96
· DOS Abstracts
Functional rehabilitation of patients with acute
Achilles tendon rupture: A meta-analysis of current
evidence.
Kristoffer Weisskirchner Barfod, Troels Mark-Christensen, Thomas Kallemose,
Anders Troelsen
Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre,
Copenhagen University Hospital Hvidovre; , Physiotherapist at Fysiocenter
Århus
Background:
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 the following
rehabilitation, suggesting that functional rehabilitation should be preferred over
traditional immobilization.
Purpose / Aim of Study:
The purpose of this meta-analysis of randomized,
controlled trials (RCT’s) was to compare functional rehabilitation to immobiliza-
tion in the rehabilitation of ATR.
Materials and Methods:
This meta-analysis was conducted using the data-
bases: PubMed, Embase, Rehabilitation & Sports Medicine Source, Amed, Cinahl,
Cochrane and PEDro using the search terms: “Achilles tendon”, “rupture”, “mo-
bilization” and “immobilization”. Seven RCT’s involving 427 participants were
eligible for inclusion, with a total of 211 participants treated functionally and
216 treated with immobilization.
Findings / Results:
Re-rupture rate, other complications, strength, range of
motion, duration of sick leave, return to sport and patient satisfaction was ex-
amined. There were no statistically significant differences between groups. A
trend favoring functional rehabilitation was seen regarding the examined out-
comes.
Conclusions:
Functional rehabilitation after acute Achilles tendon rupture does
not increase the rate of re-rupture or other complications. There is a trend to-
wards earlier return to work and a significant increased patient satisfaction us-
ing functional rehabilitation. 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 mea-
sures are needed to confirm the findings.
43.
