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Vadstyrka och hälrelaterad funktion hos vuxna med akillesinsertalgi: - jämförelse före och efter ultraljuds- och dopplerguidad kirurgi i lokalanestesi
Luleå University of Technology, Department of Health, Education and Technology.
2025 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Calf Strength and Heel-Related Function in Adults With Insertional Achilles Tendinopathy : A Pre- and Postoperative Comparison Following Ultrasound- and Doppler-Guided Surgery Under Local Anesthesia (English)
Abstract [sv]

Syftet var att jämföra vadstyrka och självupplevd hälrelaterad funktionsnivå preoperativt och tolv veckor postoperativt hos vuxna patienter med akillesinsertalgi, opererade med ultraljuds- och dopplerguidad kirurgi i lokalanestesi.

Metod: Studien är en pilotstudie med single-group pretest-posttest design med konsekutivt urval. Sju deltagare inkluderades i studien och undersöktes med Self-reported foot and ankle score (SEFAS) och The victorian institute of sports assessment - achilles questionnaire (VISA-A-S) gällande självupplevd funktion samt vadstyrka analyserat med Calf Raise app, omedelbart innan operation samt tolv veckor efter operation. Smärta under tåhävningstest skattades med Visuell Analog Skala, VAS. 

Resultat: Tre deltagare föll bort av anledningar ej relaterade till det kirurgiska ingreppet innan uppföljningsmätningarna. Poängen på SEFAS ökade från M:17,7 (7,5) preoperativt till 29,5 (9,7) tolv veckor postoperativt och VISA-A-S från 38,5 (16,6) till 50,8 (13,3). Tre av deltagarna klarade att utföra tåhävningstestet efter operationen. Totalt positivt arbete minskade från M: 411,3 (426,5) joule till M: 270 (80,7) postoperativt. Samtliga deltagare skattade smärtan lägre i samband med tåhävningarna postoperativt.

Slutsats: Samtliga deltagare hade förbättrat sitt resultat på frågeformulären SEFAS och VISA-A-S vid den postoperativa mätningen. Medelvärdet på vadstyrka var lägre tolv veckor efter operation. Övervakad träning hos fysioterapeut hade kunnat minska risken för rörelserädsla under rehabiliteringen och guida i lämplig tidpunkt för mer achillesprovocerande träning. I egenskap av pilotstudie har denna studie visat styrkor och svagheter av värde för en framtida större studie. Eftersom studien är liten, kan resultatet dock ej generaliseras mot hela populationen. 

Abstract [en]

The aim of the study was to compare calf strength and self-perceived heel-related function preoperatively and twelve weeks postoperatively in adults with insertional achilles tendinopathy, treated with ultrasonography- and doppler-guided surgery with local anaesthesia. 

Method: A pilotstudy was made with a single-group pretest-posttest design, using a consecutive sampling. Seven individuals were included and studied by using the Self-Reported foot and ankle score (SEFAS) and the Swedish version of the Victorian institute of sports assessment - achilles questionnaire (VISA-A-S) to explore self-perceived function and calf strength, by doing calf raises analyzed by the Calf Raise app, immediately before the surgery and twelve weeks after the surgery. Pain during the Calf raise test was assessed using the Visual Analogue Scale (VAS).

Results: Three participants dropped out for reasons unrelated to the surgical procedure before follow-up measurements. The SEFAS score increased from M: 17,7 (7,5) preoperatively to 29,5 (9,7) postoperatively and VISA-A-S from 38,5 (16,6) to 50,8 (13,3). Three of the participants were able to do the Calf raise test twelve weeks after the surgery. Total positive work decreased from M: 411,3 (426,5) joule to M: 270 (80,7) postoperatively. All of the participants rated lower pain on VAS during the postoperative calf raises.

Conclusion: All participants improved their results on the SEFAS and VISA-A-S questionnaires at the postoperative measurement. The mean value of calf strength was lower after surgery, why the introduction of jogging in the rehabilitation program should be postponed. Supervised training with a physiotherapist can reduce the risk of fear avoidance during rehabilitation and assess  the appropriate timing for more achilles-provoking training. In the role of being a pilot study, valuable strengths and limits using this method have been identified in the event of making a larger study in the future. As there are few participants, the results of this study can not be generalized to the population. 

Place, publisher, year, edition, pages
2025. , p. 35
Keywords [sv]
Akillesinsertalgi, hälrelaterad funktion, ultraljuds- och dopplerguidad kirurgi, vadstyrka
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:ltu:diva-112168OAI: oai:DiVA.org:ltu-112168DiVA, id: diva2:1948178
Educational program
Physiotherapy, master's level (60 credits)
Supervisors
Examiners
Available from: 2025-03-28 Created: 2025-03-28 Last updated: 2025-03-28Bibliographically approved

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