Recovering Motor Performance of the Foot After Achilles Rupture Repair: A Randomized Clinical Study about Early Functional Treatment vs. Early Immobilization of Achilles Tendon in Tension

Abstract

The purpose of the study was to examine the recovery of some motor performance aspects of the lower extremity after Achilles tendon (AT) rupture repair by early functional postoperative treatment and early postoperative immobilization of the AT in tension in the early phase of recovery. The measured motor performance aspects were reaction time, speed of movement, foot tapping speed and coordination. The study population comprised 30 patients operated on for an acute, complete, closed AT rupture. The surgical technique was Kessler sutures plus one aponeurosis flap in all cases, and postoperatively the subjects were randomly divided to have immobilization with a plaster cast or an active brace. Measurements were made 12 and 24 weeks after the operation. There were no statistically significant differences in the results between the operated and contralateral nonoperated lower extremities 12 and 24 weeks after the operation in either group. When the results were compared between the plaster cast and active brace groups, no statistically significant differences were seen in reaction times, speed of movement, tapping speed and anterior-posterior coordination on either side, but the lateral coordination value of the operated leg was higher in the plaster cast group than in the active brace group 12 weeks after the operation (p<0.05). By 24 weeks after the operation, this unique difference had disappeared. It seems that the recovery of the above mentioned motor performance functions of the leg does not depend on whether the leg is in a plaster cast with the AT in tension or in an active brace during the early postoperative period after AT rupture repair. These functions of the operated leg had recovered to the level of the contralateral nonoperated leg by 12 weeks after the operation.

Early functional rehabilitation or cast immobilisation for the postoperative management of acute Achilles tendon rupture? A systematic review and meta-analysis of randomised controlled trials

“…The bracing group comprised 281 patients and the casting group, 289 patients. Two RCTs were excluded from the meta-analysis because they did not address the outcomes specified for the review 30 31. Another RCT was excluded because the length of intervention in the functional rehabilitation group was 2 weeks 32.…”

Rotura en tendón de Aquiles: manejo postquirúrgico para acelerar el regreso a la actividad deportiva

“…Kauranen y col. evaluó varios aspectos del rendimiento del motor (42). Los autores no pudieron identificar cualquier diferencia significativa para el rendimiento del motor.…”

“…Kauranen y col. de nuevo permitió el apoyo completo después de tres semanas en ambos grupos (42). El parámetro de resultado principal fue el rendimiento motor medido por el tiempo de reacción, la velocidad de movimiento y la coordinación.…”

“…El parámetro de resultado principal fue el rendimiento motor medido por el tiempo de reacción, la velocidad de movimiento y la coordinación. El número de reinterrupciones del tendón o el tiempo para regresar a la actividad diaria o deportiva no se mencionan (42).…”

Orthopaedics

“…Two randomised controlled trials compared this regimen to standard post-operative immobilisation in surgically treated ATR. One found isokinetic calf muscle strength to be better in the early motion group (79), but the other found no difference (80). Both of these trials only allowed weight bearing to begin after three weeks, but two smaller trials have shown some functional improvements from earlier mobilisation and weight bearing in a standard cast (81,82).…”