title: Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence.
abstract: OBJECTIVE
  The optimal treatment for acute Achilles tendon rupture (ATR) is continuously debated. Recent studies have proposed that the choice of either operative or non-operative treatment may not be as important as rehabilitation, suggesting that functional rehabilitation should be preferred over traditional immobilization. The purpose of this meta-analysis of randomized controlled trials (RCTs) was to compare functional rehabilitation to immobilization in the treatment of ATR.
  
  
  METHODS
  This meta-analysis was conducted using the databases: PubMed, EMBASE, Rehabilitation and Sports Medicine Source, AMED, CINAHL, Cochrane Library and PEDro using the search terms: "Achilles tendon," "rupture," "mobilization" and "immobilization". Seven RCTs involving 427 participants were eligible for inclusion, with a total of 211 participants treated with functional rehabilitation and 216 treated with immobilization.
  
  
  RESULTS
  Re-rupture rate, other complications, strength, range of motion, duration of sick leave, return to sport and patient satisfaction were examined. There were no statistically significant differences between groups. A trend favoring functional rehabilitation was seen regarding the examined outcomes.
  
  
  CONCLUSIONS
  Functional rehabilitation after acute Achilles tendon rupture does not increase the rate of re-rupture or other complications. A trend toward earlier return to work and sport, and increased patient satisfaction was found when functional rehabilitation was used. The present literature is of low-to-average quality, and the basic constructs of the examined treatment and study protocols vary considerably. Larger, randomized controlled trials using validated outcome measures are needed to confirm the findings.
  
  
  METHODS
  II.
authors: Physiotherapist at Fysiocenter Århus, Brendstrupgaardsvej 9B 1.005, 8200, Aarhus N, Denmark. t.m.christensen@hotmail.com.
authors: Troels
authors: T
authors: Mark-Christensen
authors: Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark.
authors: Anders
authors: A
authors: Troelsen
authors: Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark.
authors: Thomas
authors: T
authors: Kallemose
authors: Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark.
authors: Kristoffer Weisskirchner
authors: KW
authors: Barfod
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012008:Recurrence; D000068958:Return to Sport; D012421:Rupture / Q000534:rehabilitation*; D018582:Sick Leave; D013708:Tendon Injuries / Q000534:rehabilitation*; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Achilles tendon; Functional rehabilitation; Immobilization; Mobilization; Rupture