Franz Pedro Bainy, de Souza Júnior José Roberto, de Lima Hortência Cordeiro, de Souza Diniz Estevão, de Brito Aguiar Rogério, Geremia Jeam Marcel, Mansur Henrique, de Cássia Marqueti Rita, Durigan João Luiz Quagliotti
Laboratory of Muscle and Tendon Plasticity, Graduate Program in Rehabilitation Science, Faculty of Health Sciences and Technologies, University of Brasília, Brasilia, Brazil.
University Center of the Federal District - UDF, Brasilia, Brazil.
Orthop Surg. 2025 Jul;17(7):2082-2092. doi: 10.1111/os.70082. Epub 2025 May 29.
INTRODUCTION: Acute lateral ankle sprain (LAS) frequently results in persistent functional limitations. Understanding changes in calf muscle and Achilles tendon (AT) stiffness after LAS may shed light on mechanisms underlying impaired function. OBJECTIVE: To investigate the effects of acute LAS on the mechanical properties of the calf muscles and the Achilles tendon, ankle function, pain, edema, and strength. METHODS: This controlled observational study was conducted from August 2023 to January 2025. Fourteen participants with acute LAS and 14 healthy controls were evaluated twice, 6 weeks apart. Shear wave elastography (SWE) assessed the stiffness of the triceps surae and AT. Ankle function, pain, and edema were evaluated using the Foot and Ankle Outcome Score, Visual Analog Scale, and figure-of-eight method. Plantar flexion strength was measured via isometric dynamometry. RESULTS: No significant differences in stiffness were found between or within groups (soleus: p = 0.932; MG: p = 0.760; LG: p = 0.800; AT: p = 0.070), although a time effect (p = 0.005, η = 0.269) indicated a general increase in AT stiffness over time (MD = -0.72, p = 0.05, d = 2.86). At baseline, the LAS group exhibited reduced ankle function (MD = 3.43, p < 0.001, d = 2.20), increased pain (MD = 1.88, p < 0.001, d = 1.86), and greater edema (MD = -51.27, p < 0.001, d = -3.58). Over time, improvements were noted in function (MD = -37.04, p < 0.001, d = 2.27), pain (MD = 2.66, p < 0.001, d = -1.31), and edema (MD = 1.07, p = 0.014, d = -0.95), but ankle function remained lower in the LAS group at follow-up (MD = -14.17, p < 0.001, d = -1.79). For plantar flexion strength, no group × time interaction was found (p = 0.745), but a group effect indicated lower peak torque in the LAS group (MD = -32.05, p = 0.012, d = -3.82). A time effect (p < 0.001, η = 0.622) showed increased torque across both groups (MD = -18.74, p < 0.001, d = 3.07). CONCLUSION: LAS reduces ankle function and leads to pain and edema but does not induce notable changes in calf muscle or AT stiffness within 6 weeks.
引言：急性外侧踝关节扭伤（LAS）常导致持续的功能受限。了解LAS后小腿肌肉和跟腱（AT）僵硬度的变化可能有助于揭示功能受损的潜在机制。 目的：研究急性LAS对小腿肌肉和跟腱的力学性能、踝关节功能、疼痛、水肿和力量的影响。 方法：本对照观察性研究于2023年8月至2025年1月进行。14名急性LAS患者和14名健康对照者接受了两次评估，间隔6周。剪切波弹性成像（SWE）评估了小腿三头肌和AT的僵硬度。使用足踝结局评分、视觉模拟量表和8字形方法评估踝关节功能、疼痛和水肿。通过等长测力法测量跖屈力量。 结果：尽管时间效应（p = 0.005，η = 0.269）表明AT僵硬度随时间总体增加（MD = -0.72，p = 0.05，d = 2.86），但组间或组内僵硬度均无显著差异（比目鱼肌：p = 0.932；内侧腓肠肌：p = 0.760；外侧腓肠肌：p = 0.800；AT：p = 0.070）。基线时，LAS组踝关节功能降低（MD = 3.43，p < 0.001，d = 2.20），疼痛增加（MD = 1.88，p < 0.001，d = 1.86），水肿更严重（MD = -51.27，p <
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