Immediate effects of Compressive Myofascial Release versus Talocrural Joint Mobilization on passive mechanical properties and functional outcomes in participants with Achilles tendon repair


TAN F., Bazancir-Apaydin Z., Kaya Utlu D., Gurler A., Akkurt M. O., GÜNEY DENİZ H.

Physiotherapy Theory and Practice, cilt.42, sa.1, ss.37-49, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 42 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1080/09593985.2025.2547294
  • Dergi Adı: Physiotherapy Theory and Practice
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, ASSIA, BIOSIS, CINAHL, MEDLINE
  • Sayfa Sayıları: ss.37-49
  • Anahtar Kelimeler: Electromyography, unstable surface, neuromuscular control, Achilles tendon, lower leg muscles
  • Atatürk Üniversitesi Adresli: Evet

Özet

Objective: To compare the immediate effects of two manual therapy techniques–Compressive Myofascial Release (CMR) and Talocrural Joint Mobilization (TJM)–on passive mechanical properties, ankle mobility, and functional performance in individuals following Achilles tendon repair. Methods: Twenty participants with surgically repaired Achilles tendons received a single session of either CMR or TJM. Passive mechanical properties (tone, elasticity, stiffness) of the medial/lateral gastrocnemius and Achilles tendon were assessed via handheld myotonometer. Functional outcomes included the Weight-Bearing Lunge Test (WBLT), Achilles Tendon Resting Angle (ATRA), and heel-rise height. Patient-reported outcomes were the Achilles Tendon Total Rupture Score (ATRS) and Foot and Ankle Outcome Score (FAOS). Results: Demographic variables were similar between groups (p >.05). The mean time since surgery was 12.8 ± 10.3 months in the TJM group and 16.8 ± 13.25 months in the CMR group. CMR led to significantly greater improvements in MG stiffness (p =.007, r = 0.85), MG tone (p =.032, r = 0.68), and LG stiffness (p =.005, r = 0.89), with changes exceeding minimal detectable change (MDC) values. Although Achilles tendon stiffness also decreased significantly (p =.037, r = 0.66), this change did not exceed its MDC. Both groups showed statistically and clinically meaningful gains in ATRA, heel-rise height, and WBLT (all p <.01, r > 0.85). ATRS and FAOS indicated high functional recovery. Conclusion: CMR yielded greater short-term improvements in clinically relevant muscle-tendon mechanical properties than TJM and may be a valuable therapeutic option following Achilles tendon repair. Level of evidence: Level II.