“The Achilles Tendon Length Measure (ATLM) – Development and validation”

Principal investigator: Maria Svennergren.

Principal supervisor: Morten Tange Kristensen.

Co-supervisor(s): Kristoffer W Barfod, MD, PhD-student at Clinical Orthopedic Research Hvidovre (CORH).

Research initiative:  Thesis, master program in Medical Science, Lund University, PMR-C and CORH.

Time frame: September 2013 – June 2015.

Background: Acute Achilles tendon rupture is a relatively common injury (11 to 13 per 100.000), but there is no consensus about which treatment (surgery or conservative) that give patients the best recovery.  Previous studies underline the importance of early controlled exercise and rehabilitation, regardless of the treatment chosen. Also, it has been shown that an Achilles tendon elongation compared to the un-injured leg is negatively associated with the clinical outcome and strength of the gastrocnemius muscle.   Despite this knowledge, there is a lack of a valid score system that can measure the length of the Achilles tendon in daily clinical practice.
Patients, who follow a rehabilitation program at the Department of Physiotherapy, also have their Achilles tendon examined for lengthening by physiotherapists, to evaluate if the heeling progresses as planned. Of concern, this examination is based on measures, which have not been thoroughly validated. 

Purpose: The purpose of this study is 1) to develop and validate a new measurement to assess the length of the Achilles tendon after rupture, and 2) to examine if goniometry (range of motion) of the ankle joint following a standardised procedure is a better method.

Experimental approach: The ATLM test use the same test position of the lower limb as being used in Matles test. Besides observing the foot’s position, we will measure the distance from a point of reference on the foot, to the examination coach. Reproducibility and responsiveness of the ATLM and ROM of the ankle joint will be examined, while concurrent validity will be examined against ultrasound of the Achilles tendon. The ultrasound is considered the most precise, secure and objective measure. The ATLM and ROM measures will be conducted at 8 and 16 weeks after the injury by physiotherapist, while a person blinded to these results will conduct the ultrasound.

Additional information: Will be registered at Clinicaltrials.gov before start of study.

Contact: maria.anna.ulla.svennergren@regionh.dk


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