J Korean Foot Ankle Soc.  2023 Mar;27(1):12-16. 10.14193/jkfas.2023.27.1.12.

Simple Postoperative Exercise of Acute Achilles Tendon Rupture without Active Range of Motion Exercise

• Hwang JK
• Jung Y
• Seo DK

• KMID: 2540401
• DOI: http://doi.org/10.14193/jkfas.2023.27.1.12

Abstract

Purpose
Postoperative exercise for acute Achilles tendon rupture is important for a patient’s return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair.
Materials and Methods
From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann–Whitney test. Statistical significance was set as p<0.05.
Results
The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05).
Conclusion
Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.

Keyword

Achilles tendon rupture; Full weight bearing; Range of motion; Postoperative exercise

Figure

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  Figure. 1 Controlled ankle motion boot with range of motion (A), and without range of motion (B).

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  Figure. 2 Full squat was considered as dynamic full range of motion of ankle (A). Double heel rise exercise (B) and single heel rise exercise (C).

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