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Achilles tendon length and function independently associated with ankle joint kinematics during gait
ESSKA Academy. Sigurðsson H. Nov 8, 2019; 284346; epAFAS-03 Topic: Biomechanics
Mr. Haraldur Sigurðsson
Mr. Haraldur Sigurðsson
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Achilles tendon length and function independently associated with ankle joint kinematics during gait

ePoster - epAFAS-03

Topic: Tendons

Sigurðsson H.1, Brorsson A.2, Tranberg R.2, Silbernagel K.G.3, Briem K.1
1University of Iceland, Department of Physical Therapy, Reykjavík, Iceland, 2Institute of Clinical Sciences at Sahlgrenska Academy, Department of Orthopaedics, Gothenburg, Sweden, 3University of Delaware, Department of Physical Therapy, Newark, United States

Introduction: After an Achilles tendon (AT) rupture, the AT may have altered length (1,2) and stiffness (2,3), as well as functional limitations (1). Ultrasound (US) techniques can measure AT length (4), but has a high threshold for clinical adoption. The AT resting angle (ATRA) is related to AT length, but also its mechanical properties (2). The heel rise test is a measure of AT function and is associated with altered jumping kinematics (5), and AT length (6). Gait kinematics are altered after AT rupture, partly due to the altered stiffness (3,7,8) but it is unknown if AT length and functional capacity influence gait kinematics.
Objectives: Examine if AT length measured with US, ATRA, and heel rise test performance (height and maximum repetitions) are independently associated with peak sagittal plane ankle angles during incline treadmill walking.
Methods: Participants with a history of AT rupture were recruited (N=32) with a minimum of 1 years from rupture (range 1-3 years). After measuring AT US length, and ATRA, participants walked on a treadmill at an incline (5°) and brisk pace for 5 minutes at the start and end of the data collection between which participants performed jump testing, the heel rise test (9), and a 5 minute slide-board fatigue intervention. Gait data were collected with marker-based motion capture for 15 seconds during the last 30 seconds of each walk. Peak stance phase ankle angles were extracted. Mixed linear models were constructed for ankle plantar- and dorsiflexion with subject as the random, and the limb and fatigue as fixed effects. Base models were compared with an ANOVA to models containing the AT length measurement, the ATRA, heel rise height, heel rise repetitions, or all four measures. Significance was set at 0.05. R (10) was used for statistical analysis.
Results: In the base models, the involved limb had less dorsiflexion (11° vs 12°, P < 0.001) and less plantarflexion (12° vs 16°, P < 0.001). Each subsequent model was a better fit than the base model (all P < 0.001), and for both dorsi- and plantarflexion the full model was the best fit. There was no difference between limbs in the full model, indicating that the inter-limb difference was accounted for by the AT length, ATRA, and heel rise measures.
Conclusions: Each measure of AT length and function has independent associations with ankle gait kinematics. In order to restore normal gait kinematics, clinicians should evaluate all aspects of AT length and function.
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