Tendon Morphology and Mechanical Properties Are Associated With the Recovery of Symptoms and Function in Patients With Achilles Tendinopathy
Tendon Morphology and Mechanical Properties Are Associated With the Recovery of Symptoms and Function in Patients With Achilles Tendinopathy
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DOI：
10.1177/2325967120917271
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发表时间：
2020-04-01
影响因子：
2.6
通讯作者：
Gravare Silbernagel, Karin
中科院分区：
文献类型：
--
作者：
Corrigan, Patrick;Cortes, Daniel H.;Gravare Silbernagel, Karin
背景：跟腱病是一种以疼痛、跟腱结构改变和功能受损为特征的使人衰弱的过度使用性损伤。评估肌腱结构作为体检的一部分可能有助于建立一个明确的预后。然而，测量肌腱结构对发展预后的有用性一直受到质疑，因为结构异常可以在没有症状的情况下存在。目的：通过前瞻性随访跟腱病患者队列，确定肌腱形态和机械性能的初始测量是否与基线、6个月随访和1年随访时患者报告的症状和小腿肌肉耐力相关。研究设计：队列研究;证据等级，2.方法：共有59名患有中部或插入处跟腱病的参与者完成了初始评估和6个月和1年的随访评估。在初始评估时，评价了患者报告的症状、小腿肌肉耐力和跟腱增厚，并估计了跟腱的机械性能。在6个月和1年的随访评估中，重新评估了患者报告的症状和小腿肌肉耐力。结果：初始评估时跟腱增厚与每次评估时患者报告的症状和小腿肌肉耐力恶化一致相关。肌腱的初始剪切模量缓和了一年中症状的变化，较低的剪切模量与症状的改善较少相关。较低的粘度在最初的评估也与更差的小腿肌肉耐力在每个assessment.Conclusion：肌腱形态和力学性能的措施似乎与患者报告的症状和小腿肌肉功能与跟腱病患者。
Background:Achilles tendinopathy is a debilitating overuse injury characterized by pain, altered Achilles tendon structure, and impaired functional performance. Evaluating tendon structure as part of the physical examination may help establish a well-defined prognosis. However, the usefulness of measuring tendon structure for developing a prognosis has been questioned since structural abnormalities can exist without symptoms.Purpose:To determine whether initial measures of tendon morphology and mechanical properties were associated with patient-reported symptoms and calf muscle endurance at baseline, 6-month follow-up, and 1-year follow-up by prospectively following a cohort of individuals with Achilles tendinopathy.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 59 participants with midportion or insertional Achilles tendinopathy completed an initial assessment and follow-up assessments at 6 months and 1 year. At the initial assessment, patient-reported symptoms, calf muscle endurance, and Achilles tendon thickening were evaluated, and Achilles tendon mechanical properties were estimated. At the 6-month and 1-year follow-up assessments, patient-reported symptoms and calf muscle endurance were reevaluated.Results:Greater Achilles tendon thickening at the initial assessment was consistently associated with worse patient-reported symptoms and calf muscle endurance at each assessment. Changes in symptoms over the year were moderated by the initial shear modulus of the tendon, with a lower shear modulus associated with less improvement in symptoms. Lower viscosity at the initial assessment was also associated with worse calf muscle endurance at each assessment.Conclusion:Measures of tendon morphology and mechanical properties appear to be associated with patient-reported symptoms and calf muscle function for patients with Achilles tendinopathy.