The Study Of The Appropriate Indexes For Evaluating The Rehabilitation Effect After Achilles Tendon Injury

Background:The incidence of Achilles tendon injury has raised by years with the growth of the number of sports participants.There are various indicators to evaluate the rehabilitation effect of Achilles tendon injury.Although some indicators have shown no difference between the healthy side and the sick side,the patient continued to experience discomfort during daily activities or exercise.Purpose:By comparing the effects of Achilles tendon injury on the mechanical properties of Achilles tendon,the morphology of Achilles tendon and calf,and the functional activities of ankle joint,the appropriate indexes for evaluating the rehabilitation effect of Achilles tendon injury were explored.By examining the correlation between various indicators,explore whether there are simple evaluation indicators that can replace the Achilles tendon stiffness index.Method:The mechanical properties and the morphological properties of the Achilles tendon,the morphological properties of the calf and the functional activity of the ankle were measured in both the Achilles tendon injury group(n=11)and the healthy group(n=15),and the symmetry index of the weak and healthy side or the left and right side was calculated.Test if all the data obey normal distribution.For the data obeying normal distribution,the paired sample t test was used to explore the difference between the weak and healthy side or the left and right side of the injured group and the healthy group,and the independent sample t test was used to explore the difference of the symmetry index between the injured group and the healthy group.Otherwise,the non-parametric test of 2 related samples was used to explore the difference between the healthy and the affected and unaffected side or the left and right side of the healthy group and the injury group,and the non-parametric test of 2 independent samples was used to explore the difference of the symmetry index between the injury group and the healthy group.Pearson correlation analysis was used to explore the correlation between the indicators.Multiple stepwise linear regression was used to explore the relationship between Achilles tendon stiffness and other indicators.The significance level was defined as one type of error probability not less than 0.05(p<0.05),and all test results were expressed as mean ± standard deviation.Result:The Achilles tendon stiffness index of the injured side was significantly higher than that of the healthy side(p=0.003),but there was no significant difference between the left and right sides of the healthy group(p=0.57).The ankle joint stiffness of the injured side was significantly higher than that of the healthy side(p=0.002),but there was no significant difference between the left and right sides of the healthy group(p=0.308).The Achilles tendon length of the injured side was significantly shorter than that of the healthy side(p=0.032),but there was no significant difference between the left and right sides of the healthy group(p=0.574).The maximum heel-rise height of the injured side was significantly lower than that of the healthy side(p=0.002),but there was no significant difference between the left and right sides of the healthy group(p=0.334).Pearson’s relevant statistics found that the Achilles tendon stiffness index was significantly correlated with the Achilles tendon length(r=0.537,p<0.01),the ankle range of motion(r=-0.705,p<0.01),maximum heel lifting height(r=-0.370,p=0.007)and the number of heel lifting(r=-0.323,p=0.02).Multiple stepwise linear regression showed a functional relationship between tendon stiffness index,tendon length and the range of motion of ankle(R2=0.551).Conclusion:As for the indicators such as Achilles tendon stiffness index,ankle joint stiffness,Achilles tendon length and maximum heel height,there were significant differences between the affected and unaffected sides of the patients with Achilles tendon injury,but no significant differences between the left and right sides of the healthy people.Therefore,the above four indicators can be included in the evaluation indexes of the rehabilitation effect after Achilles tendon injury.Since there is a low correlation between Achilles tendon stiffness index,ankle joint stiffness,Achilles tendon length and maximum heel height,they can independently reflect the recovery of their own properties,morphology and function after Achilles tendon injury,and can provide important reference information for rehabilitation personnel.In the case of unsatisfactory test conditions,we can get a preliminary understanding of the Achilles tendon state according to the equation after measuring the length of the Achilles tendon and the range of motion in the ankle.