Are static foot posture and ankle dorsiflexion range of motion associated with Achilles tendinopathy? A cross-sectional study.

Autor: Scattone Silva R; Delaware Tendon and Ligament Research Team, Department of Physical Therapy, University of Delaware, Newark, DE, United States; Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Physical Therapy, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil., Smitheman HP; Delaware Tendon and Ligament Research Team, Department of Physical Therapy, University of Delaware, Newark, DE, United States., Smith AK; Delaware Tendon and Ligament Research Team, Department of Physical Therapy, University of Delaware, Newark, DE, United States., Silbernagel KG; Delaware Tendon and Ligament Research Team, Department of Physical Therapy, University of Delaware, Newark, DE, United States. Electronic address: kgs@udel.edu.
Jazyk: angličtina
Zdroj: Brazilian journal of physical therapy [Braz J Phys Ther] 2022 Nov-Dec; Vol. 26 (6), pp. 100466. Date of Electronic Publication: 2022 Nov 30.
DOI: 10.1016/j.bjpt.2022.100466
Abstrakt: Background: Subtalar hyperpronation and ankle dorsiflexion restriction have been theoretically associated with Achilles tendinopathy (AT). However, evidence to support these associations is lacking.
Objectives: To compare foot alignment and ankle dorsiflexion range of motion (ROM) between the symptomatic and non-symptomatic limbs of individuals with unilateral AT. And to verify whether differences exist between individuals with symptomatic pronated feet and individuals with symptomatic neutral/supinated feet in terms of tendon pain, structure, and symptom severity.
Methods: Sixty-three participants with unilateral AT underwent a bilateral evaluation of pain during tendon palpation, symptom severity, tendon thickening, tendon neovascularization, ankle dorsiflexion ROM, and foot posture alignment [foot posture index (FPI), navicular drop, navicular drift, and longitudinal arch angle (LAA)]. Side and group comparisons were made using t-tests and correlations were evaluated using the Pearson test.
Results: There were no differences between the symptomatic and non-symptomatic limbs regarding foot posture alignment. Specifically, non-significant negligible differences were observed between limbs regarding FPI [mean difference (MD)=-0.23; 95% confidence interval (CI)=-0.70, 0.25), navicular drop (MD=0.58 mm; 95%CI=-0.25, 1.43), navicular drift (MD=0.16 mm; 95%CI=-0.77, 1.09), and LAA (MD=0.30º; 95%CI=-1.74, 2.34). There was no difference between limbs regarding ankle dorsiflexion ROM. However, lower ankle dorsiflexion was associated with worse symptom severity (r = 0.223). Finally, no difference was observed between individuals with symptomatic pronated feet and individuals with symptomatic neutral/supinated feet in terms of tendon pain or structure.
Conclusions: Static foot alignment measures do not seem to be clinically relevant in patients with AT. Smaller ankle dorsiflexion ROM, however, was associated with greater symptom severity in this population.
Competing Interests: Conflicts of interest The authors have no conflict of interest to disclose.
(Copyright © 2022 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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