title: Medial Gastrocnemius Myotendinous Junction Displacement and Plantar-Flexion Strength in Patients Treated With Immediate Rehabilitation After Achilles Tendon Repair.
abstract: BACKGROUND
  Pathologic plantar flexion frequently occurs after operative repair of the Achilles tendon (AT) because of immobilization and non-weight bearing in the first weeks of traditional rehabilitation. Novel rehabilitation strategies that apply mobilization and weight bearing have been proposed, but their effects on medial gastrocnemius myotendinous junction displacement (MJD) and isometric plantar-flexion strength (PFS) are unknown.
  
  
  OBJECTIVE
  To compare the effects of 12 weeks of immediate versus traditional rehabilitation on MJD and PFS in patients with percutaneous AT repair and to compare AT rupture scores (ATRSs) during follow-up.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Human performance laboratory.
  
  
  METHODS
  A total of 26 amateur soccer players (age = 42.3 ± 9.7 years, body mass index = 29.5 ± 3.9 kg/m2) with percutaneous AT repair.
  
  
  METHODS
  Athletes were randomly divided into 2 groups: an immediate group, given physical therapy from day 1 to day 84, and a traditional group, given physical therapy from day 29 to day 84. We used repeated-measures analysis of variance to compare the data.
  
  
  METHODS
  We measured MJD and PFS at days 28 (fourth week), 56 (eighth week), and 84 (12th week) after AT repair.
  
  
  RESULTS
  After 12 weeks of rehabilitation, we observed a large clinically meaningful effect and statistical difference between groups. At day 28, the immediate group showed higher values for PFS (P = .002), MJD (P = .02), and ATRS (P = .002) than the traditional group. At day 56, the immediate group presented higher values for MJD (P = .02) and ATRS (P = .009). At day 84, the immediate group registered more MJD (P = .001).
  
  
  CONCLUSIONS
  Compared with traditional rehabilitation, 12 weeks of immediate rehabilitation after percutaneous AT repair resulted in better MJD, PFS, and ATRS after 4 weeks; better MJD and ATRS after 8 weeks; and better MJD after 12 weeks.
authors.affiliation: Carrera de kinesiología, UDA Cs de la salud, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago.|Facultad Cs de la Rehabilitacion, Universidad Andres Bello, Santiago, Chile.
authors.forename: Carlos I
authors.initials: CI
authors.lastname: De la Fuente
authors.affiliation: Instituto Traumatológico, Santiago, Chile.
authors.forename: Roberto Peña Y
authors.initials: RP
authors.lastname: Lillo
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ramirez-Campillo
authors.affiliation: Vrije University, Amsterdam, The Netherlands.
authors.forename: Pablo
authors.initials: P
authors.lastname: Ortega-Auriol
authors.affiliation: Carrera de kinesiología, UDA Cs de la salud, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Delgado
authors.affiliation: Universidad Metropolitana de ciencias de la Educación, Santiago, Chile.
authors.forename: Joel
authors.initials: J
authors.lastname: Alvarez-Ruf
authors.affiliation: Universidad Iberoamericana, Santiago, Chile.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Carreño
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000328:Adult; D000704:Analysis of Variance; D016512:Ankle Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009142:Musculoskeletal Physiological Phenomena; D019637:Orthopedic Procedures / Q000379:methods; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012421:Rupture / Q000534:rehabilitation; D012916:Soccer / Q000293:injuries; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology
keywords: lower extremity; percutaneous technique; physiotherapy