The influence of an orthopaedic walker boot on forefoot force.
Achilles
Eloctromyography
Force
Muscle
Orthosis
Tendon
Journal
Foot (Edinburgh, Scotland)
ISSN: 1532-2963
Titre abrégé: Foot (Edinb)
Pays: Scotland
ID NLM: 9109564
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
17
04
2020
revised:
07
07
2020
accepted:
29
08
2020
pubmed:
8
12
2020
medline:
26
10
2021
entrez:
7
12
2020
Statut:
ppublish
Résumé
In the treatment of an Achilles tendon rupture the patients are commonly equipped with an orthopaedic walker boot with wedges. To what extent this influences the tensile force placed on the Achilles tendon is unclear. To assess the forefoot force and describe changes in muscle activity of the medial gastrocnemius, soleus and tibialis anterior when using one or three wedges during ambulation in a weightbearing orthopaedic walker boot. The force on the forefoot was measured with a force sensor insole and muscle activity of the medial gastrocnemius, soleus and tibialis anterior were measured using surface electromyography in 10 healthy participants. Three different types of ambulation were performed (walking without crutches (unass.), walking with crutches (+crutch) and walking with crutches and verbal instructions to place body weight on heel (heel+crutch) with one and three heel wedges respectively. The total peak force displayed an interaction where forefoot force decreased when wearing three wedges only for the +crutch ambulation type (80N, p=0.001) although there was a trend to decrease with three wedges also for the heel+crutch ambulation type (48N, p=0.05). The relative peak force on the forefoot showed a main effect with a significant decrease when using three wedges compared to one wedge across all three ambulation types (19.1%, p=0.009). The force on the forefoot and hereby the Achilles tendon significantly decreased when using three wedges compared to one wedge. These findings have important implications for the rehabilitation post Achilles tendon rupture.
Sections du résumé
BACKGROUND
BACKGROUND
In the treatment of an Achilles tendon rupture the patients are commonly equipped with an orthopaedic walker boot with wedges. To what extent this influences the tensile force placed on the Achilles tendon is unclear.
PURPOSE
OBJECTIVE
To assess the forefoot force and describe changes in muscle activity of the medial gastrocnemius, soleus and tibialis anterior when using one or three wedges during ambulation in a weightbearing orthopaedic walker boot.
METHODS
METHODS
The force on the forefoot was measured with a force sensor insole and muscle activity of the medial gastrocnemius, soleus and tibialis anterior were measured using surface electromyography in 10 healthy participants. Three different types of ambulation were performed (walking without crutches (unass.), walking with crutches (+crutch) and walking with crutches and verbal instructions to place body weight on heel (heel+crutch) with one and three heel wedges respectively.
FINDINGS
RESULTS
The total peak force displayed an interaction where forefoot force decreased when wearing three wedges only for the +crutch ambulation type (80N, p=0.001) although there was a trend to decrease with three wedges also for the heel+crutch ambulation type (48N, p=0.05). The relative peak force on the forefoot showed a main effect with a significant decrease when using three wedges compared to one wedge across all three ambulation types (19.1%, p=0.009).
INTERPRETATION
CONCLUSIONS
The force on the forefoot and hereby the Achilles tendon significantly decreased when using three wedges compared to one wedge. These findings have important implications for the rehabilitation post Achilles tendon rupture.
Identifiants
pubmed: 33285492
pii: S0958-2592(20)30077-8
doi: 10.1016/j.foot.2020.101739
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101739Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.