아킬레스건 파열 수술 후 걷기 및 달리기 운동역학적 분석 (Biomechanical Analysis of Walking and Running after a Surgically Repaired Achilles Tendon Rupture)

서지정보

· 발행기관 : 한국운동역학회
· 수록지 정보 : 한국운동역학회지 / 31권 / 4호 / 241 ~ 248페이지
· 저자명 : 허정, 박상균

초록

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running.
Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data.
Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05).
Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.

영어초록

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running.
Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data.
Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05).
Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.

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