Relationship between recovery of calf-muscle biomechanical properties and gait pattern following surgery for achilles tendon rupture.
BACKGROUND
The relationship between ankle plantar flexor biomechanical properties and gait pattern following surgery for acute rupture of the Achilles tendon has not yet been fully investigated.


METHODS
Forty-nine young adults (27 men and 22 women) who underwent surgical repair of a complete Achilles tendon rupture were evaluated at 3, 6, 12 and 24 months by clinical assessment, biomechanical evaluation and gait analysis.


RESULTS
Ankle range of motion, plantar flexor passive stiffness and concentric strength were recovered within 12 months. Gait abnormalities related to these factors took longer to disappear owing to the presence of anomalous muscle patterns. At 24 months, a deficit in calf-muscle eccentric strength was still present, determining adaptive changes in gait strategy that involved ankle motion and coordinated muscular activity.


CONCLUSIONS
Improvement of gait pattern is slower than recovery of plantar flexor mechanical properties. Persisting mechanical impairment resulting in gait adaptations may be detrimental to the healing structures by increasing stress on the Achilles tendon. Restoration of calf-muscle eccentric strength and coordinated antagonist muscle activity should be key points in postoperative rehabilitation following surgical repair of Achilles tendon rupture.
Don
Romildo
R
Department of Physical Medicine and Rehabilitation, La Sapienza University, Rome, Italy. romildodon@inwind.it
Ranavolo
Alberto
A
Cacchio
Angelo
A
Serrao
Mariano
M
Costabile
Francesca
F
Iachelli
Massimo
M
Camerota
Filippo
F
Frascarelli
Massimo
M
Santilli
Valter
V
D000125:Achilles Tendon / Q000473:pathology*; D000328:Adult; D001265:Athletic Injuries; D001696:Biomechanical Phenomena / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000473:pathology; D009132:Muscles / Q000473:pathology*; D012421:Rupture / Q000503:physiopathology; D013997:Time Factors