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- Title
Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence.
- Authors
Mark-Christensen, Troels; Troelsen, Anders; Kallemose, Thomas; Barfod, Kristoffer; Barfod, Kristoffer Weisskirchner
- Abstract
<bold>Purpose: </bold>The optimal treatment for acute Achilles tendon rupture (ATR) is continuously debated. Recent studies have proposed that the choice of either operative or non-operative treatment may not be as important as rehabilitation, suggesting that functional rehabilitation should be preferred over traditional immobilization. The purpose of this meta-analysis of randomized controlled trials (RCTs) was to compare functional rehabilitation to immobilization in the treatment of ATR.<bold>Method: </bold>This meta-analysis was conducted using the databases: PubMed, EMBASE, Rehabilitation and Sports Medicine Source, AMED, CINAHL, Cochrane Library and PEDro using the search terms: "Achilles tendon," "rupture," "mobilization" and "immobilization". Seven RCTs involving 427 participants were eligible for inclusion, with a total of 211 participants treated with functional rehabilitation and 216 treated with immobilization.<bold>Results: </bold>Re-rupture rate, other complications, strength, range of motion, duration of sick leave, return to sport and patient satisfaction were examined. There were no statistically significant differences between groups. A trend favoring functional rehabilitation was seen regarding the examined outcomes.<bold>Conclusion: </bold>Functional rehabilitation after acute Achilles tendon rupture does not increase the rate of re-rupture or other complications. A trend toward earlier return to work and sport, and increased patient satisfaction was found when functional rehabilitation was used. The present literature is of low-to-average quality, and the basic constructs of the examined treatment and study protocols vary considerably. Larger, randomized controlled trials using validated outcome measures are needed to confirm the findings.<bold>Level Of Evidence: </bold>II.
- Subjects
ACHILLES tendon rupture; ACHILLES tendon injury treatment; RANDOMIZED controlled trials; META-analysis; PATIENT satisfaction; THERAPEUTICS; ACHILLES tendon injuries; COMPARATIVE studies; RANGE of motion of joints; ORTHOPEDIC apparatus; RESEARCH methodology; MEDICAL cooperation; PHYSICAL therapy; RESEARCH; SICK leave; TENDON injuries; DISEASE relapse; EVALUATION research; TREATMENT effectiveness; WEIGHT-bearing (Orthopedics)
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2016, Vol 24, Issue 6, p1852
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3180-5