Fırat TAN, Hande GUNEY DENİZ, Burak ULUSOY, Gülcan HARPUT, Gürhan DÖNMEZ, Mahmut DORAL

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AŞİL TENDON TAMİRLİ BİREYLERDE CERRAHİ SONRASI UZUN DÖNEM FONKSİYONEL SONUÇLARIN İNCELENMESİ

Amaç: Çalışmanın amacı Aşil tendon tamiri (ATT) uygulanan bireylerde cerrahi taraf ile diğer taraf arasında uzun dönem fonksiyonel sonuçları karşılaştırmaktı. Yöntem: Çalışmaya 20 ATT’li birey (yaş=40,15±7,32 yıl, vücut kitle indeksi=27,17±3,27 kg/m²) dahil edildi. Alt ekstremite fonksiyonel performansını belirlemek için Y denge testi, parmak ucuna yükselme testi ve ayak-ayak bileği araştırması (FAOS) anketi kullanıldı. İstatiksel analiz için cerrahi taraf ile diğer tarafı karşılaştırmada Eşleştirilmiş t testi kullanıldı. Sonuçlar: ATT’li bireylerin cerrahi sonrası geçen süre ortalama 5,02±3,64 yıl (2,00-13,00) idi. ATT’li bireylerin cerrahi taraf Y denge testi öne (p=0,008), arka içe uzanma mesafeleri (p=0,014) ve parmak ucuna yükselme seviyesi cerrahi tarafta daha az bulundu (p<0,001) . Bireylerin, FAOS alt parametreleri, belirtiler ve tutukluluk skoru 87,90±12,34 (61-100); ağrı skoru 93,60±11,55 (58-100); iş ve günlük yaşam aktiviteleri skoru 94,95±9,76 (66-100); iş, spor ve eğlence faaliyetleri skoru 86,75±17,03 (50-100) ve yaşam kalitesi skoru 78,15±17,50 (50-100) yüksek düzeydeydi. Tartışma: ATT’li bireylerde tamir sonrası FAOS sonuçları oldukça iyi bir iyileşme gösterirken, dinamik denge ve parmak ucuna yükselme mesafesinde ekstremiteler arası farklılıkları devam etmektedir. ATT’li bireylerde erken dönemde uygulanacak alt ekstremite fonksiyonel rehabilitasyonu fonksiyonel kayıpların giderilmesine katkı sağlayabilir. Anahtar Kelimeler: Aşil Tendonu, Tendon yaralanmaları, Fonksiyon.
Anahtar Kelimeler:

Aşil Tendonu, Tendon yaralanmaları, Fonksiyon

INVESTIGATION OF LONG-TERM POSTOPERATIVE FUNCTIONAL RESULTS IN INDIVIDUALS WITH ACHILLES TENDON REPAIR

Purpose: The present study aimed to compare long term functional results between the repaired side with the uninjured side in Achilles tendon repair (ATR) individuals. Methods: Twenty individuals with ATR (Age=40.15 ± 7.32 years, body mass index=27.17 ± 3.27 kg/m²) were included in the study. The lower extremity functional performance was assessed with Y balance test, Foot and Ankle Outcome Scale (FAOS) and heel-rise test. The side-to-side differences were assessed by using a Paired samples t-test. Results: The mean time following surgery in individuals with ATR was 5.02 ± 3.64 years (2.00-13.00). Y balance test anterior direction (p=0.008) and posteromedial direction (p=0.014) reach distances and heel-rise levels (p<0.001) were lower in the repaired side. The five subscales of FAOS, activities of the daily living score 94.95±9.76 (66-100), function in sports and recreation score 86.75±17.03 (50-100), foot and ankle related quality of life score 78.15±17.50 (50-100), foot and ankle pain score 93,60±11,55 (58-100) and other symptoms 87.90±12.34 (61-100) score were higher. Conclusion: The long term FAOS results showed a better improvement while dynamic balance and the heel-rise differences remain between extremities. Functional rehabilitation of lower extremity may contribute to improve these functional differences. Key Words: Achilles Tendon; Tendon Injuries, Function.
Keywords:

Achilles Tendon, Tendon Injuries, Function,

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  • 1. Obrien M. Functional-Anatomy and Physiology of Tendons. Clin Sports Med. 1992;11(3):505-20.
  • 2. Doral MN, Alam M, Bozkurt M, Turhan E, Atay OA, Donmez G, et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):638-43.
  • 3. Houshian S, Tscherning T, Riegels-Nielsen P. The epidemiology of Achilles tendon rupture in a Danish county. Injury. 1998;29(9):651-4.
  • 4. Pedowitz D, Kirwan G. Achilles tendon ruptures. Curr Rev Musculoskelet Med. 2013;6(4):285-93.
  • 5. Zellers JA, Marmon AR, Ebrahimi A, Gravare Silbernagel K. Lower extremity work along with triceps surae structure and activation is altered with jumping after Achilles tendon repair. Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 2019;37(4):933-41.
  • 6. Brorsson A, Willy RW, Tranberg R, Gravare Silbernagel K. Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury. Am J Sports Med. 2017;45(13):3060-8.
  • 7. Silbernagel KG, Nilsson-Helander K, Thomee R, Eriksson BI, Karlsson J. A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc. 2010;18(2):258-64.
  • 8. Powden CJ, Hoch JM, Hoch MC. Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Manual Therapy. 2015;20(4):524-32.
  • 9. Horstmann T, Lukas C, Merk J, Brauner T, Mundermann A. Deficits 10-years after Achilles tendon repair. Int J Sports Med. 2012;33(6):474-9.
  • 10. Carmont MR, Silbernagel KG, Mathy A, Mulji Y, Karlsson J, Maffulli N. Reliability of Achilles tendon resting angle and calf circumference measurement techniques. Foot Ankle Surg. 2013;19(4):245-9.
  • 11. Silbernagel KG, Steele R, Manal K. Deficits in heel-rise height and achilles tendon elongation occur in patients recovering from an Achilles tendon rupture. Am J Sports Med. 2012;40(7):1564-71.
  • 12. Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy. 1998;44(3):175-80.
  • 13. Gribble PA, Hertel J, Plisky P. Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J Athl Train. 2012;47(3):339-57.
  • 14. Ozer H, Selek HY, Harput G, Oznur A, Baltaci G. Achilles Tendon Open Repair Augmented With Distal Turndown Tendon Flap and Posterior Crural Fasciotomy. J Foot Ankle Surg. 2016;55(6):1180-4.
  • 15. Wang HK, Chiang H, Chen WS, Shih TT, Huang YC, Jiang CC. Early neuromechanical outcomes of the triceps surae muscle-tendon after an Achilles' tendon repair. Arch Phys Med Rehabil. 2013;94(8):1590-8.
  • 16. Zellers JA, Pohlig RT, Cortes DH, Gravare Silbernagel K. Achilles tendon cross-sectional area at 12 weeks post-rupture relates to 1-year heel-rise height. Knee Surg Sports Traumatol Arthrosc. 2019.
  • 17. Brorsson A, Gravare Silbernagel K, Olsson N, Nilsson Helander K. Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture. Am J Sports Med. 2018;46(2):470-7.
  • 18. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Mil Med. 2013;178(11):1264-70.
  • 19. Hall EA, Docherty CL, Simon J, Kingma JJ, Klossner JC. Strength-training protocols to improve deficits in participants with chronic ankle instability: a randomized controlled trial. J Athl Train. 2015;50(1):36-44.
  • 20. Westin O, Helander KN, Silbernagel KG, Samuelsson K, Brorsson A, Karlsson J. Patients with an Achilles tendon re-rupture have long-term functional deficits in function and worse patient-reported outcome than primary ruptures. Knee Surg Sports Traumatol Arthrosc. 2018;26(10):3063-72.
  • 21. Filipa A, Byrnes R, Paterno MV, Myer GD, Hewett TE. Neuromuscular training improves performance on the star excursion balance test in young female athletes. J Orthop Sports Phys Ther. 2010;40(9):551-8.
  • 22. Roos EM, Brandsson S, Karlsson J. Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int. 2001;22(10):788-94.
  • 23. Karatepe AG, Gunaydin R, Kaya T, Karlibas U, Ozbek G. Validation of the Turkish version of the foot and ankle outcome score. Rheumatology international. 2009;30(2):169-73.
  • 24. Bruton A, Conway JH, Holgate ST. Reliability: what is it, and how is it measured? Physiotherapy. 2000;86(2):94-9.
  • 25. Eliasziw M, Young SL, Woodbury MG, Fryday-Field K. Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther. 1994;74(8):777-88.
  • 26. Brorsson A, Olsson N, Nilsson-Helander K, Karlsson J, Eriksson BI, Silbernagel KG. Recovery of calf muscle endurance 3 months after an Achilles tendon rupture. Scand J Med Sci Sports. 2016;26(7):844-53.
  • 27. Jones R, Carter J, Moore P, Wills A. A study to determine the reliability of an ankle dorsiflexion weight-bearing device. Physiotherapy. 2005;91(4):242-9.
  • 28. Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, et al. Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med. 2013;41(12):2867-76.
Türk Fizyoterapi ve Rehabilitasyon Dergisi-Cover
  • ISSN: 2651-4451
  • Başlangıç: 1974
  • Yayıncı: Türkiye Fizyoterapistler Derneği
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