{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:21:04Z","timestamp":1789514464719,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess whether the neuromuscular activation pattern following Achilles tendon rupture and repair may contributes to the observable functional deficits in this severe and increasingly frequent injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this study, the neuromuscular activation using surface EMG of\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200952 patients was assessed during a battery of functional performance tasks to assess potential alterations of muscular activation and recruitment. We analyzed the injured leg vs. the contralateral healthy leg at a mean of 3.5 years following open surgical repair. The testing battery included isokinetic strength testing, bipedal and single\u2010legged heel\u2010rise testing as well as gait analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During isokinetic testing, we observed a higher activation integral for all triceps surae muscles of the injured side during active dorsiflexion, e.g., eccentric loading on the injured leg, while concentric plantarflexion showed no significant difference. Dynamic heel\u2010rise testing showed a higher activation in concentric and eccentric loading for all posterior muscles on the injured side (not significant); while static heel\u2010rise for 10\u00a0sec. revealed a significantly higher activation. Further analysis of frequency of fast Fourier\u2010transformed EMG revealed a significantly higher median frequency in the injured leg. Gait analysis revealed a higher pre\u2010activation of the tibialis anterior before ground contact, while medial and lateral gastrocnemius muscles of the injured leg showed a significantly higher activation during push\u2010off phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this study provide evidence on the neuromuscular changes 3.5 years following open surgical Achilles tendon repair. These complex neuromuscular changes are manifested to produce the maximum force output whilst protecting the previously injured tendon. The observed alterations may be related to an increased recruitment of type II muscle fibers which could make the muscles prone to fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-021-06512-z","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T13:20:09Z","timestamp":1614777609000},"page":"2517-2527","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Neuromechanical activation of triceps surae muscle remains altered at 3.5 years following open surgical repair of acute Achilles tendon rupture"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-2317","authenticated-orcid":false,"given":"Markus","family":"Wenning","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Rennbahnklinik Muttenz Basel Switzerland"},{"name":"<!--<label>2<\/label>--> Department of Orthopedic and Trauma Surgery, Faculty of Medicine, University Medical Center Freiburg Albert\u2010Ludwigs University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Mauch","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rennbahnklinik Muttenz Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"Heitner","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rennbahnklinik Muttenz Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Lienhard","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Sport and Sport Science, Biomechanics and Motor Control Albert\u2010Ludwigs University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Ritzmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rennbahnklinik Muttenz Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Paul","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rennbahnklinik Muttenz Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12456"},{"key":"e_1_2_11_3_2","first-page":"563","article-title":"Functional outcomes of repair of Achilles tendon using a biological open surgical method","volume":"48","author":"Arslan A","year":"2014","journal-title":"ActaOrthopTraumatolTurc"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(02)00050-0"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2019.2560"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2010.07.004"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2014.11.005"},{"key":"e_1_2_11_8_2","doi-asserted-by":"crossref","unstructured":"De la FuenteC HenriquezH CarmontMR HuincahueJ ParedesT TapiaM ArayaJP D\u00edazN CarpesFPDo the heel\u2010rise test and isometric strength improve after Achilles tendon repair using Dresden technique?.Foot Ankle Surg(2021)10.1016\/j.fas.2021.01.00733509663","DOI":"10.1016\/j.fas.2021.01.007"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006010\u20108"},{"key":"e_1_2_11_10_2","first-page":"211","article-title":"Relationship between recovery of calf\u2010muscle biomechanical properties and gait pattern following surgery for Achilles tendon rupture","volume":"22","author":"Don R","year":"2007","journal-title":"ClinBiomech"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-006-0311-9"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2009.08.009"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(00)00027-4"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00189.2005"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105058\u20104"},{"key":"e_1_2_11_16_2","volume-title":"Strength and power in sport\/edited by Paavo V. 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October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was carried out at and funded by Praxisklinik Rennbahn AG.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"This study was approved by the local ethics committee and performed in accordance with the Declaration of Helsinki. All participants declared informed consent prior to inclusion.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}