{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:34:36Z","timestamp":1790800476380,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T00:00:00Z","timestamp":1572652800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T00:00:00Z","timestamp":1572652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005350","name":"Centrum for Idrottsforskning","doi-asserted-by":"publisher","award":["F2017-0041"],"award-info":[{"award-number":["F2017-0041"]}],"id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005350","name":"Centrum for Idrottsforskning","doi-asserted-by":"publisher","award":["P2017-0111"],"award-info":[{"award-number":["P2017-0111"]}],"id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","award":["SLL20150435"],"award-info":[{"award-number":["SLL20150435"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2012-3510"],"award-info":[{"award-number":["2012-3510"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee Surg Sports Traumatol Arthrosc"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>The hypothesis was that early functional mobilization would reduce the incidence of deep venous thrombosis (DVT) during leg immobilization after Achilles tendon rupture surgery. A secondary aim was to evaluate if the amount of weightbearing and daily steps influenced the risk of sustaining a DVT.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>One-hundred and fifty patients with Achilles tendon rupture repair were randomized to treatment with early functional mobilization, encouraging full weightbearing and ankle motion in orthosis, or treatment-as-usual, i.e., 2\u00a0weeks of unloading in plaster cast followed by 4\u00a0weeks weightbearing in orthosis. At 2 and 6\u00a0weeks postoperatively, all patients were screened for DVT using compression duplex ultrasound. During the first 2\u00a0weeks postoperatively, patient-reported loading, pain and step counts were assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>At 2\u00a0weeks, 28\/96 (29%) of the patients in early functional mobilization group and 15\/49 (31%) in the control group (n.s) had sustained a DVT. At 6\u00a0weeks, the DVT rate was 35\/94 (37%) in the early functional mobilization and 14\/49 (29%) in the control group (n.s). During the first postoperative week, the early functional mobilization group reported low loading and higher experience of pain vs. the control group (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Low patient-reported loading\u2009\u2264\u200950% (OR\u2009=\u20094.3; 95% CI 1.28\u201314.3) was found to be an independent risk factor for DVT, in addition to high BMI and higher age.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Early functional mobilization does not prevent the high incidence of DVT during leg immobilization in patients with Achilles tendon rupture as compared to treatment-as-usual. The low efficacy of early functional mobilization is mainly explained by postoperative pain and subsequent low weightbearing. To minimize the risk of DVT, patients should be encouraged to load at least 50% of body weight on the injured leg 1\u00a0week after surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Level of evidence<\/jats:title>\n<jats:p>Therapeutic, level 1<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00167-019-05767-x","type":"journal-article","created":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T12:02:54Z","timestamp":1572696174000},"page":"312-319","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Early mobilization does not reduce the risk of deep venous thrombosis after Achilles tendon rupture: a randomized controlled trial"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8795-105X","authenticated-orcid":false,"given":"Susanna","family":"Aufwerber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Heijne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Edman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Gr\u00e4vare Silbernagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Ackermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,2]]},"reference":[{"key":"5767_CR1","doi-asserted-by":"publisher","first-page":"I-9","DOI":"10.1161\/01.CIR.0000078469.07362.E6","volume":"107","author":"FA Anderson","year":"2003","unstructured":"Anderson FA, Spencer FA (2003) Risk factors for venous thromboembolism. 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(Dnr: 2013\/1791-31\/3). The study was registered on ClinicalTrials.gov (trial number NCT02318472).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants received oral and written information about the study procedure and provided written informed consent prior to surgery.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}