Abstract
Objectives
To evaluate the effects of vibration on Achilles’ tendon microcirculation and characteristics
following surgical repair of Achilles’ tendon rupture.
Design
Cohort study with historical controls.
Setting
A university institute.
Participants
Participants (N=32), including 19 (16 men, 3 women; median [range] age: 43.0 [25.0-57.0]
years) and 13 (10 men, 3 women; 44.00 [29.0-60.0] years) in the vibration (application
to the ball of the foot, 30Hz, 2mm amplitude, 4kg pressure, and self-administration)
and control groups, respectively, who underwent unilateral Achilles’ tendon repairs
were recruited.
Intervention
A 4-week vibration intervention in the vibration group.
Main Outcome Measurements
The tendon microcirculation was measured after the first session of vibration. The
participants were evaluated repeatedly with bilateral follow-up measurements of tendon
stiffness, 3 functional outcome tests, and a questionnaire survey.
Results
Acute effects of the vibration were observed immediately after the 5-minute vibration
(P≤.001). Lower total hemoglobin and oxygen saturation were respectively observed (P=.043) in the repaired legs 3 and 6 months postsurgery in the vibration group as compared
with the control group. The vibration group also showed greater tendon stiffness,
heel raising height and hopping distance 3 or 6 months postoperation in both the repaired
and noninjured legs (all P<.05). The microcirculatory characteristics 2 months postoperation were correlated
with the outcomes at 6 months postoperation.
Conclusions
Differences in microcirculatory characteristics and better rehabilitation outcomes
were observed in the legs with an Achilles repair that underwent the early vibration
intervention.
Keywords
List of abbreviations:
IPC (intermittent pneumatic compression), StO2 (oxygen saturation), THb (total hemoglobin)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidence of Achilles tendon rupture.Acta Orthop Scand. 1996; 67: 277-279
- Return to play post-Achilles tendon rupture: a systematic review and meta-analysis of rate and measures of return to play.Br J Sports Med. 2016; 50: 1325-1332
- Characteristics of intratendinous microcirculation shortly after an Achilles rupture and subsequent treatment outcomes.PM R. 2017; 9: 32-39
- A study of the circulation in normal tendons and healing grafts.Ann Surg. 1959; 149: 415-428
- Histologic stages of healing correlate with restoration of tensile strength in a model of experimental tendon repair.HSS J. 2010; 6: 164-170
- Microcirculation after Achilles tendon rupture correlates with functional and patient-reported outcomes.Scand J Med Sci Sports. 2018; 28: 294-302
- Quantitative variation in vascular endothelial growth factor mRNA expression during early flexor tendon healing: an investigation in a canine model.J Orthop Res. 2001; 19: 869-872
- Tendon: biology, biomechanics, repair, growth factors, and evolving treatment options.J Hand Surg Am. 2008; 33: 102-112
- Intermittent pneumatic compression reduces the risk of deep vein thrombosis during post-operative lower limb immobilisation: a prospective randomised trial of acute ruptures of the Achilles tendon.Bone Joint J. 2015; 97-B: 675-680
- Achilles tendon rupture healing is enhanced by intermittent pneumatic compression upregulating collagen type I synthesis.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 2021-2029
- Metabolic activity in early tendon repair can be enhanced by intermittent pneumatic compression.Scand J Med Sci Sports. 2012; 22: e55-e63
- Haemodynamic changes in ipsilateral and contralateral fingers caused by acute exposures to hand transmitted vibration.Occup Environ Med. 1997; 54: 566-576
- Effect of vibration on skin blood flow in an in vivo microcirculatory model.Biosci Trends. 2007; 1: 161-166
- Calf muscle function after Achilles tendon rupture. A prospective, randomised study comparing surgical and non-surgical treatment.Scand J Med Sci Sports. 2002; 12: 9-16
- Achilles tendon rehabilitation.Foot Ankle Clin. 2009; 14: 773-782
- Early neuromechanical outcomes of the triceps surae muscle-tendon after an Achilles' tendon repair.Arch Phys Med Rehabil. 2013; 94: 1590-1598
- Clinical diagnosis of Achilles tendinopathy with tendinosis.Clin J Sport Med. 2003; 13: 11-15
- Pictorial review: the sonographic diagnosis of pathology in the Achilles tendon.Clin Radiol. 1993; 48: 202-206
- Biologics for tendon repair.Adv Drug Deliv Rev. 2015; 84: 222-239
- Morphomechanical alterations in the medial gastrocnemius muscle in patients had a repaired Achilles tendon: associations to outcome measures.Clin Biomech. 2017; 43: 50-57
- Effects of therapeutic physical agents on Achilles tendon microcirculation.J Orthop Sports Phys Ther. 2015; 45: 563-569
- Spectroscopic measurement of blood volume and its oxygenation in a small volume of tissue using red laser lights and differential calculation between two point detections.Optics Laser Technol. 2003; 35: 485-489
- Effects of tendon viscoelasticity in Achilles tendinosis on explosive performance and clinical severity in athletes.Scand J Med Sci Sports. 2012; 22: e147-e155
- Ultrasound-based testing of tendon mechanical properties: a critical evaluation.J Appl Physiol. 2015; 118: 133-141
- The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy.Br J Sports Med. 2001; 35: 335-341
- Efficacy of double mirrored omega pattern for skin sparing mastectomy to reduce ischemic complications.J Plast Surg Hand Surg. 2018; 52: 14-19
- Microcirculatory effects of acupuncture and hyperthermia on Achilles tendon microcirculation.Eur J Appl Physiol. 2010; 109: 1007-1008
- Impact of passive vibration on pressure pulse wave characteristics.J Hum Hypertens. 2012; 26: 610-615
- Plantar fascia anatomy and its relationship with Achilles tendon and paratenon.J Anat. 2013; 223: 665-676
- The role of mechanical stresses in angiogenesis.Crit Rev Biomed Eng. 2005; 33: 431-510
- Neuronal pathways in tendon healing.Front Biosci. 2009; 14: 5165-5187
- Muscle performance during maximal isometric and dynamic contractions is influenced by the stiffness of the tendinous structures.J Appl Physiol. 2005; 99: 986-994
- Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults.Sports Med Open. 2015; 1: 7
- The Achilles tendon: fundamental properties and mechanisms governing healing.Muscles Ligaments Tendons J. 2014; 4: 245-255
- Randomized versus historical controls for clinical trials.Am J Med. 1982; 72: 233-240
Article info
Publication history
Published online: May 10, 2019
Footnotes
Supported by National Science Council in Taiwan, ROC (grant no. NSC105-2628-B-002 -053 -MY3).
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
