Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment – a case series

Nordenholm, Anna; Nilsson, Niklas; Senorski, Eric Hamrin; Helander, Katarina Nilsson; Westin, Olof; Olsson, Nicklas

doi:10.1186/s40634-022-00451-5

Cited by 8 publications

(14 citation statements)

References 44 publications

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“…Since linear encoders can provide the three main outcomes of repetitions, peak height, and work, these devices have been used the most in research to monitor CRT outcomes in healthy individuals (Arch et al., 2018; Byrne et al., 2017; J. A. Zellers et al., 2017) and patients with Achilles tendon pathologies (Andreasen et al., 2020; Annelie Brorsson et al., 2018; A. Brorsson et al., 2016; A. Brorsson et al., 2021; A. Brorsson et al., 2017; Hamrin et al., 2020; Nordenholm et al., 2022; Olsson et al., 2014; Silbernagel et al., 2015; Silbernagel et al., 2006; Silbernagel et al., 2010; Silbernagel et al., 2012; Svensson et al., 2019; Westin et al., 2018; Zellers et al., 2018; J. A. Zellers et al., 2020).…”

Section: Resultsmentioning

confidence: 99%

“…Of all the measuring devices, the linear encoder was used most frequently in studies ( n = 18, 51.4%) (Andreasen et al., 2020; Arch et al., 2018; Annelie Brorsson et al., 2018; A. Brorsson et al., 2021; A. Brorsson et al., 2017; Byrne et al., 2017; Hamrin et al., 2020; Nordenholm et al., 2022; Olsson et al., 2014; Silbernagel et al., 2015; Silbernagel et al., 2006; Silbernagel et al., 2010; Silbernagel et al., 2012; Svensson et al., 2019; Westin et al., 2018; Zellers et al., 2018; J. A. Zellers et al., 2020; J.…”

Section: Resultsmentioning

confidence: 99%

“…Brorsson et al, 2021;A. Brorsson et al, 2017;Byrne et al, 2017;Hamrin et al, 2020;Nordenholm et al, 2022;Olsson et al, 2014;Silbernagel et al, 2015;Silbernagel et al, 2006;Silbernagel et al, 2010;Silbernagel et al, 2012;Svensson et al, 2019;Westin et al, 2018;Zellers et al, 2018;J. A. Zellers et al, 2020;J.…”

Section: Calf Raise Test Measuring Devicesunclassified

“…Hence, total work and peak height during the CRT are deemed important measures of calf muscle‐tendon unit function (Nordenholm et al., 2022; J. A. Zellers et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

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Devices to measure calf raise test outcomes: A narrative review

Fernandez

Hébert‐Losier

2023

Physiotherapy Res Intl

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BackgroundThe calf raise test (CRT) is commonly administered without a device in clinics to measure triceps surae muscle function. To standardise and objectively quantify outcomes, researchers use research‐grade or customised CRT devices. To incorporate evidence‐based practice and apply testing devices effectively in clinics, it is essential to understand their design, applicability, psychometric properties, strengths, and limitations. Therefore, this review identifies, summarises, and critically appraises the CRT devices used in science.MethodsFour electronic databases were searched in April 2022. Studies that used devices to measure unilateral CRT outcomes (i.e., number of repetitions, work, height) were included.ResultsThirty‐five studies met inclusion, from which seven CRT devices were identified. Linear encoder (n = 18) was the most commonly used device, followed by laboratory equipment (n = 6) (three‐dimensional motion capture and force plate). These measured the three CRT outcomes. Other devices used were electrogoniometer, Häggmark and Liedberg light beam device, Ankle Measure for Endurance and Strength (AMES), Haberometer, and custom‐made. Devices were mostly used in healthy populations or Achilles tendon pathologies. AMES, Haberometer, and custom‐made devices were the most clinician‐friendly, but only quantified repetitions were completed. In late 2022, a computer vision mobile application appeared in the literature and offered clinicians a low‐cost, research‐grade alternative.ConclusionThis review details seven devices used to measure CRT outcomes. The linear encoder is the most common in research and quantifies all three CRT outcomes. Recent advances in computer‐vision provide a low‐cost research‐grade alternative to clinicians and researchers via a n iOS mobile application.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Calf Raise Test Measuring Devicesunclassified

“…Hence, total work and peak height during the CRT are deemed important measures of calf muscle‐tendon unit function (Nordenholm et al., 2022; J. A. Zellers et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Devices to measure calf raise test outcomes: A narrative review

Fernandez

Hébert‐Losier

2023

Physiotherapy Res Intl

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“…Regardless of treatment, long‐term functional deficits such as calf muscle weakness, tendon elongation, and gait abnormalities are common after an acute ATR [7–11]. Similar functional deficits have also been reported after surgical treatment of CATR [12, 13]. These sub‐groups of patients are, however, to date, less studied [14–16].…”

Section: Introductionmentioning

confidence: 97%

Greater heel-rise endurance is related to better gait biomechanics in patients surgically treated for chronic Achilles tendon rupture

Nordenholm

Senorski

Helander

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To determine the relationships among calf muscle function, tendon length and gait biomechanics in patients surgically treated for chronic Achilles tendon rupture. Methods Twenty-one patients with chronic Achilles tendon rupture (mean age 62 ± 13 years) were evaluated by heel-rise endurance test, Achilles Tendon Resting Angle (ATRA), ultrasound measurement of tendon length and three-dimensional gait analysis. A bivariate two-sided correlation test was performed on all variables in all patients. Results Better performance across all parameters of the heel-rise endurance test correlated with faster walking speed (r = 0.52–0.55), greater peak ankle power (r = 0.56–0.64), shorter stance phase (r = −0.52 to −0.76) and less peak ankle dorsiflexion angle (r = −0.49 to −0.64) during gait. Greater ATRA correlated with longer stance time (r = 0.47), greater peak ankle dorsiflexion angle (r = 0.48), less heel-rise repetitions (r = −0.52) and less heel-rise total work LSI (r = −0.44 to −0.59). Conclusion Greater calf muscle endurance, especially heel-rise total work, is moderately correlated (r = 0.49–0.76) to better ankle biomechanics during gait in patients surgically treated for CATR. The heel-rise endurance test may be a clinical proxy for power development in the ankle joint during gait. Level of evidence IV.

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Tendon Elongation and Function After Delayed or Standard Loading of Surgically Repaired Achilles Tendon Ruptures: A Randomized Controlled Trial

Hoeffner,

Agergaard,

Svensson

et al. 2024

Am J Sports Med

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Background: Achilles tendon ruptures often result in long-term functional deficits despite accelerated (standard) rehabilitation. Purpose/Hypothesis: The purpose of this study was to investigate if delayed loading would influence functional, clinical, and structural outcomes of the muscles and tendon 1 year after a surgical repair. It was hypothesized that delaying the loading would reduce the heel-rise height deficit 1 year after Achilles tendon rupture. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In total, 48 patients with a surgically repaired Achilles tendon rupture were randomized to 2 groups: the standard group received the currently accepted rehabilitation, and the delayed group received the same rehabilitation except that initial loading was delayed by 6 weeks. The primary outcome was the heel-rise height difference between the injured and uninjured sides at 1 year. The secondary outcomes were (1) tendon length measured with magnetic resonance imaging, (2) muscle fascicle length and pennation angle of the gastrocnemius medialis muscle, (3) Doppler activity measured with ultrasonography, (4) Achilles tendon Total Rupture Score (ATRS), and (5) isometric muscle strength. Results: The mean heel-rise height deficits for the standard and delayed groups were −2.2 cm and −2.1 cm, respectively ( P = .719). The soleus part of the tendon was already elongated 1 week after surgery in both groups without a between-group difference (side-to-side difference: standard, 16.3 mm; delayed, 17.5 mm; P = .997) and did not change over 52 weeks. The gastrocnemius tendon length was unchanged at 1 week but elongated over time without a between-group difference (side-to-side difference at 52 weeks: standard, 10.5 mm; delayed, 13.0 mm; P = .899). The delayed group had less Doppler activity at 12 weeks ( P = .006) and a better ATRS (standard, 60 points; delayed, 72 points; P = .032) at 52 weeks. Conclusion: Delayed loading was not superior to standard loading in reducing the heel-rise height difference at 1 year. The data indirectly suggested reduced inflammation in the initial months and a better patient-reported outcome at 1 year in the delayed group. The soleus part of the tendon was already markedly elongated (35%) 1 week after surgery, while the length of the gastrocnemius tendon was unchanged at 1 week but was 6% elongated at 1 year. Together, these data indirectly suggest that the delayed group fared better, although this finding needs to be confirmed in future investigations. Registration: NCT04263493 (ClinicalTrials.gov identifier).

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Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment – a case series

Cited by 8 publications

References 44 publications

Devices to measure calf raise test outcomes: A narrative review

Devices to measure calf raise test outcomes: A narrative review

Greater heel-rise endurance is related to better gait biomechanics in patients surgically treated for chronic Achilles tendon rupture

Tendon Elongation and Function After Delayed or Standard Loading of Surgically Repaired Achilles Tendon Ruptures: A Randomized Controlled Trial

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