title: Clinical outcome of exercise therapy and early post-operative rehabilitation for treatment of neglected Achilles tendon rupture: a randomized study.
abstract: OBJECTIVE
  Treatment of neglected Achilles tendon rupture is very challenging. This randomized study aimed to compare the clinical outcome of early post-operative rehabilitation (EPR) with post-operative cast immobilization (PCI).
  
  
  METHODS
  Fifty-seven patients with neglected Achilles tendon rupture were randomized to receive EPR (n = 26) or PCI (n = 31) management following surgery. Clinical outcome was monitored by follow-up at weeks 8, 12, 18 and 26 and year 2. The significance of intergroup differences from the Leppilahti scoring system (LSS), ultrasonography, multislice spiral computerized tomography (MSCT) and electromyography was assessed.
  
  
  RESULTS
  Ultrasonography and MSCT revealed no occurrence of tendon elongation or adhesion. Four patients could perform sustained single-leg heel-raise exercise for 60 s at post-operative day 40. The PCI group also showed increased post-operative LSS score, but recovery was slower. Post-operative complications, such as ankle joint ankylosis and osteoporosis, only occurred in the PCI group.
  
  
  CONCLUSIONS
  Compared with cast immobilization, early post-operative rehabilitation results in better clinical outcome and faster overall tendon regeneration of neglected Achilles tendon rupture.
  
  
  METHODS
  II.
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Jiasharete
authors.initials: J
authors.lastname: Jielile
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Ayinazi
authors.initials: A
authors.lastname: Badalihan
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Bayixiati
authors.initials: B
authors.lastname: Qianman
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Tuerde
authors.initials: T
authors.lastname: Satewalede
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Jianati
authors.initials: J
authors.lastname: Wuerliebieke
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Mailamuguli
authors.initials: M
authors.lastname: Kelamu
authors.affiliation: Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China. jingping-bai@163.com.
authors.forename: Ayidaer
authors.initials: A
authors.lastname: Jialihasi
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000328:Adult; D002370:Casts, Surgical; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012421:Rupture / Q000534:rehabilitation / Q000601:surgery*; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome
keywords: Exercise; Kazakh medicine; Mechanobiology; Neglected Achilles tendon rupture; Tendon regeneration; Yurt-bone suture