Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
J Orthop Res. 2013 Sep;31(9):1469-74. doi: 10.1002/jor.22381. Epub 2013 May 6.
We compared the effects of a non-weight bearing protocol (NWB) and a weight bearing (WB) protocol on energy stored, stiffness, and shock absorption in the plantar flexor muscle-tendon unit of patients managed non-operatively following an Achilles tendon rupture. Thirty-eight subjects were randomized to a WB cast fitted with a Bohler iron or a traditional non-weight-bearing cast. At a 6-month follow-up, a biomechanical assessment utilizing an isokinetic dynamometer allowed measurement of peak passive torque, energy stored, shock absorption, and stiffness. The WB group had greater peak passive torque (≈ 20%). Irrespective of group, peak passive torque in unaffected legs was greater (≈ 26%) than affected legs. Across the groups, energy stored in the NWB group was 74% of the WB group. The energy stored in affected legs was 80% of that in unaffected legs. Shock absorption was not significantly different across legs or groups. Irrespective of group, affected legs had significantly less stiffness (20-40%). While the augmentation of plaster with a Bohler iron to allow increased weight bearing had positive effects, deficits in affected compared to unaffected legs irrespective of group were notable, and should be addressed prior to participation in vigorous physical activities.
我们比较了非负重方案（NWB）和负重方案（WB）对未经手术治疗的跟腱断裂患者的跖屈肌-肌腱单位的储能、刚度和减震效果的影响。38 名受试者随机分为佩戴伯勒铁或传统非负重石膏的 WB 石膏组。在 6 个月的随访中，使用等速测力计进行生物力学评估，可测量峰值被动扭矩、储能、减震和刚度。WB 组的峰值被动扭矩（约 20%）较大。无论组别如何，未受伤腿的峰值被动扭矩（约 26%）均大于受伤腿。在所有组中，NWB 组的储能为 WB 组的 74%。受伤腿的储能为未受伤腿的 80%。减震在腿和组之间没有显著差异。无论组别如何，受伤腿的刚度明显降低（20-40%）。虽然用伯勒铁增强石膏以允许增加负重有积极的影响，但无论组别如何，受伤腿与未受伤腿相比存在明显的缺陷，在参与剧烈体育活动之前应加以解决。
