Analyses of Timing of Single Heel Raise and Muscle Power after Achilles Tendon Repair

Seong Mu Cha; Bo Hoon Chang; Jin Soo Suh

doi:10.4055/jkoa.2013.48.2.96

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Cha, Chang, and Suh: Analyses of Timing of Single Heel Raise and Muscle Power after Achilles Tendon Repair

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(2): 96-103.

Published online: 25 April 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.2.96

Analyses of Timing of Single Heel Raise and Muscle Power after Achilles Tendon Repair

Seong Mu Cha, M.D., Bo Hoon Chang, M.D., Jin Soo Suh, M.D.

Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.

Correspondence to: Jin Soo Suh, M.D. Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea. TEL: +82-31-910-7968, FAX: +82-31-910-7967, sjs0506@paik.ac.kr

Received 6 November 2012 Revised 13 December 2012 Accepted 5 February 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to analyze the progress of muscle rehabilitation for patients with acute Achilles tendon rupture, who underwent Achilles tendon repair, checking capable time of single heel raise and isokinetic plantar flexion power.

Materials and Methods

From March 2006 to June 2011, 42 of 81 patients were excluded and the other 39 patients, who underwent surgery due to acute Achilles tendon rupture in our institute, were enrolled in this study. The operation and rehabilitation were constantly performed according to the author's method. Isokinetic plantar flexion power was measured at three months post-operation, capable time of single heel raise was assessed, and clinical results of the last follow up were measured and analyzed.

Results

Single heel raise was possible at an average of 14 weeks and three days, and repetitive single heel raise more than 10 times was possible at an average of 20 weeks. The peak torque of 30°/s plantar flexion was mean 69 Nm. The peak torque of 120°/s was 41 Nm. Assessment at three months post-operation showed 69% power, compared to the contralateral leg. The group of patients who were able to perform single heel raise within three months, showed better Achilles tendon total rupture score and foot and ankle outcome score at last follow up, and showed better plantar flexion power at three months post-operation.

Conclusion

At the last follow up, we can expect better clinical results and muscle power in patients who are able to perform single heel raise early treatment of acute Achilles tendon rupture.

Keywords: Achilles tendon rupture, Achilles tendon repair, rehabilitation of Achilles tendon

Figures and Tables

Figure 1

Capable single heel raise was defined as a heel lift more than two finger breadths for 3 seconds.

Figure 2

Patient's leg was held with knee flexed at 90°, then ankle plantar flexion power was measured using the CYBEX770® system (CYBEX, USA).

Figure 3

Scatter diagrams (y axis: variables of results, x axis: date of single heel raise [SHR]). (A) Peak torque of 30° plantar flexion at three months after the operation. (B) Peak torque of 120° plantar flexion at three months after the operation. (C) Achilles tendon total rupture score (ATRS) of the last follow-up. (D) Foot and ankle outcome score (FAOS) function in daily living (ADL) of the last follow-up.

Table 1

Analysis of Clinical Examination and Muscle Power Test

AOFAS score and Arner-Lindholm score did not differ significantly between the two groups (p=0.408, p=0.271). A statistically significant difference in the ATRS and FAOS (ADL, Sprot & Rec, QOL) was observed between two groups (p=0.012, p=0.012, p=0.039, p=0.009). A statistically significant difference in isokinetic plantar-flexion muscle power (30°/s Torque, 120°/s Torque, Power %) was observed between the two groups (p=0.015, p=0.039, p=0.020). AOFAS, American Orthopedic Foot and Ankle Society; ATRS, Achilles tendon total rupture score; FAOS, foot and ankle outcome score; ADL, function in daily living; Sprot & Res, sports and recreation; QOL, foot - and ankle - related quality of life.

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