Functional Status for Surgically and Non-surgically Treated Patients With Acute Achilles Tendon Rupture Following a Public Municipal Rehabilitation

Heel rise test for endurance:

One legged heel rise test performed in standing position barefooted on the floor with fingertips placed against the wall for balance.

Number of repetitions until failure is counted on non-injured leg and afterwards on injured leg. The difference between injured leg and non-injured leg is measured by

Limb Symmetry Index in % (LSI):

(injured leg)/(non-injured leg) x 100

Heel rise test for maximal height:

One legged heel rise test performed in standing position barefooted on the floor with fingertips placed against the wall for balance.

The patient is instructed to go as high as possible. The height from the floor until the distal end of calcaneus is measured with a tape measure to the nearest 0.1 cm.

The difference between injured leg and healthy leg is measured by

Limb Symmetry Index in % (LSI):

(injured leg)/(non-injured leg) x 100

Patients are asked to identify 5 activities they are having difficulty with as a result of their current problem.

Each activity is scored on a 0 (unable to perform activity) to 10 (able to perform activity at same level as before injury or problem) points numeric rating scale.

An average Patient-Specific Functional Scale (PSFS) score is calculated and can vary from 0 to 10, with higher scores representing higher levels of lower extremity functional status.

The NRS is a modified version of the Visuel Analog Scale that consists of a segmented numerical scale with 11 points ranging from 0 to 10. The 11-point numeric scale ranges from 0 representing "no pain" to 10 representing the other pain extreme: "pain as bad as you can imagine" or "worst pain imaginable".

This scale can be administered verbally or graphically.

The Achilles tendon Total Rupture Score (ATRS) is a commonly used patient-reported outcome measure for patients with an acute Achilles tendon rupture.

It consists of 10 questions concerning symptoms and physical activity, for which patients are asked to respond using an 11-point Likert scale (0-10). A patient scoring 0 implies major limitations/symptoms and 10 no limitations or symptoms. Answers from all 10 questions are added to a total score, with 100 being the maximum score

Thompsons test (also called Simmonds squeeze test or Simmonds-Thompson test) is used in lower limb examination to test for the rupture of the Achilles tendon. The patient lies face down with feet hanging off the edge of the bed. If the test is positive, there is no movement of the foot (normally plantarflexion) on squeezing the corresponding calf, signifying likely rupture of the Achilles tendon.

Achilles tendon resting angle (ATRA) has been suggested and used as a surrogate measure of tendon length.

In this test, patients are positioned in prone with the knee flexed to 90 degrees, and the passive angle that the foot falls is measured using a goniometer.

The ATRA is the angle between the long axis of the fibula and the line from the tip of the fibula to the head of the fifth metatarsal.

Amount of tendon elongation is defined as the difference between injured and non-injured sides (positive values indicating greater tendon length on the injured side).

Calf muscle atrophy is assessed by measuring the circumference 13 cm. below the distal apex of the patellae with a tape measure. The circumference will be recorded to the nearest 0.1 cm. and measured on both injured and the non-injured leg.

The TSK is originally a 17-item self-report scale with a 4-point response scale ranging from "strongly disagree" to "strongly agree".

Items 4, 8, 12, and 16 are reversed for scoring. A 13-item version of the scale (TSK-13) without the four reversed items has also been widely used.

The original 17-item scale results in a total score ranging from 17 to 68 points with increasing values indicating a stronger degree of Kinesiophobia. Therefore the 13-item version results in a total score ranging from 13 to 52 points with increasing values indicating a stronger degree of Kinesiophobia.

The Tegner activity score is developed as a measure of activity level. The rating system scores a person's activity level between 0 and 10, where 0 is "sick leave or disability pension because of the specific problem" and 10 is "participation in competitive sports such as soccer at a national or international elite level."

Assessed as female or male through the health record system

Assessed in years through the health record system

Smoking status is described as smoking status regarding tobacco. The status is filled in by the participants with some of the patient reported outcome meassures.

The smoking status is assessed as either smoker or non-smoker.

Body weight and height are filled in by the participants with some of the patient reported outcome meassures.

BMI is then calculated:

Body weight in kilograms divided by the square og the height in meters.

Treatment status is described in either surgery or non-surgery. Assessed in through the health record system.

Length of rehabilitation period is described in number of days through the health record system.

Number of supervised treatments in rehabilitation is described in number of visits through the health record system.