 o ; –15 o ; –5 o ; 0 o ; 15 o ; 25 o ; 35 o ; 45 o ) which were chosen in randomized sequence. The tibialis anterior, soleus, gastrocnemius lateralis and medialis muscle EMG were measured during muscle MVC.Research results. The results showed that the highest ES-evoked and MVC developed torque of plantar ﬂ exion muscles was at –25° ankle angle (149.1 ± 31.6 N·m and 207.8 ± 38.1 N·m, respectively), while the highest dorsal ﬂ exion MVC muscle torque was at 25° ankle angle (47.2 ± 8.1 N·m). However, dorsal ﬂ exion muscle MVC torque increased with the muscle length only until 25° ankle angle. Discussion and conclusions. Plantar flexion muscle electrical stimulation evoked and plantar / dorsal ﬂ exion muscle maximal voluntary contraction torques are highest at that ankle angle where muscle length is the longest.Keywords: maximal voluntary contraction, electrical stimulation, EMG.

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Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture

The American Journal of Sports Medicine ◽

10.1177/0363546517737055 ◽

2017 ◽

Vol 46 (2) ◽

pp. 470-477 ◽

Cited By ~ 21

Author(s):

Annelie Brorsson ◽

Karin Grävare Silbernagel ◽

Nicklas Olsson ◽

Katarina Nilsson Helander

Keyword(s):

Physical Activity ◽

Achilles Tendon ◽

Patient Reported Outcomes ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Calf Muscle ◽

Muscle Performance ◽

Patient Reported ◽

Rise Height

Background: Optimizing calf muscle performance seems to play an important role in minimizing impairments and symptoms after an Achilles tendon rupture (ATR). The literature lacks long-term follow-up studies after ATR that describe calf muscle performance over time. Purpose: The primary aim was to evaluate calf muscle performance and patient-reported outcomes at a mean of 7 years after ATR in patients included in a prospective, randomized controlled trial. A secondary aim was to evaluate whether improvement in calf muscle performance continued after the 2-year follow-up. Study Design: Cohort study; Level of evidence, 2. Methods: Sixty-six subjects (13 women, 53 men) with a mean age of 50 years (SD, 8.5 years) were evaluated at a mean of 7 years (SD, 1 year) years after their ATR. Thirty-four subjects had surgical treatment and 32 had nonsurgical treatment. Patient-reported outcomes were evaluated with Achilles tendon Total Rupture Score (ATRS) and Physical Activity Scale (PAS). Calf muscle performance was evaluated with single-leg standing heel-rise test, concentric strength power heel-rise test, and single-legged hop for distance. Limb Symmetry Index (LSI = injured side/healthy side × 100) was calculated for side-to-side differences. Results: Seven years after ATR, the injured side showed decreased values in all calf muscle performance tests ( P < .001-.012). Significant improvement in calf muscle performance did not continue after the 2-year follow-up. Heel-rise height increased significantly ( P = .002) between the 1-year (10.8 cm) and the 7-year (11.5 cm) follow-up assessments. The median ATRS was 96 (of a possible score of 100) and the median PAS was 4 (of a possible score of 6), indicating minor patient-reported symptoms and fairly high physical activity. No significant differences were found in calf muscle performance or patient-reported outcomes between the treatment groups except for the LSI for heel-rise repetitions. Conclusion: Continued deficits in calf muscle endurance and strength remained 7 years after ATR. No continued improvement in calf muscle performance occurred after the 2-year follow-up except for heel-rise height.

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