The Acute Effect Comparisons of Manual Therapy Or Ankle Motion in Individuals Who Had Achilles Tendon Repair

Hacettepe University

Status: Enrolling

Conditions: Achilles Tendon Rupture; Functional Performance

Treatments: Other: Ankle mobilisation; Other: Compressive Myofascial Release

Study type: Interventional

Funder types: Other

Identifiers

NCT06112288

Achilles2023

Details and patient eligibility

About

Achilles tendon rupture is common among physically active individuals. Limitations, decreases in the level of standing on heel rise, and due to these limitations, failures in functional activities such as returning to sports, walking, running, jumping and performance tests are observed. Manual therapy methods included in rehabilitation programs are an effective option in solving these problems. The aim of the study is to investigate the effects of Compressive Myofascial Release and Ankle joint mobilization on ankle joint movement, functional tests, elasticity and stiffness of the muscle-tendon complex and muscle tone parameters in individuals who underwent Achilles tendon repair.

Full description

Achilles tendon rupture is common among physically active individuals. It has been reported that 73% of all Achilles tendon ruptures are sports-related and injuries frequently occur between the ages of 30-49. Conservative or surgical treatments can be applied after Achilles tendon ruptures. After Achilles tendon injuries and repair, decreases in Soleus muscle strength and endurance, changes in lower extremity muscle activation levels, decreases in Gastro-Soleus muscle circumference, increase in Achilles tendon thickness and stiffness, decreases in elasticity, elongations in the Achilles tendon, ankle dorsiflexion range of motion. Limitations, decreases in the level of standing on heel rise, and due to these limitations, failures in functional activities such as returning to sports, walking, running, jumping and performance tests are observed. Manual therapy methods included in rehabilitation programs are an effective option in solving these problems. The aim of the study is to investigate the effects of Compressive Myofascial Release and Ankle joint mobilization on ankle joint movement, functional tests, elasticity and stiffness of the muscle-tendon complex and muscle tone parameters in individuals who underwent Achilles tendon repair. Compressive myofascial release will be applied to a group that has undergone Achilles tendon repair surgery, and ankle mobilization will be applied to another group. Muscle-tendon passive mechanical properties will be evaluated with Myoton-3 before and after the applications. Toe elevation level, ankle joint range of motion and Achilles tendon rest angle will be evaluated before and after the application.

Enrollment: 20 estimated patients

Sex: Male

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• • Being male between the ages of 18-55,

  • Having unilateral Achilles tendon repair performed for at least 6 months,
  • No open wound,
  • No history of fracture accompanying Achilles injury.

Exclusion criteria

• • Presence of a history of repeated Achilles tendon rupture,

  • Having a rupture or tendon injury on the contralateral side,
  • Having a neurological deficit,
  • Having a history of injury in any of the lower extremity joints for the last 1 year,
  • Having a history of surgery other than Achilles tendon repair in any of the lower extremities,
  • Having a history of corticosteroids applied to the Achilles tendon,

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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20 participants in 2 patient groups

Compressive myofascial release (cmr)

Experimental group

Description:

Participants in the CMR group were instructed to lie prone on the treatment table with their feet off the end of the table. The clinician began the treatment by bending the knee to 90° and shaking the muscle belly of the triceps surae group for 30 seconds. Next, the knee was fully extended, and CMR was performed on the medial and lateral sides of the Achilles tendon for 1 minute, followed by the musculotendinous junction for 2 minutes. Treatment consisted of broad strokes applied with the clinician's knuckles to release superficial restrictions, followed by more specific strokes applied with the clinician's thumb to any located restrictions. Strokes were applied at a contact point of 45° to the tissue, with pressure directed from distal to proximal. At the end of the intervention, the clinician shook the belly of the triceps surae complex for 30 seconds. The same examiner (T.S.) applied all CMR treatments.

Treatment:

Other: Compressive Myofascial Release

ankle mobilization

Experimental group

Description:

The joint mobilization group received two sets of ankle joint mobilizations. Each set consisted of two-minutes of Grade III anterior-to-posterior talocrural joint mobilizations with a one-minute rest between sets with the patient in a long-sitting position. This mobilization was operationally defined as large-amplitude, one-second rhythmic oscillations from the mid- to end ROM with translation taken to tissue resistance

Treatment:

Other: Ankle mobilisation