Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Hospital Mater Dei, Belo Horizonte, MG, Brazil.
Braz J Phys Ther. 2017 Jan-Feb;21(1):51-57. doi: 10.1016/j.bjpt.2016.12.004. Epub 2017 Jan 14.
Deficits in ankle muscle strength and ankle stiffness may be present in those subjects who underwent surgical treatment for an Achilles tendon rupture. The presence of these long-term deficits may contribute to a lower performance during daily activities and may be linked to future injuries.
To compare the ankle passive stiffness and the plantar flexor muscle performance in patients who underwent unilateral surgical treatment of Achilles tendon rupture with nonsurgical subjects.
Twenty patients who underwent unilateral surgical treatment of Achilles tendon rupture [surgical (SU) group], and twenty nonsurgical subjects [non-surgical (NS) group] participated in this study. The ankle passive stiffness was evaluated using a clinical test. The concentric and eccentric plantar flexors performance (i.e. peak torque and work) was evaluated using an isokinetic dynamometer at 30°/s.
The surgical ankle of the surgical group presented lower stiffness compared to the non-surgical ankle (mean difference=3.790; 95%CI=1.23-6.35) and to the non-dominant ankle of the non-surgical group (mean difference=-3.860; 95%CI=-7.38 to -0.33). The surgical group had greater absolute asymmetry of ankle stiffness (mean difference=-2.630; 95%CI=-4.61 to -0.65) and greater absolute asymmetry of concentric (mean difference=-8.3%; 95%CI=-13.79 to -2.81) and eccentric (mean difference=-6.9%; 95%CI=-12.1 to -1.7) plantar flexor work compared to non-surgical group. There was no other difference in stiffness and plantar flexor performance.
Patients who underwent surgical repair of the Achilles tendon presented with long-term (1 year or more) deficits of ankle stiffness and asymmetries of ankle stiffness and plantar flexor work in the affected ankle compared to the uninjured side in the surgical group and both sides on the nonsurgical group.
在接受跟腱断裂手术治疗的患者中，可能存在踝关节肌肉力量和踝关节僵硬的缺陷。这些长期缺陷的存在可能会导致日常活动中的表现下降，并可能与未来的损伤有关。
比较接受单侧跟腱断裂手术治疗的患者和非手术患者的踝关节被动刚度和跖屈肌性能。
20 名接受单侧跟腱断裂手术治疗的患者（手术组，SU 组）和 20 名非手术患者（非手术组，NS 组）参与了这项研究。使用临床测试评估踝关节被动刚度。使用等速测力计在 30°/s 的角速度下评估跖屈肌的向心和离心性能（即峰值扭矩和功）。
手术组的手术踝关节与非手术踝关节（平均差异=3.790；95%CI=1.23-6.35）和非手术组的非优势踝关节（平均差异=-3.860；95%CI=-7.38 至-0.33）相比，刚度较低。手术组的踝关节刚度绝对不对称性更大（平均差异=-2.630；95%CI=-4.61 至-0.65），且在向心（平均差异=-8.3%；95%CI=-13.79 至-2.81）和离心（平均差异=-6.9%；95%CI=-12.1 至-1.7）跖屈肌功方面的绝对不对称性也更大，与非手术组相比。在刚度和跖屈肌性能方面没有其他差异。
与手术组的未受伤侧和非手术组的双侧相比，接受跟腱修复手术的患者在手术侧踝关节存在长期（1 年或更长时间）的踝关节刚度缺陷和踝关节刚度及跖屈肌功的不对称性。
