Abstract：
BACKGROUND: Subtalar hyperpronation and ankle dorsiflexion restriction have been theoretically associated with Achilles tendinopathy (AT). However, evidence to support these associations is lacking.
OBJECTIVE: 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.
OBJECTIVE: 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.
摘要：
背景：距下超旋前和踝关节背屈限制理论上与跟腱病（AT）相关。然而,缺乏支持这些关联的证据。
目的：比较单侧AT患者有症状和无症状肢体的足部对位和踝关节背屈活动度（ROM）。并验证在肌腱疼痛方面，有症状的内旋脚个体和有症状的中性/仰卧脚个体之间是否存在差异，结构,和症状严重程度。
方法：63例单侧AT患者在肌腱触诊期间接受了双侧疼痛评估，症状严重程度,肌腱增厚,肌腱新生血管,踝关节背屈ROM,和足部姿势对齐[足部姿势指数(FPI)，舟骨下降，舟骨漂流,和纵向拱角（LAA）]。使用t检验进行侧方和组间比较，并使用Pearson检验评估相关性。
结果：有症状的和无症状的肢体在足姿势对准方面没有差异。具体来说,关于FPI[平均差（MD）=-0.23;95％置信区间（CI）=-0.70，0.25），舟状跌落（MD=0.58mm；95CI=-0.25，1.43），舟骨漂移（MD=0.16mm；95CI=-0.77，1.09），和左心耳（MD=0.30º；95CI=-1.74，2.34）。关于踝关节背屈ROM，四肢之间没有差异。然而,下踝关节背屈与症状严重程度更差相关(r=0.223)。最后,在肌腱疼痛或结构方面,有症状的内旋足个体和有症状的中性/仰卧足个体之间没有观察到差异.
结论：在AT患者中，静态足部对准措施似乎与临床无关。较小的脚踝背屈ROM，然而,在该人群中与更大的症状严重程度相关。
目的：比较单侧AT患者有症状和无症状肢体的足部对位和踝关节背屈活动度（ROM）。并验证在肌腱疼痛方面，有症状的内旋脚个体和有症状的中性/仰卧脚个体之间是否存在差异，结构,和症状严重程度。
方法：63例单侧AT患者在肌腱触诊期间接受了双侧疼痛评估，症状严重程度,肌腱增厚,肌腱新生血管,踝关节背屈ROM,和足部姿势对齐[足部姿势指数(FPI)，舟骨下降，舟骨漂流,和纵向拱角（LAA）]。使用t检验进行侧方和组间比较，并使用Pearson检验评估相关性。
结果：有症状的和无症状的肢体在足姿势对准方面没有差异。具体来说,关于FPI[平均差（MD）=-0.23;95％置信区间（CI）=-0.70，0.25），舟状跌落（MD=0.58mm；95CI=-0.25，1.43），舟骨漂移（MD=0.16mm；95CI=-0.77，1.09），和左心耳（MD=0.30º；95CI=-1.74，2.34）。关于踝关节背屈ROM，四肢之间没有差异。然而,下踝关节背屈与症状严重程度更差相关(r=0.223)。最后,在肌腱疼痛或结构方面,有症状的内旋足个体和有症状的中性/仰卧足个体之间没有观察到差异.
结论：在AT患者中，静态足部对准措施似乎与临床无关。较小的脚踝背屈ROM，然而,在该人群中与更大的症状严重程度相关。
