Early to late outcomes following achilles tendon rupture: contributors to clinical success
| Author(s) | Zellers, Jennifer A. | |
| Date Accessioned | 2018-08-23T11:21:27Z | |
| Date Available | 2018-08-23T11:21:27Z | |
| Publication Date | 2018 | |
| SWORD Update | 2018-07-23T22:08:27Z | |
| Abstract | Achilles tendon rupture has an annual incidence of 31.2-37.3/100,000 individuals per year1–4. The Achilles tendon is a critical component of foot and ankle function5,6, making Achilles tendon rupture a potentially debilitating injury7. The purpose of this dissertation work is to look across the continuum of patient recovery to identify clinical outcome measures to evaluate recovery. Further, this work seeks to examine if outcomes measured early in recovery respond to changes during a patient’s healing trajectory and relate to patient functional outcomes. ☐ On the individual level, it seems that patients’ long term prognosis relates to how well an individual recovers within the first year8,9. In particular, recovery of a single leg heel-rise seems to relate to patient recovery within and after the first year9–11. The heel-rise has limited use within the first 12 weeks of recovery due to the need for the patient to weight bear without immobilization and due to the concern that only 50% of individuals are able to perform the single-leg heel-rise at 12 weeks10. This points to the need for objective criteria that are sensitive to changes in the early healing trajectory of the patient that can be used to guide treatment and predict outcomes. Later in recovery, return to sport is of concern in this patient population due to the recreationally active demographic typically associated with this injury. There is large variability in return to play rates, suggesting that not only individual but also methodological influences may need consideration. ☐ This dissertation work investigates the use of ultrasound imaging to measure structural parameters of the Achilles tendon and identify their responsiveness to change over time and the relationships of these structural changes to patient function. Ultrasound imaging techniques include B-mode ultrasound imaging as well as a novel technique, continuous shear wave elastography12. Functional testing includes components of a functional test battery previously used in this population13,14 as well as similar populations15. The results of this work indicate that there are side to side differences in tendon structural characteristics, some of which are responsive to change over the course of early tendon healing. Further, these structural characteristics relate to components of performance on the heel-rise test and to patterns of muscle activation in the triceps surae during heel-rise and jumping tasks. The final aim of this dissertation work found that 80% of individuals after Achilles tendon rupture are able to return to play, but variability may not only be at the level of the individual but also be due to risk of bias in the available literature. | en_US |
| Advisor | Gravare Silbernagel, Karin | |
| Degree | Ph.D. | |
| Program | University of Delaware, Biomechanics and Movement Science Program | |
| Unique Identifier | 1049567527 | |
| URL | http://udspace.udel.edu/handle/19716/23699 | |
| Language | en | |
| Publisher | University of Delaware | en_US |
| URI | https://search.proquest.com/docview/2084096227?accountid=10457 | |
| Keywords | Applied sciences | en_US |
| Keywords | Health and environmental sciences | en_US |
| Keywords | Ankle | en_US |
| Keywords | Elastography | en_US |
| Keywords | Imaging | en_US |
| Keywords | Rehabilitation | en_US |
| Keywords | Ultrasound | en_US |
| Keywords | Viscoelastic | en_US |
| Title | Early to late outcomes following achilles tendon rupture: contributors to clinical success | en_US |
| Type | Thesis | en_US |