A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture.
Studies evaluating treatment effects on muscle function after an Achilles tendon rupture often use various tests for evaluating calf muscle strength. However, these tests rarely demonstrate the difference between treatment groups; therefore, new tests with a higher ability to detect possible differences in outcome are needed. The purpose of this study was to evaluate the validity and ability to detect differences in outcome of a heel-rise work test that would measure both the height of each heel-rise and the number of repetitions. Seventy-eight patients (65 men and 13 women) at a mean (standard deviation) age of 42 (9) years with Achilles tendon ruptures were included. The patients were evaluated with the new heel-rise test at 6 and 12 months after injury. The limb symmetry index (LSI = involved/uninvolved x 100) was calculated to determine the size of the difference in function between the injured and the uninjured side. The heel-rise height differed significantly between the injured and uninjured sides at the 6- and 12-month evaluations (P < 0.001). At the 6-month evaluation, the patients had achieved a mean LSI of 84% on the number of repetitions parameter but only a mean LSI of 61% on the work parameter. At the 12-month evaluation the mean, LSI of the heel-rise repetition parameter was 95%, indicating that the patients had fully recovered function, but on the work parameter the mean LSI was only 76%. The heel-rise work test in the present study has good validity and greater ability to detect differences between the injured and the uninjured sides than a test that measures only the number of heel-rise repetitions in patients with Achilles tendon rupture.
Silbernagel
Karin Grävare
KG
Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. karin.gravare-silbernagel@orthop.gu.se
Nilsson-Helander
Katarina
K
Thomeé
Roland
R
Eriksson
Bengt I
BI
Karlsson
Jón
J
D000125:Achilles Tendon / Q000293:injuries* / Q000503:physiopathology; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010807:Physical Endurance; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012422:Rupture, Spontaneous
Arch Phys Med Rehabil. 1982 Apr;63(4):171-5
7082141
J Bone Joint Surg Am. 1981 Mar;63(3):394-9
7204438
J Bone Joint Surg Am. 1999 Jul;81(7):983-90
10428130
Clin Orthop Relat Res. 2006 Apr;445:216-21
16456316
Scand J Med Sci Sports. 2002 Feb;12(1):9-16
11985760
Scand J Rehabil Med. 1998 Jun;30(2):67-72
9606767
Am J Sports Med. 2007 Jan;35(1):59-64
16973901
Clin J Sport Med. 1997 Jul;7(3):207-11
9262889
Cochrane Database Syst Rev. 2004;(3):CD003674
15266495
Am J Sports Med. 2002 Nov-Dec;30(6):783-90
12435641
BMC Musculoskelet Disord. 2007 Nov 26;8:116
18039357
Am J Sports Med. 2007 Mar;35(3):421-6
17158277
J Bone Joint Surg Am. 2008 Sep;90(9):1876-83
18762647
Clin Sports Med. 1992 Jul;11(3):533-78
1638640
Orthopedics. 1992 Aug;15(8):899-903
1508765
Curr Opin Rheumatol. 2001 Mar;13(2):150-5
11224740
Am J Sports Med. 2000 Jul-Aug;28(4):499-505
10921640
Foot Ankle Int. 2005 Nov;26(11):932-6
16309606
J Trauma. 2003 Jun;54(6):1171-80; discussion 1180-1
12813340
J Bone Joint Surg Br. 2001 Aug;83(6):843-8
11521926
Clin Orthop Relat Res. 1998 Jan;(346):152-61
9577423
Orthopedics. 1986 Feb;9(2):160-4
3960758
Foot Ankle Clin. 2005 Jun;10(2):371-82
15922925
Am J Sports Med. 2003 Sep-Oct;31(5):685-91
12975187
Knee Surg Sports Traumatol Arthrosc. 2005 Jan;13(1):60-71
14634720
Am J Sports Med. 2006 Jul;34(7):1120-5
16476917
Injury. 1998 Nov;29(9):651-4
10211195
Clin Orthop Relat Res. 2002 Jul;(400):190-200
12072762
Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1207-17
16858560
Foot Ankle Clin. 2005 Jun;10(2):331-56
15922923
Knee Surg Sports Traumatol Arthrosc. 2008 Jun;16(6):614-20
18273601
J Bone Joint Surg Am. 2005 Oct;87(10):2202-10
16203884
Clin Biomech (Bristol, Avon). 2007 Feb;22(2):211-20
17126970