Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Israel.
The Academic College Levinsky-WIngate, Wingate Campus, Netanya, Israel.
Musculoskelet Sci Pract. 2024 Nov;74:103197. doi: 10.1016/j.msksp.2024.103197. Epub 2024 Sep 27.
To determine the relationship between Achilles tendon (AT) structure, functional ability and chronic ankle instability (CAI) in military recruits.
Three hundred and sixty newly recruited infantry male soldiers recruited in April 2022 were assessed for AT structure by Ultrasound Tissue Characterization (UTC), for functional abilities (included proprioception ability, heel-raise test, dynamic postural balance, and hopping agility ability) and for CAI (recurrent sprains and a positive perceived instability).
Soldiers that were identified with disorganized tendon had significantly lower heel-raise and agility scores compared to those with organized tendon structures (33.6 ± 18.1(n) vs. 49.9 ± 28.9(n), p < 0.001; and 5.39 ± 2.12(n) vs. 6.16 ± 1.90(n), p = 0.002, respectively). The best discriminator between soldiers with organized vs. disorganized structure, was heel-raise test (AUC = 0.741). Moreover, soldiers with disorganized AT structure had a higher prevalence of CAI compared with those with organized tendon structures (p < 0.05).
Recruits with disorganized tendon structures displayed reduced heel-raise score, agility ability and dynamic postural-balance and greater ankle instability. Inferior tendon quality at the onset of military service is an important physical indicator to consider when seeking to manage future injuries and potential for physical performance. Pre-recruitment screening of the AT structure, CAI, and functional abilities, especially in high-intensity infantry programs, needs to be considered.
探讨新兵跟腱（AT）结构、功能能力与慢性踝关节不稳定（CAI）之间的关系。
2022 年 4 月招募的 360 名新兵步兵男性士兵，通过超声组织特征化（UTC）评估 AT 结构，评估功能能力（包括本体感觉能力、跟腱抬高试验、动态姿势平衡和跳跃敏捷能力）和 CAI（复发性扭伤和感知不稳定）。
与具有组织化肌腱结构的士兵相比，具有紊乱肌腱结构的士兵跟腱抬高和敏捷评分显著降低（33.6±18.1(n) vs. 49.9±28.9(n)，p<0.001；5.39±2.12(n) vs. 6.16±1.90(n)，p=0.002）。组织化与紊乱结构之间士兵的最佳鉴别特征是跟腱抬高试验（AUC=0.741）。此外，与组织化肌腱结构的士兵相比，具有紊乱 AT 结构的士兵 CAI 发生率更高（p<0.05）。
新兵具有紊乱的肌腱结构时，跟腱抬高评分、敏捷能力和动态姿势平衡降低，踝关节不稳定度增加。在兵役开始时，跟腱结构紊乱、CAI 和功能能力较差是考虑未来受伤和身体表现潜力的重要身体指标。需要考虑对 AT 结构、CAI 和功能能力进行预征兵筛查，尤其是在高强度步兵计划中。
