Changes in physical function and ambulatory state after Achilles tendon lengthening for diabetic foot ulcers.
Shinsuke Imaoka, Genki Kudou, Shohei Minata and 2 others
PMID 36628146WHAT IT FOUND
Gait independence scores did not change after Achilles tendon lengthening, hospitalization, physical therapy, and foot off-loading in 10 patients, although ankle dorsiflexion rose from 3.0 to 13.5 degrees and plantar load fell from 11.5 to 9.3 kgf.
Key findings
01Postoperatively, gait independence scores stayed at median 6 (p=0.951), and walking speed changed from 33.9 to 28.1 cm/sec without statistical significance (p=0.061).
02Postoperatively, median ankle dorsiflexion rose from 3.0 to 13.5 degrees (p=0.001).
03Postoperatively, median plantar load fell from 11.5 to 9.3 kgf (p=0.031), while knee extension strength fell from 22.5 to 19.7 kgf (p=0.024).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 10 patients were studied, so the results could easily reflect chance or this small group. The study was done at one hospital, so the participants and care may not match other settings. It had no control group, so changes after surgery could not be separated from recovery, hospitalization, or rehabilitation. Because it was retrospective, the authors could not fully measure leg range of motion or muscle strength after discharge. The authors state it is difficult to generalize the results. Patients also received hospitalization, physical therapy, and foot off-loading, so the contribution of Achilles tendon lengthening alone cannot be separated.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that Achilles tendon lengthening alone improves walking or prevents ulcers. The study had only 10 patients, no comparison group, and participants also received hospitalization, physical therapy, and foot off-loading, so the contribution of any single component cannot be separated.