Salsich Gretchen B, Mueller Michael J, Hastings Mary K, Sinacore David R, Strube Michael J, Johnson Jeffrey E
Department of Physical Therapy, Saint Louis University, 3437 Caroline Street, St Louis, MO 63104, USA.
Phys Ther. 2005 Jan;85(1):34-43.
The effect of a tendo-Achilles lengthening (TAL) procedure on ankle muscle performance has not been clearly established. The purpose of this study was to compare the effects of TAL and total-contact casting (TCC) with TCC alone on ankle muscle performance in subjects with diabetes mellitus (DM) and a neuropathic plantar ulcer.
Subjects were randomly assigned to either a TAL group (3 female and 12 male subjects) or a TCC group (4 female and 10 male subjects).
Muscle performance measurements were obtained using an isokinetic dynamometer.
Concentric plantar-flexor peak torque decreased 31% after TAL but returned to the baseline level after 8 months. Dorsiflexor peak torque did not change in either group. Plantar-flexor passive torque at 0 degrees of dorsiflexion decreased after TAL but increased to 60% of the baseline level after 8 months. Maximal dorsiflexion angle increased 11 degrees after TAL and remained increased at 8 months.
The TAL resulted in an increase in ankle dorsiflexion range of motion and a temporary reduction in concentric plantar-flexor peak torque and passive torque at 0 degrees of dorsiflexion. If TAL is being considered for people with DM and a neuropathic forefoot ulcer, the initial compromise in plantar-flexor muscle performance should be addressed.
跟腱延长术（TAL）对踝关节肌肉功能的影响尚未明确。本研究旨在比较TAL联合全接触石膏固定（TCC）与单纯TCC对糖尿病（DM）合并神经性足底溃疡患者踝关节肌肉功能的影响。
受试者被随机分为TAL组（3名女性和12名男性）或TCC组（4名女性和10名男性）。
使用等速测力计测量肌肉功能。
TAL后，向心跖屈峰值扭矩下降31%，但8个月后恢复至基线水平。两组的背屈峰值扭矩均未改变。TAL后，背屈0度时的跖屈被动扭矩下降，但8个月后增加至基线水平的60%。TAL后最大背屈角度增加11度，并在8个月时保持增加。
TAL导致踝关节背屈活动范围增加，以及背屈0度时向心跖屈峰值扭矩和被动扭矩暂时降低。如果考虑对DM合并神经性前足溃疡患者进行TAL，应解决跖屈肌功能最初的下降问题。
