Browse > Article
http://dx.doi.org/10.5103/KJSB.2021.31.4.241

Biomechanical Analysis of Walking and Running after a Surgically Repaired Achilles Tendon Rupture  

Heo, Jeong (FILA Footwear Biomechanics Lab. FILA Holdings)
Park, Sang-Kyoon (Motion Innovation Centre, Korea National Sport University)
Publication Information
Korean Journal of Applied Biomechanics / v.31, no.4, 2021 , pp. 241-248 More about this Journal
Abstract
Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running. Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data. Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05). Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.
Keywords
Achilles tendon rupture; Walking; Running; Biomechanical analysis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Lantto, I., Heikkinen, J., Flinkkila, T., Ohtonen, P. & Leppilahti, J. (2015). Epidemiology of A chilles tendon ruptures: Increasing incidence over a 33-year period. Scandinavian Journal of Medicine & Science in Sports, 25(1), e133-e138.
2 Lee, Y. S., Ryu, S. H., Gil, H. J. & Park, S. K. (2021). Impact and Shock Attenuation of the Runners with and without Low Back Pain. Korean Journal of Sport Biomechanics, 31(1), 16-23.   DOI
3 Marcolin, G., Buriani, A., Balasso, A., Villaminar, R. & Petrone, N. (2015). Gait analysis before and after achilles tendon surgical suture in a single-subject study: A case report. The Journal of Foot and Ankle Surgery, 54(2), 247-250.   DOI
4 Nilsson-Helander, K., Thomee, R., Gravare-Silbernagel, K., Thomee, P., Faxen, E., Eriksson, B. I. & Karlsson, J. (2007). The Achilles tendon total rupture score (ATRS) development and validation. The American Journal of Sports Medicine, 35(3), 421-426.   DOI
5 O'Brien, M. (2005). The anatomy of the Achilles tendon. Foot and Ankle Clinics, 10(2), 225-238.   DOI
6 So, V. & Pollard, H. (1997). Management of Achilles tendon disorders: a case review. Australasian Chiropractic & Osteopathy, 6(2), 58.
7 Park, W. S., Lee, M. J., Kang, J. M. & Lee, S. Y. (2018). Comparative Study of Clinical Outcome of Three Surgical Techniques in the Achilles Tendon Rupture: Open Repair, Percutaneous Repair, and Minimal Incision Repair by Achillon. Journal of Korean Foot & Ankle Society, 22(2), 68-73.   DOI
8 Ryu, J. S. (2019). Complexity Pattern of Center of Pressure between Genders via Increasing Running Speed. Korean Journal of Sport Biomechanics, 29(4), 247-254.   DOI
9 Sadeghi, H., Allard, P., Prince, F. & Labelle, H. (2000). Symmetry and limb dominance in able-bodied gait: a review. Gait & Posture, 12(1), 34-45.   DOI
10 Starkey, C. & Ryan, J. L. (2002). Evaluation of orthopedic and athletic athletes. Philadelphia : FA Davis Co, 39, 82.
11 Jandacka, D., Zahradnik, D., Foldyna, K. & Hamill, J. (2013). Running biomechanics in a long-term monitored recreational athlete with a history of Achilles tendon rupture. Case Reports, 2013, bcr2012007370.   DOI
12 Alexander, R. M. (1984). Elastic energy stores in running vertebrates. American Zoologist, 24(1), 85-94.   DOI
13 Rebeccato, A., Santini, S., Salmaso, G. & Nogarin, L. (2001). Repair of the Achilles tendon rupture: a functional comparison of three surgical techniques. The Journal of Foot and Ankle Surgery, 40(4), 188-194.   DOI
14 White, D. W., Wenke, J. C., Mosely, D. S., Mountcastle, S. B. & Basamania, C. J. (2007). Incidence of major tendon ruptures and anterior cruciate ligament tears in US Army soldiers. The American Journal of Sports Medicine, 35(8), 1308-1314.   DOI
15 Willy, R. W., Brorsson, A., Powell, H. C., Willson, J. D., Tranberg, R. & Gravare Silbernagel, K. (2017). Elevated knee joint kinetics and reduced ankle kinetics are present during jogging and hopping after Achilles tendon ruptures. The American Journal of Sports Medicine, 45(5), 1124-1133.   DOI
16 Dawe, E. J. & Davis, J. (2011). (vi) Anatomy and biomechanics of the foot and ankle. Orthopaedics and Trauma, 25(4), 279-286.   DOI
17 Schepsis, A. A., Jones, H. & Haas, A. L. (2002). Achilles tendon disorders in athletes. The American Journal of Sports Medicine, 30(2), 287-305.   DOI
18 Tengman, T. & Riad, J. (2013). Three-dimensional gait analysis following Achilles tendon rupture with nonsurgical treatment reveals long-term deficiencies in muscle strength and function. Orthopaedic Journal of Sports Medicine, 1(4), 2325967113504734.
19 Zellers, J. A., Carmont, M. R. & Silbernagel, K. G. (2016). Return to play post-Achilles tendon rupture: a systematic review and meta-analysis of rate and measures of return to play. British Journal of Sports Medicine, 50(21), 1325-1332.   DOI
20 Aroen, A., Helgo, D., Granlund, O. G. & Bahr, R. (2004). Contralateral tendon rupture risk is increased in individuals with a previous Achilles tendon rupture. Scandinavian Journal of Medicine & Science in Sports, 14(1), 30-33.   DOI
21 Porter, D. A., Barnes, A. F., Rund, A. M., Kaz, A. J., Tyndall, J. A. & Millis, A. A. (2014). Acute Achilles tendon repair: strength outcomes after an acute bout of exercise in recreational athletes. Foot & Ankle International, 35(2), 123-130.   DOI
22 Beskin, J. L., Sanders, R. A., Hunter, S. C. & Hughston, J. C. (1987). Surgical repair of Achilles tendon ruptures. The American Journal of Sports Medicine, 15(1), 1-8.   DOI
23 Don, R., Ranavolo, A., Cacchio, A., Serrao, M., Costabile, F., Iachelli, M., Camerota, F., Frascarelli, M. & Santilli, V. (2007). Relationship between recovery of calf-muscle biomechanical properties and gait pattern following surgery for Achilles tendon rupture. Clinical Biomechanics, 22(2), 211-220.   DOI
24 Erickson, B. J., Mascarenhas, R., Saltzman, B. M., Walton, D., Lee, S., Cole, B. J. & Bach Jr, B. R. (2015). Is operative treatment of Achilles tendon ruptures superior to nonoperative treatment? A systematic review of overlapping meta-analyses. Orthopaedic Journal of Sports Medicine, 3(4), 2325967115579188.
25 Francis, P., Whatman, C., Sheerin, K., Hume, P. & Johnson, M. I. (2019). The proportion of lower limb running injuries by gender, anatomical location and specific pathology: a systematic review. Journal of Sports Science & Medicine, 18(1), 21.
26 Biewener, A. A. (1998). Muscle-tendon stresses and elastic energy storage during locomotion in the horse. Comparative Biochemistry and Physiology PART B: Biochemistry and Molecular Biology, 120(1), 73-87.   DOI
27 Aubry, S., Risson, J. R., Kastler, A., Barbier-Brion, B., Siliman, G., Runge, M. & Kastler, B. (2013). Biomechanical properties of the calcaneal tendon in vivo assessed by Transient Shear Wave Elastography. Skeletal Radiology, 42(8), 1143-1150.   DOI
28 Brorsson, A., Olsson, N., Nilsson-Helander, K., Karlsson, J., Eriksson, B. I. & Silbernagel, K. G. (2016). Recovery of calf muscle endurance 3 months after an Achilles tendon rupture. Scandinavian Journal of Medicine & Science in Sports, 26(7), 844-853.   DOI
29 Byers III, G. E. & Berquist, T. H. (1996). Radiology of sports-related injuries. Current Problems in Siagnostic Radiology, 25(1), 2-49.   DOI
30 Ciacci, S., Di Michele, R., Fantozzi, S. & Merni, F. (2013). Assessment of Kinematic Asymmetry for Reduction of Hamstring Injury Risk. International Journal of Athletic Therapy and Training, 18(6), 18-23.   DOI
31 Giddings, V. L., Beaupre, G. S., Whalen, R. T. & Carter, D. R. (2000). Calcaneal loading during walking and running. Medicine & Science in Sports & Exercise, 32(3), 627-634.   DOI
32 Heiderscheit, B. C., Chumanov, E. S., Michalski, M. P., Wille, C. M. & Ryan, M. B. (2011). Effects of step rate manipulation on joint mechanics during running. Medicine and Science in Sports and Exercise, 43(2), 296.   DOI
33 Houshian, S., Tscherning, T. & Riegels-Nielsen, P. (1998). The Epidemiology of Achilles tendon rupture in a Danish county. Injury, 29(9), 651-654.   DOI
34 Jandacka, D., Silvernail, J. F., Uchytil, J., Zahradnik, D., Farana, R. & Hamill, J. (2017). Do athletes alter their running mechanics after an Achilles tendon rupture?. Journal of Foot and Ankle Research, 10(1), 53.   DOI
35 Kim, J. B., Ha, S. H., Park, S. H., Yoon, S. H., Ryu, J. S. & Part, S. K. (2019). Comparison of Physical Characteristics and Lower Extremity Biomechanics of Elderly and Young Adult Runners. Korean Journal of Sport Biomechanics, 29(3), 145-155.   DOI
36 Komi, P. V. (1990). Relevance of in vivo force measurements to human biomechanics. Journal of Biomechanics, 23, 23-34.   DOI