hYmo6+DU f[j;;4vv+yw=lrD Hepatocyte Growth Factor-Induced Tendon Stem Cell Conditioned Medium Promotes Healing of Injured Achilles Tendon. Impact control exercises beginning with two feet to two feet, progressing from one foot to the other, and then one foot to the same foot. en Change Language. doi: 10.1590/ACB360407. Introduction. The Achilles tendon, which is about 12-15 cm long and comprises both the gastrocnemius and the soleus tendons, is the thickest, strongest and largest tendon in the human body. The use of early functional rehabilitation in the treatment of nonoperative Achilles tendon ruptures has been shown to provide patients with outcomes similar to operative treatments. 2 0 obj The aim of this study was to define the most effective and safe post-operative rehabilitation protocol following minimal invasive repair. sharing sensitive information, make sure youre on a federal The exercises stretch your Achilles tendon in ways that help it handle forces and stress better. 2022 Aug 19;2022:2363230. doi: 10.1155/2022/2363230. bearing Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? CAMBOOT with 20mm heel lift or VACOPED (2) and wedge sole for 3rd week. Hydrotherapy Careers. 3,10,13,25 Historically, surgical repair of Achilles tendon rupture was thought to decrease the risk of re-rupture substantially. Muscle strength and balance. Operative versus non-operative treatment of acute Achilles tendon ruptures: a multi-center randomized trial using accelerated functional rehabilitation. %PDF-1.7 Bookshelf 0 xwn $8sxkL=. *MoaoLzhN:fOad)t-h96.&JxEys4JUy-nEu Begin by using one to two-inch heel lifts in tennis shoes for short distances on level surfaces and gradually remove heel lifts during the fifth through the eighth week depending on symptoms. Brumann M, Baumbach SF, Mutschler W, Polzer H. Accelerated rehabilitation following Achilles tendon repair after acute rupture-development of an evidence-based treatment protocol. ^C< ^/PgN`r3~LV*m{ (3Nl(+J?~I Disclaimer. Procedure: Conservative Management of Tendo-Achilles Rupture - Accelerated 8-week protocol Indications for Procedure: Tendo-Achilles Rupture Expected Length of Stay: n/a Surgeons: All orthopaedic trauma surgeons Scope of Practice These guidelines are designed to guide physiotherapists when treating patients following conservative management . Four trials compared early ankle mobilization to immobilization. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. : MOFL?Wo(H&dxl. Do not perform exercises that create movement compensations. Design of a randomized controlled trial. In some cases, the Achilles tendon can tear, or rupture. The acute rupture of the Achilles tendon is a protracted injury. Treatments are chosen based on the size of the tendon defect. Surgery is only the beginning of a long rehabilitation period. J Bone Joint Surg Am. Higher level proprioception An objective assessment of surgical and non-surgical treatment. endstream endobj 180 0 obj <>/Metadata 7 0 R/PageLayout/OneColumn/Pages 177 0 R/StructTreeRoot 11 0 R/Type/Catalog>> endobj 181 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 182 0 obj <>stream To correct these problems, a physical therapist may show you exercises or use hands-on techniques to ease the tension. Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? weight) In revision cases or when the tendon was damaged before the rupture, the tendon may need to be reconstructed using a graft from another tendon in your body. . PMC Study Selection Criteria Randomized . Diagnosis can be made clinically with weakness of plantarflexion with a positive Thompson's test. Achilles tendon ruptures (ATRs) mainly occur during sports activities . Wr5)Z nK!e*~[~[)$WoU]sMHUoUbmJ9yOJ}` Zhang Z, Li Y, Zhang T, Shi M, Song X, Yang S, Liu H, Zhang M, Cui Q, Li Z. Massen FK, Shoap S, Vosseller JT, Fan W, Usseglio J, Boecker W, Baumbach SF, Polzer H. EFORT Open Rev. <> 2010 Dec 1; 92(17): 276-75. . Methods: Static balance exercises (begin in two-foot stance, then two-foot stance on balance board and gradually progress to single-leg stance). knee strengthening as 2,14,20 This finding was believed to . Careers. Foot Ankle Spec. %PDF-1.5 Five trials compared full to non weight bearing, all applying immobilization in equinus. 24 staples. ':IU""e"E/JT?|OW:_Yn]n7buq}].moS_7xbU]}\o/|`ND^QTK/EnTYJ=U6~U1 1990 Mar;18(2):188-95. -, Unfallchirurg. Avoid overstressing the repair (avoid large movements up and down, forceful PF while in a dorsiflexed position, aggressive passive ROM, and impact activities). -, Am J Sports Med. This site needs JavaScript to work properly. Continue strength exercises as above including gentle closed chain quads, hamstrings, glutes. $AIsQ(P>U[bwA4po@-CIqRg ;qjt*]&a7Vc)]|1:|0_ Would you like email updates of new search results? 3{pn04,NMi"]C@C!r-\8yJY cMylwJ nOVn:K"ldCsseC! 8]z].U3wKI2 endobj A systematic literature search in Embase, MEDLINE and Cochrane Library for prospective trials reporting on early functional rehabilitation after minimal invasive repair was performed. endobj -, Injury. Operative versus Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Multicenter Randomized Trial Using Accelerated Functional Rehabilitation Kevin Willits, Annunziato Amendola, Dianne Bryant, Nicholas G. Mohtadi, J. Robert Giffin, Peter Fowler, Crystal O. Kean and Alexandra . 2011 Dec;17(4):211-7 Federal government websites often end in .gov or .mil. <> Achilles tendinopathy can be described as an insertional or mid-portion, the difference . Evidence-based accelerated rehabilitation protocol following operative repair of acute Achilles tendon ruptures; DF: dorsiflexion, PF: plantar flexion, ROM: range of motion. Level of evidence: Epub 2014 Jul 24. x\*"S&Rd9l)+%\hwMROw3$\Z1~v/^x|m],^}3fdY7iTe*)XU6ugshO_KQ`F5vYU? official website and that any information you provide is encrypted 2021 Apr 7;9:654084. doi: 10.3389/fcell.2021.654084. FOIA Independent gait. This can strain your Achilles tendon. 228 0 obj <>stream bearing transitioning towards full weightbearing. Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair. Progression of calf stretching past plantar grade. . National Library of Medicine Cont. Our rehab protocols outline timing, precautions and progression criteria for returning to activity. Massen FK, Shoap S, Vosseller JT, Fan W, Usseglio J, Boecker W, Baumbach SF, Polzer H. EFORT Open Rev. Can commence light isometric calf exercises at low resistance and reps, not past plantar grade. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Ruptures of the tendo achillis. Acute Achilles tendon rupture: minimally invasive surgery versus non operative treatment, with immediate full weight bearing. Closed chain weight bearing quads, hamstrings, glutes, calf strengthening with physio guidance. OJSM 2016 2. Various treatment methods are used for acute and chronic rupture. independently). After nonoperative treatment with an accelerated rehabilitation program, the patient still experienced significant strength and functional deficits. +2 b6b ] ]-oF%@ZUiV'US7\4yk@RAQA$EB-;D2yR"H#YH ~Z/K>S'E_ R>-C^^[i. Touch weight Immediate weight bearing in a functional brace, together with early mobilization, is safe and has superior outcome following minimally invasive repair of Achilles tendon rupture. stream Braunstein M, Baumbach SF, Boecker W, Carmont MR, Polzer H. Knee Surg Sports Traumatol Arthrosc. Healing time clock restarts from day of surgery rather than day of injury /n%^xij_2]!J] n >!UGld Kangas J, Pajala A, Siira P, Hmlinen M, Leppilahti J. J Trauma. Splint/Boot: Locked 20-30 degree plantarflexion for two weeks The non-comparative study reported high satisfaction, good functional results and an early return to work/sports following combined treatment. Partial Mosconi M, Pasta G, Annunziata S, Guerrieri V, Ghiara M, Perelli S, Torriani C, Grassi FA, Jannelli E. Diagnostics (Basel). The tendons twist from proximal to distal as they insert into the calcaneous, creating a shearing force. endobj 8600 Rockville Pike group 2-4 weeks Aircast walking boot with 2-cm heel lift* Protected weight-bearing with crutches Keywords: We performed a systematic literature search in Medline, Embase and Cochrane library. Clipboard, Search History, and several other advanced features are temporarily unavailable. Injury2014;45(11):1782-1790. If you have a concern, please consult with Dr. Roe. Accessibility Surgery is only the beginning of a long rehabilitation period. 0_'|,t0:!: . ^Fz,l6N}{D6Y?TP),#uz/i3F~bHG(BQ" May begin sports specific training drills: if returning to contact sport only controlled Our recommended treatment protocol provides quality assurance for the patient and reliability for the attending physician. The injury is often accompanied by an audible and palpable pop with limited ability to push off of the injured limb. The Thompson Test should be applied in all suspected cases Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prevention of further injury Moderate load plyometrics at Non-Operative Treatment of Achilles Tendon Rupture Post-Operative Protocol Accelerated Rehabilitation Program: Weeks 1-2: Short leg fiberglass cast with ankle in plantarflexion of ~20 degrees Non-weight bearing with crutches for ambulation assistance Weeks 2-6: Transition to CAM walking boot with 6 heel lifts Sports massage techniques and ultrasound can aid torn Achilles rehabilitation by helping to realign the new fibres in line with the tendon. V.&!Na 1"}2C1[irXd8`<9f4X|(iTerx_&>uQMAv/>My]Zg}?;fl|Hpt. Disadvantages. He was able to ambulate without assistive devices at the 5-week follow-up examination. Treatment of acute Achilles tendon rupture in Scandinavia does not adhere to evidence-based guidelines: a cross-sectional questionnaire-based study of 138 departments . x][~|.T%c<8A+qwX+)#`T];% t4!^}I? 2016 Jun;24(6):1852-9. doi: 10.1007/s00167-014-3180-5. **No hopping, Results: PoT"u+: Cardiovascular: stationary bike, StairMaster, swimming. -, Am J Sports Med. Metz R, Kerkhoffs GM, Verleisdonk EJ, van der Heijden GJ. In an acute Achilles Tendon Rupture, there are two options: Surgical repair with accelerated rehab protocol. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, Kean CO, Kirkley A. J Bone Joint Surg Am. 2023 Feb 10;11(2):23259671221145199. doi: 10.1177/23259671221145199. endobj 2010 Dec 1;92(17):2767-75. doi: 10.2106/JBJS.I.01401. Achilles tendon repair surgery is a type of surgery to fix a damaged Achilles tendon. Transitioning towards plantargrade until boot is completely removed. Slowly wean from boot. Despite several trials available comparing different treatment regimes, there is still no consensus regarding the optimal protocol. Hydrotherapy, stationary cycling. 1 0 obj 24 staples. jumping, running. In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Low level calf plyometric exercises (fast CRs, tip toe Centre for Reviews and Dissemination (UK), York (UK). 4d1olrz?+Vg.TxH38@ g%L There is increasing evidence, summarized in systematic reviews, that one can successfully use a non-operative treatment protocol to manage patients who suffer an acute rupture of the Achilles tendon. The Achilles tendon gives your leg strength to walk, run and jump. <>/Metadata 358 0 R/ViewerPreferences 359 0 R>> 3. % Moderate load close/open chain calf strengthening to Achilles Tendon Ruptures are common tendon injuries that occur due to sudden dorsiflexion of a plantarflexed foot, most commonly associated with sporting events. Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. 1. II. Open navigation menu. 2022 Oct 26;7(10):680-691. doi: 10.1530/EOR-22-0072. 1995 Jan;98 (1):21-32 In addition, surgical repair involves, but is not limited to, an increased risk of infection, adhesions and disturbed skin sensibility with a pooled relative risk of 10.6 (95% CI; 4.8;23.3) as . Graduated!resistanceexercises! L6YZN Ko:7}BFk| Clipboard, Search History, and several other advanced features are temporarily unavailable. Post-op weeks 2-3: boot at 20 degrees, sleep in boot, TTWB with crutches, no active DF. Would you like email updates of new search results? Brumann, M., Baumbach, S. F., Mutschler, W., & Polzer, H. Accelerated rehabilitation following Achilles tendon repair after acute rupture-Development of an evidence-based treatment protocol. initially We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete. [PubMed: 25059505]. The acute rupture of the Achilles tendon is a protracted injury. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with tendon augmentation, re-rupture after non-surgical management, revision, chronic tendinosis, and co-morbidities, for example, obesity, older age, and steroid use. 5 0 obj TABLE E-1 Achilles Tendon Rupture Rehabilitation Protocol Time Frame Activity 0-2 weeks Posterior slab/splint; non-weight-bearing with crutches: immed. Gentle calf stretching with a towel (not body weight). close menu NCI CPTC Antibody Characterization Program, Foot Ankle Surg. Regular soft tissue treatments (i.e. Despite several trials available comparing different treatment regimes, there is still no consensus regarding the optimal protocol. 4 0 obj Cardiovascular upper extremity circuit training. Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back of your lower leg. endobj The only randomized controlled trial performed the most accelerated protocol demonstrating a superior functional outcome and fewer complications after immediate full weight bearing combined with free ankle mobilization. Stretching for patient-specific muscle imbalances. %%EOF 2020-2023 Mr Daniel Goldbloom | Privacy Policy | Disclaimer | Website design: Berwick - St John of God Consulting Suites. A systematic review of early rehabilitation methods following a rupture of the Achilles tendon. Clinical, Ultrasonographic, and Elastographic Comparison. Methods: Seven studies were included. <>>> Epub 2010 Oct 29. Your surgeon and you will determine what is best for you by discussing your specific injury and goals. ,dDu=hQ*S:m6 _0}NTD4%Dw $k7pQ(@Wi:s.K^ but an accelerated rehabilitation program should be accompanied by good results. We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. All trials found mobilization to be superior as it shortens time to return to work and sports significantly. Physical therapy appointments are once a week. bearing Patients showed significantly higher satisfaction, less use of rehabilitation resources, earlier return to pre-injury activities and further demonstrated significantly increased calf muscle strength, reduced atrophy and tendon elongation. stream Achilles Rupture Non-operative Protocol Page 3 of 3 Last Updated September 3, 2020 REFERENCES: 1. !.XyR-Kd-+"v+l3,~l|LR {Z^R}TTKS`p*9szqAdJAs2QGE6pzHf)'a n7=pMi-Sn3r7$5B"yUMQy^&hkj)V&a55JZp5JSb^]"37H919=N]?&h6.M{Af[Uf`0R;DW x^Q^5fu;%)Ptu$DtqEHg Squat to 30 degrees knee flexion without weight shift. Epub 2020 Dec 17. 2021 May 28;18:112-116. doi: 10.1016/j.reth.2021.05.002. It is rare to have this procedure immediately after going to the emergency room for an injury. 2 0 obj ACHILLES TENDON RUPTURE ACCELERATED REHAB PROTOCOL - Fowler Kennedy Sport Medicine. kicking small. Begin standing calf stretch at 5 weeks (knee flexed and extended) Continue eversion, inversion and plantar flexion isometrics with resistance bands. Dynamic neuromuscular control with multi-plane activities, without pain or swelling. The acute rupture of the Achilles tendon is a protracted injury. Objectives To (1) describe which resistance exercises are used in the first 8 weeks of treatment for acute Achilles tendon rupture and (2) assess the completeness of reporting of the exercise descriptions. Sometimes healthcare providers misdiagnose Achilles tendon injuries as a sprained ankle. The length of the incision and the surgical approach will depend on location of the rupture. basketball, tennis shots from standing start, contralateral <> Achilles tendon rupture; Ankle mobilization; Evidence-based; Functional treatment; Immobilization; Rehabilitation; Surgical repair; Treatment protocol; Weight bearing. With!weighted!resisted . Injury to the Achilles tendon causes pain along the back of your leg near the heel. Passive dorsiflexion both with knee in extension and flexed to 35 - 400 until gentle stretch on achilles. This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). Post-op weeks 3-4: boot at 10 degrees, sleep in boot, TTWB with crutches. Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis. Effect of Transdermal Fentanyl Patch Combined with Enhanced Recovery after Surgery on the Curative Effect and Analgesic Effect of Liver Cancer. Injury. Copyright 2014 Elsevier Ltd. All rights reserved. s% i5iYd}mYSz;0Wj|*:2aO5ZmJeNWhqLx* EUgm"5l94`0;C1B]@-yH?0{2ER'fL-j6U,@tyS]?sZn|(E31-*=} Achilles Tendon Repair Rehabilitation Protocol Phase I (surgery to 2 weeks after): Splint/Boot: Locked 20-30 degree plantarflexion for two weeks Weight-bearing: Touchdown weight-bearing (TDWB) with crutches Cardiovascular: Upper body circuit training Patient Precautions: Keep elevated. Frontal and sagittal plane stepping drills (side-step, crossover step, grapevine step). x\n#}!{B^pq8h*S=rz YTWu]N]zGo?Sz$ByhTTu_[UtzrVZO7'. The Achilles tendon is a strong, fibrous cord in the lower leg. Bethesda, MD 20894, Web Policies <> Cardiovascular: Upper body circuit training, Physical therapy appointments begin one to two visits per week. Minimal invasive surgery reduces these risks; however, there are concerns about its stability. nb^t~luNS zRBR}mHbKz!MKCZ?/ibO'"qwDG&lQz=>4 QG`7]qvZ;{t;-rq@ .iij1QB\:Lw;hxAMOPNw(v9`K-{ig@@HymirxF> IRh3J@+ZR*RNE+Ni$Gg3) x):+!#$SEL*u:Jd4r and transmitted securely. We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. Early functional rehabilitation protocol for Achilles tendon rupture improved patient satisfaction, compared with standard immobilisation regimens, with reductions in minor complications and no difference in re-rupture rates. 2013 Dec;41(12):2867-76 National Library of Medicine stream Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. We performed a systematic literature search in Medline, Embase and Cochrane library. 3 0 obj 2022 Oct 14;19(20):13254. doi: 10.3390/ijerph192013254. <>/F 4/A<>/StructParent 0>> The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. Light concentric and eccentric calf raises with heel lift and progression to resisted ankle We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete. Cardiovascular: replicate sport/work-specific energy demands. Accelerated rehab protocol without surgery. 2022 Jul 25;2022:9722458. doi: 10.1155/2022/9722458. Bethesda, MD 20894, Web Policies Return to the original sport at only 3 months after an Achilles tendon rupture by a combination of intra-tissue injection of freeze-dried platelet-derived factor concentrate and excessively early rehabilitation after operative treatment in a male basketball player: A case report. After the Achilles tendon rupture repaired , patients were randomly divided into 2 groups, and the rehabilitation protocol was traditional rehabilitation protocol and accelerated rehabilitation protocol under ultrasonic monitoring , respectively, to study the difference in efficacy between the groups. CAMBOOT with 10mm heel lift or VACOPED at (1) with flat sole for 4th week Achilles Tendon Rupture - Non-operative treatment rehabilitation guidelines 0-2 WEEKS REST (PHASE 1) Goals Rest, recovery and mobilise non-weight bearing safely on crutches Immobilisation Plaster cast/Rigid boot with foot pointing downwards 20 (with 3 wedges inside - 22/16/10, more if needed) Weight-bearing: Touchdown weight-bearing (TDWB) with crutches The site is secure. 2017 Mar;137(3):333-340. doi: 10.1007/s00402-017-2627-9. Knee Surg Sports Traumatol Arthrosc. Unauthorized use of these marks is strictly prohibited. Jogging, increase exercise intensity, Sports specific drills, Full active ankle range of movement with dorsiflexion as tolerated, Progress muscle strengthening from open chain to closed chain during this period, Single leg stance, eyes closed, wobble board/ BOSU, Double heel raise progress to single heel raise, Dorsiflexion equal to contralateral side, no need to push to extreme, Hopping, Mini hurdle jumps, Straight line running, Introduce cutting/side to side/ carioca/ figure of 8 runs, Normal activity, explosive actions and return to sport. in surgical group, after injury in nonop. The guiding principle for this rehabilitation protocol is early ankle motion, since it is believed to be the main reason why surgically treated Achilles tendon ruptures show a lesser rate of recurrence than those treated conservatively with a period of immobilization. Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence. Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study. Rerupture after Achilles repair is reported at about 2-12%, with no statistical difference reported between open, percutaneous, augmented, or closed treatment methods [1-4, 7, 9, 16].Open rerupture is an exceedingly rare complication and has only been described a handful of times [17-19].This report is the first case that we are aware of described in the literature of an . 4 0 obj Surgery is only the beginning of a long rehabilitation period. Conclusion: endobj In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment . The .gov means its official. endobj Knee Surg Sports Traumatol Arthrosc. etc until cleared by Rehabilitation regimen for non-surgical treatment of Achilles tendon rupture: A systematic review and meta-analysis of randomised controlled trials. Single leg stance with good control for 10 seconds. In an acute Achilles Tendon Rupture, there are two options: If you have any questions please do not hesitate to contact Mr Goldblooms rooms on 0493051985.The Accelerated Rehabilitation Program has been developed by Mr Goldbloom in conjunction with Physiotherapists Brodie Leonard-Shannon and Brendan Mason from Back in Motion, Aspendale Gardens. Begin gait and ankle proprioception retraining. 179 0 obj <> endobj A potentially more accelerated rehabilitation and return to activity; Tendon healing with optimal end to end re-attachment, hence restoring Calf muscle-Achilles anatomy with minimal scar tissue bridging. Goals: Achilles Tendon Repair Rehabilitation Protocol, North Fork Orthopaedic and Sports Medicine, Lower Extremity Fracture Care Post-Op Instructions. Download Accelerated Rehab Program Patient Information Sheet. (50% BW) by Morimoto S, Iseki T, Nakayama H, Shimomura K, Nishikawa T, Nakamura N, Tachibana T. Regen Ther. Can begin upper limb sports specific training eg. <>/Metadata 1559 0 R/ViewerPreferences 1560 0 R>> A Prospective Randomized Trial Comparing Surgical and Nonsurgical Treatments of Acute Achilles It is found at the back of the lower leg, just above the heel bone. cJ%]lKSfd9\{5D y} Ua~0i}::1Qq){)+"0xpOp bd%\`3 G{$u~` mlEt$/yf;'ds;Z1y4@$ Xr PMC ACHILLES RUPTURE: OPERATIVE PROTOCOL In this surgery, the torn ends of the tendon are sewn together with strong suture. Sport/work-specific balance and proprioceptive drills. Consequently, physicians may have reservations about adopting functional rehabilitation. 2021 May 21;36(4):e360407. Pool exercises if the wound is completely healed. Rehabilitation phases after an Achilles tendon rupture The rehabilitation can be divided into four phases (1): The decision when a patient should proceed from one phase to the next is proposed to be based on both the recovery of the patient and the time since the injury. health, rehab compliance and injury severity, our team has established time frames, precautions and progression criteria that help ensure a safe return to sport. Knee Surg Sports Traumatol Arthrosc. Arch Orthop Trauma Surg. Discussion. Mastering proprioceptive control in wearing normal footwear. Ankle range of motion (ROM) respecting precautions. )$Ffni(G"okg]3io m"7r ;NOsGL8ad{qF%k-+c0R N-1@i[L6Sy=0C4ddB2@g.! IM5^]rCFWD-0y- 9NL~4,MHJOh The American journal of sports medicine. r ?h{vV4ECHD+A?E_Q-9U1DJY;p9 I* XX%|EjbwJH(g0Nf5.I ;v$c7H(d a_2d6QN&m <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol, Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet], Centre for Reviews and Dissemination (UK). Keywords: Tendon is a specialized tissue mainly composed of collagen extracellular matrix (ECM), transmitting forces from muscle to bone [1].Tendon injury accounts for a large proportion of musculoskeletal system disorders and poses a substantial burden on human health [2].Therapeutic interventions including surgery, drug, physical therapy and rehabilitation are used for tendon repair [3].
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