Sophie Zhu, Josh Garofalo, Monther Abuhantash, Sheila McRae, Peter MacDonald, Rob Longstaffe, Dan Ogborn
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The secondary objective was to assess the degree of association between AT morphology and performance outcomes.</p><p><strong>Study design: </strong>Retrospective cohort with a single prospective evaluation.</p><p><strong>Methods: </strong>All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance.</p><p><strong>Results: </strong>Affected limb AT was elongated and thickened (p\\<0.01), gastrocnemius was atrophied (p\\< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance.</p><p><strong>Conclusions: </strong>Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144663/pdf/","citationCount":"0","resultStr":"{\"title\":\"Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures.\",\"authors\":\"Sophie Zhu, Josh Garofalo, Monther Abuhantash, Sheila McRae, Peter MacDonald, Rob Longstaffe, Dan Ogborn\",\"doi\":\"10.26603/001c.117549\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes.</p><p><strong>Study design: </strong>Retrospective cohort with a single prospective evaluation.</p><p><strong>Methods: </strong>All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance.</p><p><strong>Results: </strong>Affected limb AT was elongated and thickened (p\\\\<0.01), gastrocnemius was atrophied (p\\\\< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance.</p><p><strong>Conclusions: </strong>Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. 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引用次数: 0
摘要
背景：虽然关于跟腱（AT）断裂（ATR）的手术治疗（OM）与非手术治疗（NOM）的相对益处仍存在争议，但很少有研究对跳跃和跳跃等高冲击力动作的影响进行研究。次要目标是评估AT形态与表现结果之间的关联程度：研究设计：具有单一前瞻性评估的回顾性队列：所有患者均在一家机构的二级医疗中心接受治疗。符合条件的参与者（n=12 OM；12 NOM）在受伤后三周内接受了ATR的OM或NOM治疗，并在ATR后至少20个月接受了评估。通过 B 型超声波对 AT 长度、厚度和腓肠肌厚度进行评估。完成了等速跖屈肌力量、跳跃测试、反向运动和落跳。对所有测试的单侧值进行了双向方差分析，对双侧结果进行了独立t检验，并进行了线性回归以评估归一化AT长度与成绩之间的关系：结果：受累肢体AT变长变粗（p/Conclusions：尽管存在跖屈无力、腓肠肌萎缩和助行肌伸长，但跳跃测试的成绩仍能保持。这可能是代偿运动模式的结果。跖屈肌长度对跖屈肌力量的解释力有限，但这种关系应进一步评估：证据等级：III 级。
Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures.
Background: While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping.
Hypothesis/purpose: The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes.
Study design: Retrospective cohort with a single prospective evaluation.
Methods: All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance.
Results: Affected limb AT was elongated and thickened (p\<0.01), gastrocnemius was atrophied (p\< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance.
Conclusions: Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further.
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