Effect of Achilles tendon lengthening on ankle muscle performance in people with diabetes mellitus and a neuropathic plantar ulcer.

Abstract:

BACKGROUND AND PURPOSE:The effect of a tendo-Achilles lengthening (TAL) procedure on ankle muscle performance has not been clearly established. The purpose of this study was to compare the effects of TAL and total-contact casting (TCC) with TCC alone on ankle muscle performance in subjects with diabetes mellitus (DM) and a neuropathic plantar ulcer. SUBJECTS:Subjects were randomly assigned to either a TAL group (3 female and 12 male subjects) or a TCC group (4 female and 10 male subjects). METHODS:Muscle performance measurements were obtained using an isokinetic dynamometer. RESULTS:Concentric plantar-flexor peak torque decreased 31% after TAL but returned to the baseline level after 8 months. Dorsiflexor peak torque did not change in either group. Plantar-flexor passive torque at 0 degrees of dorsiflexion decreased after TAL but increased to 60% of the baseline level after 8 months. Maximal dorsiflexion angle increased 11 degrees after TAL and remained increased at 8 months. DISCUSSION AND CONCLUSION:The TAL resulted in an increase in ankle dorsiflexion range of motion and a temporary reduction in concentric plantar-flexor peak torque and passive torque at 0 degrees of dorsiflexion. If TAL is being considered for people with DM and a neuropathic forefoot ulcer, the initial compromise in plantar-flexor muscle performance should be addressed.

journal_name

Phys Ther

journal_title

Physical therapy

authors

Salsich GB,Mueller MJ,Hastings MK,Sinacore DR,Strube MJ,Johnson JE

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

34-43

issue

1

eissn

0031-9023

issn

1538-6724

journal_volume

85

pub_type

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