{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:21:05Z","timestamp":1789514465019,"version":"build-2803163510"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately 30% of individuals with Achilles tendon rupture do not fully restore normal gait function, regardless of the treatment chosen. Limited knowledge exists about the long-term kinematic, kinetic, and neuromuscular adaptations after repair of an acute Achilles tendon rupture and their impact on muscle\/tendon function. This exploratory cross-sectional study assessed between-limb differences in terms of lower-limb kinematics, kinetics, and muscle activation during walking and jogging stance phases one year after an Achilles tendon rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-seven participants (29 males, 8 females; mean age 47.4\u2009\u00b1\u20099.4 years) were included in the study one year after Achilles tendon rupture, who were both operatively and non-operatively treated. Electromyography (EMG) was recorded synchronously with kinematic and kinetic data using an optical motion capture system with a cluster-based marker set allowing six degrees of freedom. Bilateral EMG was collected from the tibialis anterior, medial and lateral gastrocnemius, and soleus muscles. The stance phase was divided into initial contact to mid-stance (IC-MS) and mid-stance to toe-off (MS-TO). Differences between affected and unaffected limbs were analyzed with multivariate normal models, reporting point estimates and 95% credible intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During walking, triceps surae activation increased in MS\u2013TO, while running showed greater activation in IC\u2013MS. Affected limbs showed higher lateral gastrocnemius activation during walking IC-MS (2.1 EMG%; CI: 0.5\u20133.7) as well as greater medial (3.4%; CI: 0.5\u20136.3) and lateral (4.9%; CI: 2.3\u20137.6) activation in MS-TO. Ankle sagittal joint excursion was reduced in walking MS-TO (-1.8\u00b0; CI: -2.8 to - -0.8) and running MS-TO (-4.1\u00b0; CI: -5.8 to -3.5), with decreased sagittal plantarflexor moments during running (0.06 Nm\/kg: CI: 0.01\u20130.11).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One year after Achilles tendon rupture, walking was characterized by increased gastrocnemius muscle activation and reduced ankle sagittal joint excursion compared with the unaffected side. Moreover, running also showed reduced ankle joint excursion accompanied by attenuated plantar flexor moments, however, without any evident side-to-side differences in EMG recordings. Despite the observed inter-limb deficits, gait resembled normative kinematic patterns, likely reflecting compensatory mechanisms. EMG and joint moments were more variable than kinematics. These results support the need for individualized targeted long-term triceps surae rehabilitation following Achilles tendon rupture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-025-06221-0","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T12:09:37Z","timestamp":1757938177000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Interlimb differences in gait kinematics, kinetics, and muscle activation during walking and running one year after acute unilateral Achilles tendon rupture"],"prefix":"10.1186","volume":"20","author":[{"given":"Kari","family":"Huseth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gu\u00f0ni Rafn","family":"Har\u00f0arson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Aagaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelie","family":"Gutke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Z\u00fcgner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3n","family":"Karlsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina Nilsson","family":"Helander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelie","family":"Brorsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Tranberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"issue":"5","key":"6221_CR1","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1007\/s00167-010-1083-7","volume":"18","author":"MN Doral","year":"2010","unstructured":"Doral MN, Alam M, Bozkurt M, Turhan E, Atay OA, D\u00f6nmez G, et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):638\u201343.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"6221_CR2","doi-asserted-by":"publisher","first-page":"151461","DOI":"10.1016\/j.aanat.2020.151461","volume":"229","author":"K Winnicki","year":"2020","unstructured":"Winnicki K, Ocha\u0142a-K\u0142os A, Rutowicz B, P\u0119kala PA, Tomaszewski KA. Functional anatomy, histology and biomechanics of the human Achilles tendon - A comprehensive review. Ann Anat. 2020;229:151461.","journal-title":"Ann Anat"},{"key":"6221_CR3","doi-asserted-by":"crossref","unstructured":"Perry J, Burnfield J. Gait analysis: normal and pathological function. CRC; 2024.","DOI":"10.1201\/9781003525592"},{"issue":"3","key":"6221_CR4","doi-asserted-by":"publisher","first-page":"e001960","DOI":"10.1136\/bmjsem-2024-001960","volume":"10","author":"S Svedman","year":"2024","unstructured":"Svedman S, Marcano A, Ackermann PW, Fell\u00e4nder-Tsai L, Berg HE. Acute Achilles tendon ruptures between 2002\u20132021: sustained increased incidence, surgical decline and prolonged delay to surgery-a nationwide study of 53 688 ruptures in Sweden. BMJ Open Sport Exerc Med. 2024;10(3):e001960.","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"11","key":"6221_CR5","doi-asserted-by":"publisher","first-page":"232596712211315","DOI":"10.1177\/23259671221131536","volume":"10","author":"O Leino","year":"2022","unstructured":"Leino O, Keskinen H, Laaksonen I, M\u00e4kel\u00e4 K, L\u00f6yttyniemi E, Ekman E. Incidence and treatment trends of Achilles tendon ruptures in finland: A nationwide study. Orthop J Sports Med. 2022;10(11):23259671221131536.","journal-title":"Orthop J Sports Med"},{"key":"6221_CR6","doi-asserted-by":"crossref","unstructured":"Parekh SG, Wray WH 3rd, Brimmo O, Sennett BJ, Wapner KL. Epidemiology and outcomes of Achilles tendon ruptures in the National football league. Foot Ankle Spec. 2009;2(6):283\u20136.","DOI":"10.1177\/1938640009351138"},{"issue":"8","key":"6221_CR7","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1177\/0363546513490659","volume":"41","author":"NH Amin","year":"2013","unstructured":"Amin NH, Old AB, Tabb LP, Garg R, Toossi N, Cerynik DL. Performance outcomes after repair of complete Achilles tendon ruptures in National basketball association players. Am J Sports Med. 2013;41(8):1864\u20138.","journal-title":"Am J Sports Med"},{"key":"6221_CR8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.gaitpost.2019.07.121","volume":"73","author":"I Sancho","year":"2019","unstructured":"Sancho I, Malliaras P, Barton C, Willy RW, Morrissey D. Biomechanical alterations in individuals with Achilles tendinopathy during running and hopping: A systematic review with meta-analysis. Gait Posture. 2019;73:189\u2013201.","journal-title":"Gait Posture"},{"issue":"6","key":"6221_CR9","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1055\/s-0032-1301932","volume":"33","author":"T Horstmann","year":"2012","unstructured":"Horstmann T, Lukas C, Merk J, Brauner T, M\u00fcndermann A. Deficits 10-years after Achilles tendon repair. Int J Sports Med. 2012;33(6):474\u20139.","journal-title":"Int J Sports Med"},{"issue":"6","key":"6221_CR10","doi-asserted-by":"publisher","first-page":"232596711877986","DOI":"10.1177\/2325967118779862","volume":"6","author":"D Jandacka","year":"2018","unstructured":"Jandacka D, Plesek J, Skypala J, Uchytil J, Silvernail JF, Hamill J. Knee joint kinematics and kinetics during walking and running after surgical Achilles tendon repair. Orthop J Sports Med. 2018;6(6):2325967118779862.","journal-title":"Orthop J Sports Med"},{"key":"6221_CR11","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s13047-017-0235-0","volume":"10","author":"D Jandacka","year":"2017","unstructured":"Jandacka D, Silvernail JF, Uchytil J, Zahradnik D, Farana R, Hamill J. Do athletes alter their running mechanics after an Achilles tendon rupture? J Foot Ankle Res. 2017;10:53.","journal-title":"J Foot Ankle Res"},{"issue":"8","key":"6221_CR12","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1302\/0301-620X.87B8.16540","volume":"87","author":"ML Costa","year":"2005","unstructured":"Costa ML, Kay D, Donell ST. Gait abnormalities following rupture of the tendo achillis: a pedobarographic assessment. J Bone Joint Surg Br. 2005;87(8):1085\u20138.","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"6221_CR13","doi-asserted-by":"publisher","first-page":"232596711350473","DOI":"10.1177\/2325967113504734","volume":"1","author":"T Tengman","year":"2013","unstructured":"Tengman T, Riad J. Three-Dimensional gait analysis following Achilles tendon rupture with nonsurgical treatment reveals Long-Term deficiencies in muscle strength and function. Orthop J Sports Med. 2013;1(4):2325967113504734.","journal-title":"Orthop J Sports Med"},{"issue":"6","key":"6221_CR14","doi-asserted-by":"publisher","first-page":"232596711985432","DOI":"10.1177\/2325967119854324","volume":"7","author":"MB Speedtsberg","year":"2019","unstructured":"Speedtsberg MB, Kastoft R, Barfod KW, Penny J, Bencke J. Gait function and postural control 4.5 years after nonoperative dynamic treatment of acute Achilles tendon ruptures. Orthop J Sports Med. 2019;7(6):2325967119854324.","journal-title":"Orthop J Sports Med"},{"key":"6221_CR15","doi-asserted-by":"crossref","unstructured":"Sun D, Fekete G, Baker JS, Mei Q, Istv\u00e1n B, Zhang Y et al. A pilot study of musculoskeletal abnormalities in patients in recovery from a unilateral Rupture-Repaired Achilles tendon. Int J Environ Res Public Health. 2020;17(13).","DOI":"10.3390\/ijerph17134642"},{"issue":"2","key":"6221_CR16","first-page":"49","volume":"2","author":"MR Carmont","year":"2015","unstructured":"Carmont MR, Gr\u00e4vare Silbernagel K, Brorsson A, Olsson N, Maffulli N, Karlsson J. The Achilles tendon resting angle as an indirect measure of Achilles tendon length following rupture, repair, and rehabilitation. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(2):49\u201355.","journal-title":"Asia Pac J Sports Med Arthrosc Rehabil Technol"},{"issue":"5","key":"6221_CR17","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1177\/0363546516685055","volume":"45","author":"RW Willy","year":"2017","unstructured":"Willy RW, Brorsson A, Powell HC, Willson JD, Tranberg R, Gr\u00e4vare Silbernagel K. Elevated knee joint kinetics and reduced ankle kinetics are present during jogging and hopping after Achilles tendon ruptures. Am J Sports Med. 2017;45(5):1124\u201333.","journal-title":"Am J Sports Med"},{"issue":"8","key":"6221_CR18","doi-asserted-by":"publisher","first-page":"2517","DOI":"10.1007\/s00167-021-06512-z","volume":"29","author":"M Wenning","year":"2021","unstructured":"Wenning M, Mauch M, Heitner A, Lienhard J, Ritzmann R, Paul J. Neuromechanical activation of triceps Surae muscle remains altered at 3.5 years following open surgical repair of acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc. 2021;29(8):2517\u201327.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"5","key":"6221_CR19","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/j.humov.2011.06.002","volume":"30","author":"N Stergiou","year":"2011","unstructured":"Stergiou N, Decker LM. Human movement variability, nonlinear dynamics, and pathology: is there a connection? Hum Mov Sci. 2011;30(5):869\u201388.","journal-title":"Hum Mov Sci"},{"issue":"2","key":"6221_CR20","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.medengphy.2011.07.013","volume":"34","author":"EB Simonsen","year":"2012","unstructured":"Simonsen EB, Alkj\u00e6r T. The variability problem of normal human walking. Med Eng Phys. 2012;34(2):219\u201324.","journal-title":"Med Eng Phys"},{"issue":"6","key":"6221_CR21","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1161\/01.CIR.38.6.1104","volume":"38","author":"SALTINB Grimby","year":"1968","unstructured":"Grimby SALTINB. Physiological analysis of middle-aged and old former athletes: comparison with still active athletes of the same ages. Circulation. 1968;38(6):1104\u201315.","journal-title":"Circulation"},{"key":"6221_CR22","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s40258-017-0310-5","volume":"15","author":"NJ Devlin","year":"2017","unstructured":"Devlin NJ, Brooks R. EQ-5D and the EuroQol group: past, present and future. Appl Health Econ Health Policy. 2017;15:127\u201337.","journal-title":"Appl Health Econ Health Policy"},{"issue":"5","key":"6221_CR23","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/S1050-6411(00)00027-4","volume":"10","author":"HJ Hermens","year":"2000","unstructured":"Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361\u201374.","journal-title":"J Electromyogr Kinesiol"},{"key":"6221_CR24","unstructured":"Hermens HJ, Freriks B. SENIAM [cited 2024 ]. Available from: http:\/\/www.seniam.org\/"},{"key":"6221_CR25","unstructured":"Konrad P. The abc of emg. A practical introduction to kinesiological electromyography. 2005;1(2005):30\u2009\u2013\u20095."},{"issue":"6","key":"6221_CR26","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/j.jelekin.2010.07.004","volume":"20","author":"A Burden","year":"2010","unstructured":"Burden A. How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research. J Electromyogr Kinesiol. 2010;20(6):1023\u201335.","journal-title":"J Electromyogr Kinesiol"},{"issue":"3","key":"6221_CR27","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.jelekin.2003.07.001","volume":"14","author":"W Dankaerts","year":"2004","unstructured":"Dankaerts W, O\u2019Sullivan PB, Burnett AF, Straker LM, Danneels LA. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyogr Kinesiol. 2004;14(3):333\u201342.","journal-title":"J Electromyogr Kinesiol"},{"issue":"4","key":"6221_CR28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/JSM.0b013e31817f3e35","volume":"18","author":"MK Zebis","year":"2008","unstructured":"Zebis MK, Bencke J, Andersen LL, D\u00f8ssing S, Alkj\u00e6r T, Magnusson SP, et al. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players. Clin J Sport Med. 2008;18(4):329\u201337.","journal-title":"Clin J Sport Med"},{"issue":"13","key":"6221_CR29","doi-asserted-by":"publisher","first-page":"3060","DOI":"10.1177\/0363546517717698","volume":"45","author":"A Brorsson","year":"2017","unstructured":"Brorsson A, Willy RW, Tranberg R, Gr\u00e4vare Silbernagel K. Heel-Rise height deficit 1 year after Achilles tendon rupture relates to changes in ankle biomechanics 6 years after injury. Am J Sports Med. 2017;45(13):3060\u20138.","journal-title":"Am J Sports Med"},{"key":"6221_CR30","unstructured":"Team RC. R: a language and enviornment for statistical computing Vienna. Austria: Foundation of statistical computing. 2025 [Available from: https:\/\/www.R-project.org\/"},{"key":"6221_CR31","doi-asserted-by":"crossref","unstructured":"B\u00fbrkner PC. An R package for bayesian multilevel models using Stan. J Stat Softw. 2017(80):1\u201328.","DOI":"10.18637\/jss.v080.i01"},{"key":"6221_CR32","unstructured":"Vehtari A, Gabry J, Magnussin M, Yao Y, B\u00fcrkner P, Paananen T et al. Ioo: Efficient leave-one-out cross-validation and WAIC for Bayesian models. R package version 2.8.o. 2024."},{"issue":"3","key":"6221_CR33","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1007\/s00167-013-2512-1","volume":"23","author":"SM Suydam","year":"2015","unstructured":"Suydam SM, Buchanan TS, Manal K, Silbernagel KG. Compensatory muscle activation caused by tendon lengthening post-Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):868\u201374.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"6221_CR34","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1002\/jor.24260","volume":"37","author":"JA Zellers","year":"2019","unstructured":"Zellers JA, Marmon AR, Ebrahimi A, Gr\u00e4vare Silbernagel K. Lower extremity work along with triceps Surae structure and activation is altered with jumping after Achilles tendon repair. J Orthop Res. 2019;37(4):933\u201341.","journal-title":"J Orthop Res"},{"key":"6221_CR35","doi-asserted-by":"publisher","first-page":"102962","DOI":"10.1016\/j.jelekin.2024.102962","volume":"80","author":"RM Khair","year":"2025","unstructured":"Khair RM, Watt J, Sukanen M, Cronin NJ, Finni T. Neuromechanical adaptations in the gastrocnemius muscle after Achilles tendon rupture during walking. J Electromyogr Kinesiol. 2025;80:102962.","journal-title":"J Electromyogr Kinesiol"},{"key":"6221_CR36","doi-asserted-by":"publisher","first-page":"111459","DOI":"10.1016\/j.jbiomech.2023.111459","volume":"148","author":"C De la Fuente","year":"2023","unstructured":"De la Fuente C, Martinez-Valdes E, da Rocha ES, Geremia JM, Vaz MA, Carpes FP. Distal overactivation of gastrocnemius medialis in persistent plantarflexion weakness following Achilles tendon repair. J Biomech. 2023;148:111459.","journal-title":"J Biomech"},{"issue":"4","key":"6221_CR37","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.fas.2018.04.004","volume":"25","author":"S Manegold","year":"2019","unstructured":"Manegold S, Tsitsilonis S, Gehlen T, Kopf S, Duda GN, Agres AN. Alterations in structure of the muscle-tendon unit and gait pattern after percutaneous repair of Achilles tendon rupture with the Dresden instrument. Foot Ankle Surg. 2019;25(4):529\u201333.","journal-title":"Foot Ankle Surg"},{"issue":"6","key":"6221_CR38","doi-asserted-by":"publisher","first-page":"3426","DOI":"10.1152\/jn.00081.2006","volume":"95","author":"G Cappellini","year":"2006","unstructured":"Cappellini G, Ivanenko YP, Poppele RE, Lacquaniti F. Motor patterns in human walking and running. J Neurophysiol. 2006;95(6):3426\u201337.","journal-title":"J Neurophysiol"},{"key":"6221_CR39","unstructured":"Ivanenko YP. Motor patterns in human walking and running. 2006."},{"issue":"11","key":"6221_CR40","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1016\/0021-9290(86)90185-5","volume":"19","author":"MF Bobbert","year":"1986","unstructured":"Bobbert MF, Huijing PA, van Ingen Schenau GJ. An Estimation of power output and work done by the human triceps Surae musle-tendon complex in jumping. J Biomech. 1986;19(11):899\u2013906.","journal-title":"J Biomech"},{"issue":"06","key":"6221_CR41","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1055\/s-2008-1025921","volume":"5","author":"L Gregoire","year":"1984","unstructured":"Gregoire L, Veeger H, Huijing P, van Ingen Schenau G. Role of mono-and biarticular muscles in explosive movements. Int J Sports Med. 1984;5(06):301\u20135.","journal-title":"Int J Sports Med"},{"issue":"6","key":"6221_CR42","doi-asserted-by":"publisher","first-page":"872","DOI":"10.3390\/biology12060872","volume":"12","author":"M Kharazi","year":"2023","unstructured":"Kharazi M, Theodorakis C, Mersmann F, Bohm S, Arampatzis A. Contractile work of the soleus and biarticular mechanisms of the gastrocnemii muscles increase the net ankle mechanical work at high walking speeds. Biology. 2023;12(6):872.","journal-title":"Biology"},{"key":"6221_CR43","doi-asserted-by":"publisher","first-page":"7445398","DOI":"10.1155\/2022\/7445398","volume":"2022","author":"R Hoeffner","year":"2022","unstructured":"Hoeffner R, Svensson RB, Bjerregaard N, Kj\u00e6r M, Magnusson SP. Persistent deficits after an Achilles tendon rupture: A narrative review. Transl Sports Med. 2022;2022:7445398.","journal-title":"Transl Sports Med"},{"issue":"4","key":"6221_CR44","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1177\/03635465241227178","volume":"52","author":"R Hoeffner","year":"2024","unstructured":"Hoeffner R, Agergaard AS, Svensson RB, Cullum C, Mikkelsen RK, Konradsen L, et al. Tendon elongation and function after delayed or standard loading of surgically repaired Achilles tendon ruptures: A randomized controlled trial. Am J Sports Med. 2024;52(4):1022\u201331.","journal-title":"Am J Sports Med"},{"key":"6221_CR45","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.clinbiomech.2017.02.002","volume":"43","author":"WC Peng","year":"2017","unstructured":"Peng WC, Chang YP, Chao YH, Fu SN, Rolf C, Shih TT, et al. Morphomechanical alterations in the medial gastrocnemius muscle in patients with a repaired Achilles tendon: associations with outcome measures. Clin Biomech (Bristol). 2017;43:50\u20137.","journal-title":"Clin Biomech (Bristol)"},{"issue":"6","key":"6221_CR46","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1002\/tsm2.103","volume":"2","author":"RB Svensson","year":"2019","unstructured":"Svensson RB, Coupp\u00e9 C, Agergaard AS, Ohrhammar Josefsen C, Jensen MH, Barfod KW, et al. Persistent functional loss following ruptured Achilles tendon is associated with reduced gastrocnemius muscle fascicle length, elongated gastrocnemius and soleus tendon, and reduced muscle cross-sectional area. Translational Sports Med. 2019;2(6):316\u201324.","journal-title":"Translational Sports Med"},{"issue":"10","key":"6221_CR47","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1016\/j.ultrasmedbio.2024.06.005","volume":"50","author":"RM Khair","year":"2024","unstructured":"Khair RM, Sukanen M, Finni T. Achilles tendon stiffness: influence of measurement methodology. Ultrasound Med Biol. 2024;50(10):1522\u20139.","journal-title":"Ultrasound Med Biol"},{"issue":"3","key":"6221_CR48","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.jshs.2021.01.003","volume":"11","author":"M Mohr","year":"2022","unstructured":"Mohr M, von Tscharner V, Nigg S, Nigg BM. Systematic reduction of leg muscle activity throughout a standard assessment of running footwear. J Sport Health Sci. 2022;11(3):309\u201318.","journal-title":"J Sport Health Sci"},{"issue":"11","key":"6221_CR49","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1002\/1097-4598(200011)23:11<1647::AID-MUS1>3.0.CO;2-M","volume":"23","author":"RL Lieber","year":"2000","unstructured":"Lieber RL, Frid\u00e9n J. Functional and clinical significance of skeletal muscle architecture. Muscle Nerve. 2000;23(11):1647\u201366.","journal-title":"Muscle Nerve"},{"issue":"18","key":"6221_CR50","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.2106\/JBJS.16.01491","volume":"99","author":"J Heikkinen","year":"2017","unstructured":"Heikkinen J, Lantto I, Piilonen J, Flinkkil\u00e4 T, Ohtonen P, Siira P, et al. Tendon length, calf muscle atrophy, and strength deficit after acute Achilles tendon rupture: long-term follow-up of patients in a previous study. JBJS. 2017;99(18):1509\u201315.","journal-title":"JBJS"},{"issue":"4","key":"6221_CR51","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1152\/japplphysiol.00255.2019","volume":"127","author":"TJ Hullfish","year":"2019","unstructured":"Hullfish TJ, O\u2019Connor KM, Baxter JR. Medial gastrocnemius muscle remodeling correlates with reduced plantarflexor kinetics 14 weeks following Achilles tendon rupture. J Appl Physiol (1985). 2019;127(4):1005\u201311.","journal-title":"J Appl Physiol (1985)"},{"key":"6221_CR52","doi-asserted-by":"publisher","first-page":"792576","DOI":"10.3389\/fphys.2022.792576","volume":"13","author":"B St\u00e4udle","year":"2022","unstructured":"St\u00e4udle B, Seynnes O, Laps G, Br\u00fcggemann GP, Albracht K. Altered gastrocnemius contractile behavior in former Achilles tendon rupture patients during walking. Front Physiol. 2022;13:792576.","journal-title":"Front Physiol"},{"issue":"Pt 17","key":"6221_CR53","doi-asserted-by":"publisher","first-page":"4339","DOI":"10.1113\/jphysiol.2009.174912","volume":"587","author":"NJ Cronin","year":"2009","unstructured":"Cronin NJ, Ishikawa M, Af Klint R, Komi PV, Avela J, Sinkjaer T, et al. Effects of prolonged walking on neural and mechanical components of stretch responses in the human soleus muscle. J Physiol. 2009;587(Pt 17):4339\u201347.","journal-title":"J Physiol"},{"issue":"1","key":"6221_CR54","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1186\/s12891-024-07649-x","volume":"25","author":"H Gu","year":"2024","unstructured":"Gu H, Hong J, Wang Z, Chen J, Yuan F, Jiang Y, et al. Association of MRI findings with paraspinal muscles fat infiltration at lower lumbar levels in patients with chronic low back pain: a multicenter prospective study. BMC Musculoskelet Disord. 2024;25(1):549.","journal-title":"BMC Musculoskelet Disord"},{"issue":"6","key":"6221_CR55","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1002\/ca.23893","volume":"35","author":"T Seyedhoseinpoor","year":"2022","unstructured":"Seyedhoseinpoor T, Taghipour M, Dadgoo M, Ebrahimi Takamjani I, Sanjari MA, Kazemnejad A, et al. Relationship between the morphology and composition of the lumbar paraspinal and Psoas muscles and lumbar intervertebral motion in chronic low-back pain: an exploratory study. Clin Anat. 2022;35(6):762\u201372.","journal-title":"Clin Anat"},{"issue":"12","key":"6221_CR56","doi-asserted-by":"publisher","first-page":"4011","DOI":"10.1007\/s00167-020-06010-8","volume":"28","author":"P Diniz","year":"2020","unstructured":"Diniz P, Pacheco J, Guerra-Pinto F, Pereira H, Ferreira FC, Kerkhoffs G. Achilles tendon elongation after acute rupture: is it a problem? A systematic review. Knee Surg Sports Traumatol Arthrosc. 2020;28(12):4011\u201330.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"6221_CR57","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.clinbiomech.2010.03.007","volume":"25","author":"LA DiBerardino III","year":"2010","unstructured":"DiBerardino LA III, Polk JD, Rosengren KS, Spencer-Smith JB, Hsiao-Wecksler ET. Quantifying complexity and variability in phase portraits of gait. Clin Biomech Elsevier Ltd. 2010;25(6):552\u20136.","journal-title":"Clin Biomech Elsevier Ltd"},{"issue":"8","key":"6221_CR58","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1080\/14763141.2020.1713207","volume":"21","author":"JT Wight","year":"2022","unstructured":"Wight JT, Garman JEJ, Hooper DR, Robertson CT, Ferber R, Boling MC. Distance running stride-to-stride variability for sagittal plane joint angles. Sports Biomech. 2022;21(8):966\u201380.","journal-title":"Sports Biomech"},{"issue":"10","key":"6221_CR59","doi-asserted-by":"publisher","first-page":"3579","DOI":"10.1007\/s00167-022-06874-y","volume":"30","author":"R Kastoft","year":"2022","unstructured":"Kastoft R, Barfod K, Bencke J, Speedtsberg MB, Hansen SB, Penny J. 1.7\u00a0cm elongated Achilles tendon did not alter walking gait kinematics 4.5 years after non-surgical treatment. Knee Surg Sports Traumatol Arthrosc. 2022;30(10):3579\u201387.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"6221_CR60","unstructured":"Winter DA. Biomechanics and motor control of human gait: normlderly and pathological 1991."},{"issue":"1","key":"6221_CR61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1600-0838.1997.tb00110.x","volume":"7","author":"E Simonsen","year":"1997","unstructured":"Simonsen E, Dyhre-Poulsen P, Voigt M, Aagaard P, Fallentins N. Mechanisms contributing to different joint moments observed during human walking. Scand J Med Sci Sports. 1997;7(1):1\u201313.","journal-title":"Scand J Med Sci Sports"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-025-06221-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-025-06221-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-025-06221-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T13:04:13Z","timestamp":1757941453000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-025-06221-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6221"],"URL":"https:\/\/doi.org\/10.1186\/s13018-025-06221-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6915036\/v1","asserted-by":"object"}]},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]},"assertion":[{"value":"17 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2025","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 no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"819"}}