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Swennergren Hansen M.1, Weisskirchner Barfod K.W.B.2, Tange Kristensen M.3
1Copenhagen University Hospital, Hvidovre, Department of Physiotherapy, Copenhagen, Denmark, 2Copenhagen University Hospital, Hvidovre, Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen, Denmark, 3Copenhagen University Hospital, Hvidovre, Department of Physiotherapy, Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen, Denmark
Background: A prolonged Achilles Tendon (AT) following AT rupture is associated with strength deficits and reduced function. The first three months after injury have been identified as the time when the main changes of the AT length occur. Therefore a valid, reliable, and easily applicable clinical measure of the length of the AT that can be used during this time period after rupture is needed.
Purpose: To examine the reliability of a new ruler based measurement, the Achilles Tendon Length Measure (ATLM) in comparison with the goniometer-based Achilles Tendon Resting Angle (ATRA).
Methods: The development of ATLM originates from the well-known Matles test. The ATLM use identical positioning of the patient and feet, but aim to provide an objective assessment by measuring the exact distance between the feet and the examination couch with a ruler. As well as ATRA, the resting position of the feet is measured during ATLM as an indirect measure of the length of the AT. ATLM and ATRA measurements were performed by two independent physiotherapists eight weeks after AT rupture on 28 patients treated non-operatively. The data assessors were inter- and intra-rater blinded to outcome data.
Results: The mean (SD) injured ATLM was 56.5 (2.3) cm, ICC2.1 0.91(CI [0.72-0.97]), SEM 0.7cm (SEM% 1.2), MDC 1.9cm (MDC% 3.4). Corresponding data for the injured ATRA was mean 64.4° (3.9°), ICC2.1 0.84 (CI [0.68-0-92]), SEM 1.5° (SEM% 2.4), MDC 4.3° (MDC% 6.6).
Conclusion(s): Both ATLM and ATRA showed excellent inter-rater reliability with low measurement error. Both measurements seem easy to use in clinical practice and potentially providing an indirect measure of the length of the AT after rupture.
Implications: In order to treat our patients optimal, reliable and valid measurements are needed. This study present possible methods of how to measure elongation of the Achilles tendon after rupture.
Funding acknowledgements: No founding.
Topic: Orthopaedics
Ethics approval: The study was reported to Capital Regions Research Ethics Committee, which deemed that no approval was needed (journal number: H-4-2013-FSP).
All authors, affiliations and abstracts have been published as submitted.
