A Pilot Study of Musculoskeletal Abnormalities in Patients in Recovery from a Unilateral Rupture-Repaired Achilles Tendon

Dong Sun, Gusztáv Fekete, Julien S. Baker, Qichang Mei, Bíró István, Yan Zhang and Yaodong Gu
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Dong Sun: Faculty of Sports Science, Ningbo University, Ningbo 315211, China
Gusztáv Fekete: Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary
Julien S. Baker: Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong 999077, China
Qichang Mei: Faculty of Sports Science, Ningbo University, Ningbo 315211, China
Bíró István: Department of Technology, Faculty of Engineering, University of Szeged, 6727 Szeged, Hungary
Yan Zhang: Faculty of Sports Science, Ningbo University, Ningbo 315211, China
Yaodong Gu: Faculty of Sports Science, Ningbo University, Ningbo 315211, China

IJERPH, 2020, vol. 17, issue 13, 1-20

Abstract: The purpose of this study was to compare the inter-limb joint kinematics, joint moments, muscle forces, and joint reaction forces in patients after an Achilles tendon rupture (ATR) via subject-specific musculoskeletal modeling. Six patients recovering from a surgically repaired unilateral ATR were included in this study. The bilateral Achilles tendon (AT) lengths were evaluated using ultrasound imaging. The three-dimensional marker trajectories, ground reaction forces, and surface electromyography (sEMG) were collected on both sides during self-selected speed during walking, jogging and running. Subject-specific musculoskeletal models were developed to compute joint kinematics, joint moments, muscle forces and joint reaction forces. AT lengths were significantly longer in the involved side. The side-to-side triceps surae muscle strength deficits were combined with decreased plantarflexion angles and moments in the injured leg during walking, jogging and running. However, the increased knee extensor femur muscle forces were associated with greater knee extension degrees and moments in the involved limb during all tasks. Greater knee joint moments and joint reaction forces versus decreased ankle joint moments and joint reaction forces in the involved side indicate elevated knee joint loads compared with reduced ankle joint loads that are present during normal activities after an ATR. In the frontal plane, increased subtalar eversion angles and eversion moments in the involved side were demonstrated only during jogging and running, which were regarded as an indicator for greater medial knee joint loading. It seems after an ATR, the elongated AT accompanied by decreased plantarflexion degrees and calf muscle strength deficits indicates ankle joint function impairment in the injured leg. In addition, increased knee extensor muscle strength and knee joint loads may be a possible compensatory mechanism for decreased ankle function. These data suggest patients after an ATR may suffer from increased knee overuse injury risk.

Keywords: Achilles tendon rupture; musculoskeletal modeling; knee; ankle; gait (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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