Christensen Marianne, Silbernagel Karin Grävare, Zellers Jennifer A, Kjær Inge Lunding, Rathleff Michael Skovdal
Physiotherapy and Occupational Therapy, Aalborg University Hospital, Hobrovej 18-22, Aalborg, 9000, Denmark.
Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Pilot Feasibility Stud. 2024 Apr 22;10(1):66. doi: 10.1186/s40814-024-01494-4.
Long-term strength deficits are common after Achilles tendon ruptures. Early use of progressive resistance exercises may help reduce strength deficits, but the feasibility of this approach is unknown. The aim was to investigate the feasibility of early progressive resistance exercises regarding patient acceptability and compliance with the intervention.
We recruited patients with an acute Achilles tendon rupture treated non-surgically. During 9 weeks of immobilisation with a walking boot, participants attended weekly supervised physiotherapy sessions of progressive resistance exercises and performed home exercises, consisting of isometric ankle plantarflexion, seated heel-rise, and elastic band exercises. Acceptability was evaluated using a 7-point Likert scale (1 = very unacceptable and 7 = very acceptable) with feasibility threshold at 80% of the participants rating ≥ 4. Adherence to the exercises was defined as 80% of the participants performing at least 50% of the home exercises. During the intervention, tendon healing and adverse events were monitored.
Sixteen participants (mean age 46 (range 28-61), male/female = 13/3) completed the intervention. Pre-injury Achilles tendon total rupture score was 98 (SD 8). All participants rated the acceptability of the exercises ≥ 5 (moderate acceptable to very acceptable) at 9- and 13-week follow-up and 9/16 rated 7 points (very acceptable). Participants performed 74% (range 4-117) of the total prescribed home exercises and 15/16 performed > 50%. One participant was not compliant with the home exercises due to feeling uncomfortable performing these independently. There were no re-ruptures, but one case of deep venous thrombosis.
The early progressive resistance exercise program for treatment of non-surgically treated Achilles tendon rupture was feasible. Future studies should investigate the efficacy of the progressive intervention.
The study was registered at Clinical Trials (NCT04121377) on 29 September 2019.
NCT04121377 .
跟腱断裂后长期存在力量不足很常见。早期使用渐进性抗阻训练可能有助于减少力量不足,但这种方法的可行性尚不清楚。目的是研究早期渐进性抗阻训练在患者可接受性和干预依从性方面的可行性。
我们招募了非手术治疗的急性跟腱断裂患者。在使用步行靴固定9周期间,参与者每周参加一次由专业人员指导的渐进性抗阻训练物理治疗课程,并进行家庭训练,包括等长踝跖屈、坐位提踵和弹力带训练。使用7分李克特量表(1 = 非常不可接受,7 = 非常可接受)评估可接受性,可行性阈值为80%的参与者评分≥4分。训练依从性定义为80%的参与者完成至少50%的家庭训练。在干预期间,监测肌腱愈合情况和不良事件。
16名参与者(平均年龄46岁(范围28 - 61岁),男/女 = 13/3)完成了干预。伤前跟腱总断裂评分为98分(标准差8)。所有参与者在9周和13周随访时对训练的可接受性评分≥5分(中度可接受至非常可接受),9/16的参与者评分为7分(非常可接受)。参与者完成了规定家庭训练总量的74%(范围4 - 117),15/16的参与者完成量>50%。一名参与者因独立进行训练时感觉不适而未依从家庭训练。没有再断裂情况,但有1例深静脉血栓形成。
用于治疗非手术治疗跟腱断裂的早期渐进性抗阻训练计划是可行的。未来研究应调查该渐进性干预的疗效。
该研究于2019年9月29日在临床试验注册中心(NCT04121377)注册。
NCT04121377