본문 바로가기
KERD
논문KCI 등재

아킬레스건 파열 이후의 능동적인 관절 범위 운동이 없는 간단한 재활 운동 방법

Simple Postoperative Exercise of Acute Achilles Tendon Rupture without Active Range of Motion Exercise

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient’s return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of mo- tion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann–Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statisti- cal difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate

Abstract

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient’s return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of mo- tion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann–Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statisti- cal difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate

참고문헌 (20)

  1. Amar A. Suchak, "The Incidence of Achilles Tendon Ruptures in Edmonton, Canada", Foot Ankle Int, 26(11), pp.932~936 (2005), SAGE Publications[DOI]
  2. Julian F. Maempel, "Operative repair of acute Achilles tendon rupture does not give superior patient-reported outcomes to nonoperative management", Bone Joint J, 102-B(7), pp.933~940 (2020), British Editorial Society of Bone & Joint Surgery[DOI]
  3. Heath P. Gould, "Postoperative Rehabilitation Following Achilles Tendon Repair: A Systematic Review", Sports Medicine and Arthroscopy Review, 29(2), pp.130~145 (2021), Ovid Technologies (Wolters Kluwer Health)[DOI]
  4. R McCormack, "Early functional rehabilitation or cast immobilisation for the postoperative management of acute Achilles tendon rupture? A systematic review and meta-analysis of randomised controlled trials", British Journal of Sports Medicine, 49(20), pp.1329~1335 (2015), BMJ[DOI]
  5. B. Frankewycz, "Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine?", Archives of Orthopaedic and Trauma Surgery, 137(3), pp.333~340 (2017), Springer Science and Business Media LLC[DOI]
  6. Uk Kim, "Early rehabilitation after open repair for patients with a rupture of the Achilles tendon", Injury, 48(7), pp.1710~1713 (2017), Elsevier BV[DOI]
  7. Kelechi R. Okoroha, "Comparison of Tendon Lengthening With Traditional Versus Accelerated Rehabilitation After Achilles Tendon Repair: A Prospective Randomized Controlled Trial", The American Journal of Sports Medicine, 48(7), pp.1720~1726 (2020), SAGE Publications[DOI]
  8. Anna E. Röell, "Rehabilitation After Surgical Repair of Acute Achilles Tendon Rupture: Functional Outcome With a Minimum Follow-Up of 6 Months", The Journal of Foot and Ankle Surgery, 60(3), pp.482~488 (2021), Elsevier BV[DOI]
  9. Kars P. Valkering, "Functional weight-bearing mobilization after Achilles tendon rupture enhances early healing response: a single-blinded randomized controlled trial", Knee Surgery, Sports Traumatology, Arthroscopy, 25(6), pp.1807~1816 (2016), Wiley[DOI]
  10. Ki Won Lee, "Immediate Weightbearing and Ankle Motion Exercise After Acute Achilles Tendon Rupture Repair", The Journal of Foot and Ankle Surgery, 61(3), pp.604~608 (2022), Elsevier BV[DOI]
  11. Alexandra Soroceanu, "Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a metaanalysis of randomized trials", Journal of Bone and Joint Surgery, 94(23), pp.2136~2143 (2012), Ovid Technologies (Wolters Kluwer Health)[DOI]
  12. Tomas Movin, "Acute Rupture of the Achilles Tendon", Foot and Ankle Clinics, 10(2), pp.331~356 (2005), Elsevier BV[DOI]
  13. Umile Giuseppe Longo, "No Influence of Age, Gender, Weight, Height, and Impact Profile in Achilles Tendinopathy in Masters Track and Field Athletes", The American Journal of Sports Medicine, 37(7), pp.1400~1405 (2009), SAGE Publications[DOI]
  14. A. Notarnicola, "Overload and neovascularization of Achilles tendons in young artistic and rhythmic gymnasts compared with controls: an observational study", MUSCULOSKELETAL SURGERY, 98, pp.115~120 (2013), Springer Science and Business Media LLC[DOI]
  15. Inglis AE, "Ruptures of the tendo achillis. An objective assessment of surgical and non-surgical treatment", J Bone Joint Surg Am, 58, pp.990~993 (1976)
  16. D. Jacobs, "Comparison of conservative and operative treatment of Achilles tendon rupture", The American Journal of Sports Medicine, 6(3), pp.107~111 (1978), SAGE Publications[DOI]
  17. L. C. Maxwell, "Immobilization‐induced muscle atrophy is not reversed by lengthening the muscle", The Anatomical Record, 234(1), pp.55~61 (1992), Wiley[DOI]
  18. J. Rantanen, "Calf muscle atrophy and Achilles tendon healing following experimental tendon division and surgery in rats. Comparison of postoperative immobilization of the muscletendon complex in relaxed and tensioned positions", Scand J Med Sci Sports, 9(1), pp.57~61 (1999), Wiley[DOI]
  19. Xuan Liu, "Early functional rehabilitation compared with traditional immobilization for acute Achilles tendon ruptures: a meta-analysis", Bone Joint J, 103-B(6), pp.1021~1030 (2021), British Editorial Society of Bone & Joint Surgery[DOI]
  20. Mario Mosconi, "Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? Clinical, Ultrasonographic, and Elastographic Comparison", Diagnostics, 12(8), pp.1824~ (2022), MDPI AG[DOI]

관련 논문AI추천

이 간행물의 다른 논문 (6건)