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Incidence of microtrauma in the Achilles tendon compared in athletic runners and swimmers using diagnostic ultrasonography
Novotný, Aleš ; Routner, Petr (advisor) ; Katolický, Jakub (referee)
9 ABSTRACT INTRODUCTION: The Achilles tendon is the tendon with the most volume in the human body. It is capable of handling enormous loads, though it can be damaged with overuse. Overloading the Achilles tendon can lead to microtrauma, which can cause the development of Achilles tendinopathy. Diagnostic ultrasonography is used to investigate the incidence of microtrauma of the Achilles Tendon in runners and swimmers and whether there is any kind of correlation between their occurrence and training intensity. OBJECTIVE: This study aims to determine the presence of microtrauma in the Achilles tendon in a group of runners and swimmers using diagnostic ultrasonography. In addition to the observation of microtrauma, this study focuses on finding other Achilles tendon pathologies from overuse in runners and swimmers. This study seeks to increase awareness of the potential of using diagnostic ultrasonography in physiotherapy practice. METHODS: A total of 20 subjects (13 women and 7 men, mean age 22.6 ± 1.16 years) participated in this study. The subjects were divided into two groups of 10 swimmers and 10 runners each. Data collection was carried out at a private outpatient clinic at ALAFIA- RHB s.r.o. located in Parník Policlinic in Černý Most, Prague. The methodology for obtaining the personal data and sports...
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Effect of physical exercise on ultrasonographic assessment of Achilles tendon region in runners
Benešová, Adéla ; Machač, Stanislav (advisor) ; Novák, Jakub (referee)
The master thesis entitled "The effect of physical activity on the ultrasonographic evaluation of the Achilles tendon in runners" aims to elucidate the role of physical activi-ty on the outcome of ultrasonographic (USG) examinations. Thirty-two runners un-derwent a 10km run preceded by a USG examination to evaluate and measure their Achilles tendon (AT). These findings were compared with the results of an identical USG examination acquired after the run. Statistical analysis showed significantly diffe-rent values for the following parameters: cross section area (CSA), m. flexor hallucis longus (m. FHL) diameter and heel fat pat compresibility (HFP). Subjectively assessed retrocalcaneal bursa size also showed differences in dimensions. Another focus of the study was to compare the client-centric state of the AT assessed by the VISA-A questi-onnaire with the CSA values and the size of the musculotendinous junction (MTJ) angle of the m. soleus. The size of CSA was inversely correlated with VISA-A values. MTJ angle and VISA-A did not show a statistically significant association.
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Viscous and elastic properties of soft tissue "in situ"
Moravcová, Kamila ; Šifta, Petr (advisor) ; Bittner, Václav (referee)
Title: Viscousand elastic properties of soft tissue"in situ" Goals and methods: The aim of this thesis is to measure the viscoelastic properties of human soleus muscle and Achilles tendonin vivo and post mortem in situ. It is a pilot study that uses myotonometry as the method of measurement. Based on the response of connective tissues on deformation made by tip of myotonometer, resp. its viscoelastic properties, curves in graphsare created. Three main described parameters of thecurveare steepness, deflection and its surface area. Main goal of the experiment is to compare properties of different types of tissue and their potential differences while denervated or innervated. Results of this study may help with better understanding of the soft tissues behavior in response to manual therapeutic contact. The study also describes the differences between in vivo and post mortem tissue properties that may be help further studies which use post mortem tissues to predict in vivo behavior. Results: Soft tissues in vivo have higher viscosity. In comparison, post mortem tissues have significantly higher stiffness and energy dissipation than in vivo. Elasticproperties of denervated soft tissue manifest with approx. 7 secondsdelay. Viscoelastic properties of muscle tissueshow changes depending on deeper...
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The Effects of Extracorporeal Shock Wave Therapy in Treatment of Achilles Tendinopathy
Katolický, Jakub ; Machač, Stanislav (advisor) ; Novák, Jakub (referee)
Diplomová práce Účinky rázové vlny v léčbě tendinopatie Achillovy šlachy 1 Abstract This thesis focuses on the observation of the effects of low-energetic focused extracorporeal shock wave therapy (ESWT) in the treatment of Achilles tendinopathy. The theoretical part summarizes the current knowledge of anatomical, histological, kinesiological and biomechanical aspects of Achilles tendon (AT), as well as pathological processes, which can be described as Achilles tendinopathy, their differential diagnosis and treatment options. Last but not least, we present up-to-date information on the physical principles and biological effects of ESWT, not only in the treatment of AT diseases. The main goal of our research was to determine the effectiveness of low-energetic focused ESWT in the treatment of Achilles tendinopathy in comparison to the placebo group. The subject of observation was not only changes in clinical manifestations, but also possible changes in the morphology of AT using ultrasonography (USG). Methods: A total of 20 patients with symptomatic Achilles tendinopathy was included in the study, while only 18 of them completed the entire program, and therefore only the results of these patients were evaluated. They were randomly divided into two groups in 1:1 ratio. Group A was treated by ESWT with...
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Analysis of risk factors for development of tendinopathies in runners - literature review
Voleský, Kryštof ; Pavlů, Dagmar (advisor) ; Pánek, David (referee)
Title: The analysis of risk factors for tendinopathy in runners Objectives: The aim of this thesis is to find out the most important risk factor for development of Achilles tendinopathy, detect the most relevant diagnostic approach with preventive monitoring for Achilles tendinopathy and evaluate the best treatment for Achilles tendinopathy in runners. Methods: The diploma thesis is in form of literary review. The Scopus, PubMed and Web of science databases were used to search for studie using a combination of keywords. A total of 1084 titles were identified. Due to duplicates 402 titles were excluded. On the basis of the name of the article 51 titles were included. On the basis of the availability 50 titles were included. On the basis of the abstract 46 titles were included. Finally 29 titles were included in this review. Results: The most important risk factor for development of Achilles tendinopathy was training intensity for distances 1500-3000 m, week running volume >65 km or being new to running. The most relevant diagnostic approach for Achilles tendinopaty was clinical examination assessing pain (Achilles tendon pain, positive palpation test) and function (pain during physical aktivity) of Achilles tendon. This approach serves as indication for sonographic assessment of Achilles tendon...
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Musculoskeletal ultrasound. Possibilities of selected morphological changes evaluation in the lower extremity.
Mezian, Kamál ; Navrátil, Leoš (advisor) ; Dylevský, Ivan (referee) ; Otáhal, Jakub (referee)
1 Abstract The aim is to investigate whether the distal femoral cartilage (DFC), Achilles tendon (AT) and plantar fascia (PF) were different between healthy young women wearing high-heel shoes (HHS) (> 5 cm) and flat shoes (< 1.4 cm). Measurements from aforementioned structures were obtained by using ultrasound. There were 910 measurement parameters analyzed in total. There were 34 women in the HHS group (mean age 31.1±6.4 years; BMI 21.6 ± 2.3 kg/m2 ) and 57 women in the control group (mean age; 29.5 ± 7.3 years; BMI 22.5 ± 3.4 kg/m2 ). Wearing HHS resulted in thickening of the right medial DFC (2.00 ± 0.41 mm) and left AT (4.07 ± 0.48 mm) in women wearing HHS compared to flat shoes (1.96 ± 0.35 mm, 3.76 ± 0.66 mm, respectively). This might be interpreted as secondary to chronic overload. PF thicknesses were similar both within and between group. Our findings have shown significant thickening of the right medial DFC and left AT in women wearing HHS and these changes might be interpreted as secondary to chronic overload. Further follow-up studies are definitely awaited to provide a better insight into understanding the musculoskeletal consequences of this "social" issue ever-existing in ladies lives. The secondary aim of the thesis comprises two case reports: 1. the first is describing the usefulness of MSK...
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Physiotherapeutic Techniques for Patients with Achilles Tendon Rupture with Possibility of Using Balance Aids
JIRÁSKOVÁ, Helena
This bachelor thesis deals with physiotherapeutic techniques in Achilles tendon rupture patients with possibility of using balance aids. My personal interest in these problems lead me to select this topic. There is increasing offer of leisure activity connected with increasing injuries of locomotive organs. Rupture of Achilles tendon is one of them and concerns both top sportsmen and those doing sports in leisure time. The preceding degenerative alteration is a frequent cause of the rupture. My thesis consists of a theoretical and practical part. The theoretical part is a knowledge summary from different disciplines related to this topic. The rupture of Achilles tendon is described in a proper chapter from various aspects etiopathogenesis, mechanism of origin, symptoms, diagnostics and treatment. In the part called therapeutic rehabilitation I described physiotherapeutic methods and concepts I used in therapy. There are two case interpretations of Achilles tendon rupture in the practical part. Investigation was performed using a qualitative form of the initial and final examinations. Based on the initial examination of patients both short-term and longterm rehabilitation plans were prepared with selected physiotherapeutic methods. The goal of my thesis was to evaluate the influence of injury on the locomotive organ and gait patttern. Based on results (comparison of initial a final examinations) the long-term rehabilitation plan was suggested with a participation of balance aids. Physiotherapy shows to be a very contributive by means of the used methods as the tested parameters improved. Soresness in heel and scarf decreased, movement in talar joint to dorsal and plantar flexions improved as well as the muscle strength of m. triceps surae. The values of anthropometry changed. The therapy had a smaller effect on the gait pattern. This thesis can serve to education of students and physiotherapy assistants, but also to patients and public.
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Case report of physiotherapy care of patient with ruptured Achilles tendon
Novotná, Tereza ; Vláčilová, Ivana (advisor) ; Slezáková, Petra (referee)
Name: Tereza Novotná Supervisor's name: Mgr. Ivana Jelínková Title: Case report of physiotherapy care of patient with ruptured Achilles tendon Summary: The aim of this bachelor thesis is introducing the reader with the topic post-operatice physiotherapeutic care on a patient after ruptured Achilles tendon. The thesis includes anatomical, biomechanical and kinesiological knowledge as a foundation for treatment. I described possible operative and conservative procedures. In the special part there is formulated a casae report of one patient in detail. Ten therapeutic units are described including kinesiological analysis and final evaluation. Effectivity of used methods is valorized at the end. Key words: case report, Achilles tendon, physiotherapy, rupture
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