Evaluation of the effectiveness of a physical therapy complex program in patients after surgical treatment of ruptured Achilles tendon
DOI:
https://doi.org/10.14739/2409-2932.2020.3.216233Keywords:
outcome assessment, program, physical therapy, surgical treatment, Achilles tendon, patientsAbstract
The purpose of the work is to evaluate the effectiveness of a comprehensive program of physical therapy in patients after surgical reconstruction of the Achilles tendon.
Materials and methods. Subjects population comprises 58 patients (aged 34–57 years), including 39 (67.24 %) males and 19 (32.76 %) females, who were up to the surgical restoration of the Achilles tendon. All patients were divided into two groups: the main group (MG, n = 29) and the control one (CG, n = 29). Research methods embraced a review of scientific literature presented on the Internet; experimental research of ascertaining and formative orientation; pedagogical observation; goniometry, plantodynamometry, modified Romberg test; methods of mathematical statistics.
Results. After surgery, the angle of plantar flexion was better (P < 0.01) in MG patients compared with CG patients (4 weeks): 29.1 ± 1.19° and 28.1 ± 1.13°. However, statistically significant differences between MG and CG patients in subsequent measurements were not found (P > 0.05). The percentage values of the load distribution on the operated extremity had improved by the final measurement date (16 weeks), which reduced the difference in the load distribution on the extremities to 9.20 ± 3.09 % in MG patients and up to 14.60 ± 2.98 % in CG patients (Me (25 %; 75 %) ) ‒ 8 (6; 12) % and 16 (12; 18) %). The indicators of the final performance of Romberg test were significantly better in MG patients, making 11.4 ± 2.13 s, which is 2.5 seconds better than in CG patients (P < 0.01).
Conclusions. Dynamic characteristics of plantar flexion were restored by the following means: adaptive physical exercises and corrective gymnastics, different walking exercises, exercises with fitball, exercises on an exercise bike and step platforms, hydrotherapeutic exercises, orthopedic shoes, physiotherapeutic methods, and massage. The proposed comprehensive program is effective and can be used for post-surgical physical therapy in patients diagnosed with Achilles tendon rupture.
References
Hertsyk, A., & Tyravska, O. (2016). Patsiient yak pidsystema fizychnoi reabilitatsii pry porushenniakh diialnosti oporno-rukhovoho aparatu [The patient as a subsystem of the physical rehabilitation in the musculoskeletal disorders]. Sports science of Ukraine, (3), 32-41. [in Ukrainian].
Gershburg, M. I., Popov, S. N., & Ahmida, A. M. (2012). Fizicheskaya reabilitatsiya posle operativnogo lecheniya razryva akhillova sukhozhiliya u sportsmenov [Physical rehabilitation after the surgical treatment of rupture of achilles tendon in athletes]. Lechebnaya fizkultura i sportivnaya meditsina, (7), 28-34. [in Russian].
Golovakha, М. L., Gorelov, А. М., & Тitаrchuk, R. V. (2011). Rannyaya funktsionalnaya nagruzka posle vosstanovleniya povrezhdenii Akhillova sukhozhilya [Early functional loading after restoration of injuries to the Achilles tendon]. Litopys travmatolohii ta ortopedii, (1), 275. [in Russian].
Korzh, O. O., Khokhol ,M. I., & Burianov O. A. (2009). Metodolohichni ta orhanizatsiini problemy reabilitatsii pry urazhenniakh oporno-rukhovoi systemy [Methodological and organizational problems of rehabilitation in lesions of the musculoskeletal system]. Ortopediya, travmatologiya i protezirovanie, (1), 5-9. [in Ukrainian].
Kostrub, O. O., Zayets, V. B., Zasadnyuk, I. A., & Blonsky, R. I. (2013). Metod operatyvnoho likuvannia spontannoho rozryvu akhillovoho sukhozhyllia [Method of surgical treatment of spontaneous Achilles tendon rupture]. Sportyvna medytsina, (1), 81-86. [in Ukrainian].
Kostrub, O. O., Zayets, V. B., & Zasadnyuk, I. A. (2015). Taktyka likuvannia khvorykh iz zastarilymy rozryvamy akhillovoho sukhozhillia [Tactics of treatment of patients with obsolete Achilles tendon ruptures]. Problemy travmatolohii ta osteosyntezus, (1), 56-57. [in Ukrainian].
Kravchuk, L. D., Zinchenko, V. V., Koval, O. A., & Khodyrev, D. E. (2019). Vidnovlennia funktsii khody u khvorykh z rozryvamy akhillovoho sukhozhillia [Restoration of the function of walking in patients with Achill's tendon ruptures]. Scientific journal National Pedagogical Dragomanov University. Series 15: Scientific and pedagogical problems of physical culture (physical culture and sports), (1), 40-43. [in Ukrainian].
Kuleva, O. V., Lyabah, A. P., & Turchin, O. A. (2014). Viddaleni rezultaty transpozytsii m. peroneus brevispry likuvanni zastsrilykh rozryviv akhillovoho sukhozhillia [Long-term transposition results m. peroneus brevis in the treatment of obsolete ruptures of the Achilles tendon]. Visnyk ortopedii, travmatolohii ta protezuvannia, (4), 28-31. [in Ukrainian].
Kuleva, O. V., Snisarevskyi, P. E., & Liabakh, A. P. (2016). Obhruntuvannia miazovo-sukhozhylnykh transpozytsii pry likuvanni ushkodzhen akhillovoho sukhozhilka (anatomichne doslidzhennia [The background of muscle-tendons transposition at the treatment of achilles tendon rupture (anatomic study))]. Visnyk ortopedii, travmatolohii ta protezuvannia, (2), 35-39. [in Ukrainian].
Kuleva, O. V., Osadcha, L. Yе., & Liabakh, A. P. (2016). Ekskursiia akhillovoho sukhozhilka pry vykonanni testu Tompsona za dannymy ultrazvukovoho doslidzhennia [Achilles tendon excursion at the tompson test by ultrasound data]. Visnyk ortopedii, travmatolohii ta protezuvannia, (4), 42-46. [in Ukrainian].
Lazarev, A. I., Radomsky, O. A., Ryabokon, P. V., & Skiban, M. V. (2015). Napruzhenno-deformovanyi stan akhillovoho sukhozhillia pry perelomi piatkovoi kistky zi zmishchenniam peryferychnoho frahmenta [Stress-strain state of the Achilles tendon in fracture of the heel bone with displacement of the peripheral fragment]. Travma, 16(3), 21-27. [in Ukrainian].
Nikanorov, O. K., & Zaiets, V. B. (2020). Strukturno-funktsionalni osoblyvosti piatkovoho (akhillovoho) sukhozhilka, etiolohiia, patohenez poshkodzhennia [Structural and functional peculiarities of the Achilles tendon, etiology and pathogenesis of rupture]. Sportyvna medytsyna i fizychna reabilitatsiia, (1), 61-63. [in Ukranian]. https://doi.org/10.32652/spmed.2020.1.61-63
Pinchuk, E. I., & Pokropivny, O. M. (2018). Phisychna reabilitatsiia pry ushkodzheni akhillovoho sukhozhillia [Physical rehabilitation in case of damage Achilles tendon]. Aktualni problem klinichnoi ta profilaktychnoi medytsiny, 2(1), 55-59. [in Ukrainian].
Pustovoit, B. A. (2019). Fizychna terapiia pry perelomakh kistok homilkovostopnoho suhloba [Physical therapy for fractures of the ankle bones]. Fizychna terapiia ta rekreatsiino-ozdorovchi tekhnolohii, (1), 4-13. [in Ukrainian]. http://journals.uran.ua/frir_journal/article/view/192412
Ra'ad, A., Vitomsky, V. V., Jafar, T. M., & Nikanorov, O. K. (2017). Vidnovlennia funktsionalnykh pokaznykjv nyzhnoi kintsivky ta yakosti zhyttia pislia operatyvnoho likuvannia rozryvu akhillovoho sukhozhilka [Restoration of functional parameters of the lower extremity and quality of life after surgical treatment of Achilles tendon rupture]. Sportyvna medytsina i fizychna reabilitatsiia, (1), 79-87. [in Ukrainian].
Ra'ad, A., Vitomsky, B., Lazareva, O., & Vitomskaya, M. (2017). Fisychna reabilitatsiia pislia rozryviv akhillovoho sukhozhillia: ohliad suchasnykh pidkhodiv [Physical rehabilitation after Achilles tendon ruptures: a review of modern approaches]. Slobozhanskyi naukovo-sportyvnyi visnyk, (2), 78-86. [in Ukrainian]. https://doi.org/10.15391/snsv.2017-2.014
Ra'ad, A., Vitomsky, B., Lazareva, O., Nikanorov, O., & Vitomska, M. (2017). Metodychni osnovy pobudovy prohramy fizychnoi reabilitatsii patsientiv pislia khirurhichnoho likuvannia rozryviv akhillovoho sukhozhillia [Methodical bases of construction of the program of physical rehabilitation of patients after surgical treatment of ruptures of the Achilles tendon]. Sportyvnyi visnyk Prydniprovia, (2), 226-233. [in Ukrainian].
Ra'ad, A. H. (2019). Fizychna reabilitatsiia pislia khirurhichnoho likuvannia rozryviv akhillovoho sukhozhillia [Physical rehabilitation after surgical treatment of Achilles tendon rupture]. Extended abstract of candidate`s sciences in Phys. education and sports. Kyiv: NUPhESU [in Ukrainian].
Calder, J. D., & Saxby, T. S. (2005). Early, active rehabilitation following mini-open repair of Achilles tendon rupture: a prospective study. British journal of sports medicine, 39(11), 857-859. https://doi.org/10.1136/bjsm.2004.017509
Lantto, I., Heikkinen, J., Flinkkila, T., Ohtonen, P., Kangas, J., Siira, P., & Leppilahti, J. (2015). Early functional treatment versus cast immobilization in tension after achilles rupture repair: results of a prospective randomized trial with 10 or more years of follow-up. The American journal of sports medicine, 43(9), 2302-2309. https://doi.org/10.1177/0363546515591267
Olsson, N. (2013). Acute Achilles Tendon Rupture: Outcome, Prediction and Optimized Treatmente. University of Gothenburg. https://gupea.ub.gu.se/bitstream/2077/32386/1/gupea_2077_32386_1.pdf
Pepe, G., Ingegneros, L., Pepe, F., Monciino, P., Consoli, S., Mangiameli, A., Panella, M., & Scuderi, C. (1987). Le lesioni delle parti molli degli arti inferiori. Revisione statistica su 3588 casi [Lesions of the soft tissues of the legs. Statistical review of 3588 cases]. Minerva chirurgica, 42(10), 879-881.
Uquillas, C. A., Guss, M. S., Ryan, D. J., Jazrawi, L. M., & Strauss, E. J. (2015). Everything Achilles: Knowledge Update and Current Concepts in Management: AAOS Exhibit Selection. The Journal of bone and joint surgery, 97(14), 1187-1195. https://doi.org/10.2106/JBJS.O.00002
Willits, K., Amendola, A., Bryant, D., Mohtadi, N. G., Giffin, J. R., Fowler, P., Kean, C. O., & Kirkley, A. (2010). Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. The Journal of bone and joint surgery, 92(17), 2767-2775. https://doi.org/10.2106/JBJS.I.01401
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)