Short-term influence of a percussive soft-tissue technique on active weightbearing dorsiflexion and Achilles tendon excursion : a case series
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Citation:Scott-Weekly, D. (2016). Short-term influence of a percussive soft-tissue technique on active weightbearing dorsiflexion and Achilles tendon excursion : a case series. An unpublished thesis submitted in partial fulfilment of the requirements for the degree of Master of Osteopathy, Unitec Institute of Technology, New Zealand.
Permanent link to Research Bank record:https://hdl.handle.net/10652/3631
Background: Restriction of lower limb dorsiflexion has been associated with poor musculoskeletal outcomes. Impairment to soft tissue sliding of the tendo-Achilles region is one possible cause of decreased dorsiflexion. Anecdotally, a novel percussive soft tissue technique has been used to increase tissue sliding and improve dorsiflexion range. Aim: To explore the effects of a percussive soft tissue technique applied to the tendo Achilles region of healthy participants with reduced dorsiflexion, as measured by prepost changes in active weight-bearing dorsiflexion (ADF), and Achilles tendon (AT) excursion as measured by high-resolution, B-mode, real-time ultrasound imaging. Design: Six n=1 case studies were undertaken using a pre-post repeated measures design for the purpose of hypothesis generation. Methods: A novel percussive soft tissue technique was administered once on Day 1 and once on Day 4. Pre-post comparisons of ADF and AT excursion were made on Day1, Day 4 and Day 8. Findings were interpreted using a minimal detectible change (MDC) established as 1.76 deg for ADF, and 0.64mm for AT excursion. Results: Six healthy participants (M = 3, F = 3, mean age 27.2 ± 6.3 years, mean height 1.75 ± 1.1 m, median body weight = 75kg [range 62 to 98 kg]) with reduced ADF participated in the study. Mean change in ADF pre-post for Day 1 was 6.15 deg (d=0.81), pre-post for Day 4 was 3.10 deg (d=0.37), and between pre-intervention Day1 and follow up Day 8 was 11.29deg (d=1.49). Between pre-intervention Day 1 and follow-up Day 8, 3 participants increased AT excursion, 2 participants decreased AT excursion, and change was unclear (<MDC) for 1 participant. Conclusions: All participants showed improvement in ADF as a result of the intervention. Achilles tendon excursion was improved for some participants and not others. These findings provide evidence to support further research with more power to investigate theinfluence of the percussive soft tissue technique on AT excursion and ADF.