Aşil Tendon Tamiri Yapılan Bireylerde Yumuşak Dokuya veya Ekleme Yönelik Manuel Terapi Uygulamalarının Ayak Bileği Eklem Hareketi, Fonksiyonelliği ve Kas Pasif Mekanik Özellikleri Üzerine Akut Etkisinin Karşılaştırılması

Abstract

Tan F. The Acute Effect Comparisons of Manual Therapy Application to Ankle Soft Tisues or to Ankle Joint on Ankle Motion, Functional Status, and Passive Mechanical Properties of Muscle in Individuals Who Had Achilles Tendon Repair. Hacettepe University, Graduate School of Health Sciences, Doctoral Thesis in Orthopedic Physiotherapy and Rehabilitation Program, Ankara, 2025. This study aimed to compare the acute effects of manual therapy techniques targeting soft tissue and joint mobilization on ankle joint mobility, functionality, and passive mechanical properties of muscles in individuals who underwent Achilles tendon repair. A total of 20 participants with repaired Achilles tendons were included in the study and divided into two groups: one group received Compressive Myofascial Release (CMR), and the other group underwent Talocrural joint mobilization, with 10 participants in each group. Before to the interventions, the passive mechanical properties (tone, elasticity, stiffness) of the Medial and Lateral Gastrocnemius (MG and LG) muscles and the Achilles tendon were assessed using Myoton-3. The Achilles tendon resting angle was measured with a universal goniometer, the heel rise level was evaluated using the Heel Rise Test, and ankle dorsiflexion was assessed with the Weight-Bearing Lunge Test (WBLT). Functional levels were evaluated using the Achilles Tendon Total Rupture Score (ATRS) and the Foot and Ankle Outcome Score (FAOS). No additional physiotherapy interventions were administered to the individuals prior to the manual therapy applications. Following a single-session intervention, the same assessment measurements were repeated. The demographic characteristics of the two groups were found to be similar (p>0.05). CMR was more effective than Talocrural joint mobilization in reducing the stiffness of the MG, LG, and Achilles tendon, as well as in decreasing MG muscle tone (p<0.05). In both groups, the Achilles tendon resting angle, Heel rise height, and WBLT scores significantly increased post-intervention compared to pre-intervention values (p<0.05). Additionally, ATRS and FAOS scores were high in both groups. These findings suggest that incorporating CMR into rehabilitation programs following Achilles tendon repair may enhance improvements in the passive mechanical properties of muscles. Furthermore, both CMR and Talocrural joint mobilization were effective in improving functional performance measures, such as Achilles tendon resting angle, Heel rise height, and WBLT, indicating that these interventions can be beneficially integrated into rehabilitation protocols.