{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:19:09Z","timestamp":1792804749995,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000738","name":"University of Leicester","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Achilles tendon rupture (ATR) is the most common tendon rupture affecting the lower limb. This study investigates Achilles tendon structure, strength and function 1\u00a0year or more after ATR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study recruited individuals \u2265\u00a012\u00a0months post ATR. Structure was assessed using ultrasound tissue characterisation (UTC) including cross\u2010sectional area (CSA), aligned fibrillar structure (AFS), disorganised fibrillar structure (DFS) and echo type percentage. Strength was measured using maximal voluntary isometric contraction (MVIC) plantarflexor testing and the calf raise test. Patient\u2010reported outcomes included the Achilles tendon rupture score (ATRS), EQ\u20105D\u20105L and general practice physical activity questionnaire (GPPAQ). Achilles tendon resting angle (ATRA) was used as an indirect measure of tendon elongation. The relationship between outcomes and time since ATR was analysed using linear regression adjusting for age, sex, ethnicity and body mass index (BMI). Between limb comparisons were made using paired t\u2010tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Sixty participants (mean age 55.2\u00a0years and 78.5% male) were assessed at a mean of 6.8\u00a0years post ATR. The affected tendon showed a 62% larger cross\u2010sectional area, with 28.7\u00a0mm\n                      <jats:sup>2<\/jats:sup>\n                      (16%) DFS compared to 7.3\u00a0mm\n                      <jats:sup>2<\/jats:sup>\n                      (7%) on the nonaffected side (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Linear regression showed decreasing AFS with time postinjury (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04); no significant associations were found for CSA or DFS. Significant deficits were observed in plantarflexor strength and function, with MVIC and calf raise work 18% and 40% lower in the affected limb (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). ATRA indicated tendon elongation in the affected limb of 6.7\u00b0 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Median ATRS was 83, EQ\u20105D index was 0.95 and VAS was 85; 93% were physically active based on the GPPAQ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant structural and functional deficits persist years after ATR, including increased tendon size, fibre disorganisation, reduced strength and tendon elongation. ATRS scores were consistent with previous nonsurgical immobilisation protocol outcomes in the United Kingdom. Longitudinal studies are needed to understand the trajectory of recovery following ATR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jfa2.70134","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T04:03:44Z","timestamp":1770869024000},"source":"Crossref","is-referenced-by-count":3,"title":["Structure and Function of the Achilles Tendon and Plantarflexors 1\u00a0Year Following Achilles Tendon Rupture in the United Kingdom: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-3173","authenticated-orcid":false,"given":"Samuel","family":"Briggs\u2010Price","sequence":"first","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra","family":"Mangwani","sequence":"additional","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"},{"name":"Orthopaedics University Hospitals of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kilcran","sequence":"additional","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchal","family":"Prasad","sequence":"additional","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reihaneh","family":"Salimian","sequence":"additional","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0904-1381","authenticated-orcid":false,"given":"Seth","family":"O'Neill","sequence":"additional","affiliation":[{"name":"University of Leicester School of Healthcare  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12253"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem\u20102024\u2010001960"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620x.99b1.bjj\u20102016\u20100434.r1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046\u20103758.44.2000400"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005608\u2010x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/jsm.0000000000000749"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105049\u20105"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9030288"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7445398"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620x.99b1.bjj\u20102016\u20100452.r1"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620x.102b11.bjj\u20102020\u20100908.r1"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2021.06.008"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2025.101188"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2024.102112"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512447926"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.16.01491"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517717698"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmart.2014.12.002"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.03.007"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ede.0b013e3181577654"},{"key":"e_1_2_12_22_1","unstructured":"NICE \u201cAchilles Tendinopathy: When Should I Suspect Achilles Tendon Rupture? \u201d2020."},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.061010"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515605077"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9348298"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0282395"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102711"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506294856"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010011\u20109903\u2010x"},{"key":"e_1_2_12_30_1","unstructured":"Department of Health (UK). \u201cThe General Practice Physical Activity Questionnaire (GPPAQ): A Screening Tool to Assess Adult Physical Activity Levels Within Primary Care \u201d Best Practice Guidance. 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