Anwendung der Bewegungsanalyse zur Bewertung des funktionellen Behandlungsergebnisses nach operativer Therapie der Achillessehnenruptur
Introduction: The Achilles tendon rupture (ATR) is usually surgically treated in order to reconnect the muscle fibres to the tendon. The muscle fibres which are not connected degenerate. Insufficiency of the triceps surae muscles is a common complication which results in a change of the kinematics and kinetics of the leg. The aim of the study is to develop and validate a method which quantitatively assesses and analyses these changes in the performance of exercises which are relevant for the daily life of the patients. Material and methods: 25 healthy subjects and 35 patients with a total rupture of the Achilles tendon took part in this study. 7 of the patients were surgically treated by suturing and 28 by fibrin gluing. Four different exercises were chosen to test the performance of the lower limb: Jumping, standing on toes, stretching by knee flexion with heel contact and repeated heel rising. All exercises were performed one-legged. The trajectories of markers fixed at foot and the shank were measured with a Vicon 370 motion analysis system and used to calculate the ankle joint angles. The ground reaction forces were measured by a Kistler force plate. From all exercises the minimum and maximum values of the ankle joint angles, the angular velocities and the ground reaction forces were determined. These parameters were used to find differences between the injured and unaffected side of the patients and between the patients‘ injured and subjects‘ legs. Results: Statistical significant deficiencies of the injured leg are restricted to the flexion and extension angles and the vertical force component. The most sensitive parameters of the joint motion are the maximum plantarflexion angle and velocity during jumping as well as the active range of motion which significantly differ from the unaffected and the subjects‘ leg performances. The maximum vertical force is also significantly reduced in the injured leg compared to the unaffected leg. Other parameters do not show significant differences. Conclusion: With the motion analysis of exercises adopted to the ATR is possible to discriminate between injured and unaffected legs as well as between injured and healthy subjects‘ legs. Several quantitative parameters could be identified which describe the changes in the injured legs‘ motion during the test exercises. These exercises cover motions which are relevant for the patients‘ daily life in contrast to artificial isokinetic tests. In addition motion analysis could be extended to assess the motions of the knee and the hip, which can reveal strategies of compensation for the impaired leg
info:eu-repo/classification/ddc/610, Medizin
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