Marcolin Giuseppe, Buriani Alessandro, Balasso Alberto, Villaminar Renato, Petrone Nicola
Senior Research Scientist, Biomechanical Laboratory for Physical Therapy and Rehabilitation, Data Medica Padova s.p.a., Padova, Italy.
Head of Research and Development, Gruppo Data Medica Padova s.p.a., Padova, Italy.
J Foot Ankle Surg. 2015 Mar-Apr;54(2):247-50. doi: 10.1053/j.jfas.2014.11.014. Epub 2015 Jan 23.
Achilles tendon rupture is a disabling injury that requires a long recovery time. We describe a unique case of a 46-year-old male who had undergone gait analysis as part of a personal physical examination and who, 16 months later, ruptured his left Achilles tendon while running. With gait kinematic and kinetic data available both before and after his injury, we determined the residual gait asymmetries on his uninjured side and compared the pre- and postinjury measurements. We analyzed his gait at 1, 4, and 7 weeks after his return to full weightbearing. Compared with the preinjury values, at 7 weeks he had almost complete range of motion in his left ankle (-2%) and a slight increase in gait velocity (+6%) and cadence (+3%). The peak power of his injured ankle was 90% of its preinjury value. In contrast, the unaffected ankle was at 118%. These observations suggest that measuring the asymmetries of the gait cycle, especially at the beginning of rehabilitation, can be used to improve treatment. We had the patient strengthen his ankle using a stationary bicycle before he returned to running. Kinetics also appears to be more powerful than kinematics in detecting functional asymmetries associated with reduced calf strength, even 15 weeks after surgery. Gait analysis could be used to predict the effectiveness of rehabilitation protocols and help calibrate and monitor the return to sports participation while preventing overloading muscle and tendon syndromes.
跟腱断裂是一种致残性损伤，需要很长的恢复时间。我们描述了一个独特的病例，一名46岁男性，他在一次个人体检中进行了步态分析，16个月后，在跑步时左跟腱断裂。由于其受伤前后都有步态运动学和动力学数据，我们确定了其未受伤侧残留的步态不对称性，并比较了受伤前后的测量结果。我们在他恢复完全负重后的1周、4周和7周分析了他的步态。与受伤前的值相比，在7周时，他的左脚踝几乎有完整的活动范围（-2%），步态速度略有增加（+6%），步频增加（+3%）。受伤脚踝的峰值功率为受伤前值的90%。相比之下，未受影响的脚踝为118%。这些观察结果表明，测量步态周期的不对称性，尤其是在康复开始时，可用于改善治疗。在患者恢复跑步之前，我们让他使用固定自行车来增强脚踝力量。即使在手术后15周，动力学在检测与小腿力量减弱相关的功能不对称方面似乎也比运动学更有效。步态分析可用于预测康复方案的有效性，并有助于校准和监测恢复运动参与的情况，同时防止肌肉和肌腱综合征的过度负荷。
