Understanding limitations in sport 1 year after an Achilles tendon rupture: a multicentre analysis of 285 patients

Abstract

Purpose The purpose of this study was to determine patient‐related and treatment‐related predictors of superior and inferior function in sport and recreational activities 1 year after an Achilles tendon rupture. Methods This study is based on a multicentre cohort from 4 previous randomised controlled trials. All the patients who had responded to the Foot and Ankle Outcome Score (FAOS) at the 1‐year follow‐up were included. All the patients had a clinically verified Achilles tendon rupture and patients who underwent surgery were treated within 96 h of the time of rupture. Patients were excluded in the event of a previous Achilles tendon rupture or the presence of other lifestyle diseases. The primary outcomes of the study were reported in the 20th and 80th percentiles of the FAOS subscale, function in sports and recreational activities. Results A total of 285 (84% men) patients with an average age of 40.0 (SD 8.4) years were included. Smoking increased the odds of superior self‐reported FAOS sport and recreation [OR 4.59 (95% CI 1.58–13.32), p = 0.005] compared with non‐smoking, while being female [OR 0.38 (95% CI 0.16–0.93), p = 0.035] and every increment of one unit in BMI [OR 0.89 (95% CI 0.81–0.99), p = 0.029] reduced the odds. No variable was statistically significant when attempting to predict which patients report inferior FAOS sport and recreation. The recovery of symmetry in heel‐rise tests had no effect on 1‐year FAOS sport and recreation. Patient‐reported outcomes had a good‐to‐excellent explanatory capacity of superior and inferior 1‐year function in sport and recreational activities (AUC = 0.87–0.93). Conclusion BMI is a modifiable risk factor, which, when lowered, may be associated with less impairment in sports 1 year after an Achilles tendon rupture. Females appear to perceive more limitations than males. Unexpectedly, smokers experience less limitations in foot and ankle function. Patients who report no functional limitation in sport are characterised by an overall perception of adequate foot, ankle and Achilles function, despite not having recovered symmetry in the heel‐rise test. Level of evidence I.

Devices to measure calf raise test outcomes: A narrative review

“…Finally, one study (2.9% each) used the force plate with an electrogoniometer (Österberg et al., 1998), 3D motion capture with a linear encoder (Andreasen et al., 2020), and a custom made CRT device (Sara et al., 2021), as reported in Table 1. These devices were used most often in studies to examine Achilles tendon pathologies ( n = 18, 51.4%) (Andreasen et al., 2020; Annelie Brorsson et al., 2018; A. Brorsson et al., 2021; A. Brorsson et al., 2017; Häggmark et al., 1986; Hamrin et al., 2020; Nawoczenski et al., 2016; 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; Tengman et al., 2015; Westin et al., 2018; Zellers et al., 2018; J. A. Zellers et al., 2020) and healthy populations ( n = 17, 48.6%) (Arch et al., 2018; Byrne et al., 2017; DeWolf et al., 2018; Haber et al., 2004; Hébert‐Losier & Holmberg; Hébert‐Losier et al., 2012; Hébert‐Losier et al., 2011; Jan et al., 2005; Lunsford & Perry, 1995; Möller et al., 2005; Österberg et al., 1998; Pereira et al., 2010; Sara et al., 2021; Sman et al., 2014; Svantesson, Osterberg, Grimby, & Sunnerhagen, 1998; Svantesson, Osterberg, Thomeé, et al., 1998; J.…”

“…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).…”

“…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.…”

“…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.…”

“…Brorsson et al, 2021;A. Brorsson et al, 2017;Häggmark et al, 1986;Hamrin et al, 2020;Nawoczenski et al, 2016;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;Tengman et al, 2015;Westin et al, 2018;Zellers et al, 2018;J. A. Zellers et al, 2020) and healthy populations (n = 17, 48.6%) (Arch et al, 2018;Byrne et al, 2017;DeWolf et al, 2018;Haber et al, 2004;Hébert-Losier & Holmberg;Hébert-Losier et al, 2012;Hébert-Losier et al, 2011;Jan et al, 2005;Lunsford & Perry, 1995;Möller et al, 2005;Österberg et al, 1998;Pereira et al, 2010;Sara et al, 2021;Sman et al, 2014;Svantesson, Osterberg, Grimby, & Sunnerhagen, 1998;Svantesson, Osterberg, Thomeé, et al, 1998;J.…”