HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Salsich, G. B Articles by Johnson, J. E Search for Related Content PubMed PubMed Citation Articles by Salsich, G. B Articles by Johnson, J. E

Effect of Achilles Tendon Lengthening on Ankle Muscle Performance in People With Diabetes Mellitus and a Neuropathic Plantar Ulcer

GB Salsich, PT, PhD, is Assistant Professor, Department of Physical Therapy, Saint Louis University, 3437 Caroline St, St Louis, MO 63104 (USA) (salsichg{at}slu.edu)
MJ Mueller, PT, PhD, FAPTA, is Associate Professor and Director of the Applied Biomechanics Laboratory, Program in Physical Therapy, Washington University School of Medicine, St Louis, Mo
MK Hastings, PT, DPT, ATC, is Instructor, Program in Physical Therapy, Washington University School of Medicine
DR Sinacore, PT, PhD, is Associate Professor, Program in Physical Therapy, Washington University School of Medicine
MJ Strube, PhD, is Professor, Department of Psychology, Washington University
JE Johnson, MD, is Associate Professor, Chief, Foot and Ankle Service, Department of Orthopaedic Surgery, Washington University School of Medicine

Address all correspondence to Dr Salsich

Background and Purpose. The effect of a tendo-Achilles lengthening (TAL) procedure on ankle muscle performance has not been clearly established. The purpose of this study was to compare the effects of TAL and total-contact casting (TCC) with TCC alone on ankle muscle performance in subjects with diabetes mellitus (DM) and a neuropathic plantar ulcer. Subjects. Subjects were randomly assigned to either a TAL group (3 female and 12 male subjects) or a TCC group (4 female and 10 male subjects). Methods. Muscle performance measurements were obtained using an isokinetic dynamometer. Results. Concentric plantar-flexor peak torque decreased 31% after TAL but returned to the baseline level after 8 months. Dorsiflexor peak torque did not change in either group. Plantar-flexor passive torque at 0 degrees of dorsiflexion decreased after TAL but increased to 60% of the baseline level after 8 months. Maximal dorsiflexion angle increased 11 degrees after TAL and remained increased at 8 months. Discussion and Conclusion. The TAL resulted in an increase in ankle dorsiflexion range of motion and a temporary reduction in concentric plantar-flexor peak torque and passive torque at 0 degrees of dorsiflexion. If TAL is being considered for people with DM and a neuropathic forefoot ulcer, the initial compromise in plantar-flexor muscle performance should be addressed.

Key Words: Ankle • Clinical trial • Stiffness • Torque