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Abstract

Rehabilitation following Achilles tendon rupture remains highly variable, with progression often guided by subjective observations rather than objective physiological metrics. Wearable near-infrared spectroscopy (NIRS) technology provides a means to quantify local muscle recovery and educate both clinicians and patients on the physiology of healing. PURPOSE: To evaluate the use of the Moxy muscle oxygen sensor in monitoring gastrocnemius muscle oxygen saturation (SmO₂) during rehabilitation after Achilles tendon repair and to translate these data into actionable insights for clinical and athlete education. METHODS: A 23-year-old male NCAA Division I football lineman (IRB #2113291-6) underwent right Achilles tendon repair on 12/5/2024. SmO₂ of the medial gastrocnemius was continuously recorded during progressive loading, isometric holds, and functional movement assessments at four and five months post-surgery (4/11 and 5/8). Contralateral SmO₂ increased from 65.54% to 68.04%, while surgical limb SmO₂ decreased from 41.75% to 38.92%. NIRS data were analyzed for desaturation amplitude, recovery slope, and half-time to evaluate perfusion asymmetry and muscular endurance. Two key decision points (modifying load intensity and delaying plyometric progression) were guided directly by SmO₂ recovery kinetics. RESULTS: Early rehabilitation showed pronounced desaturation and slower reoxygenation in the injured limb compared to the contralateral side (~40% lower baseline SmO₂). Structured loading and neuromuscular retraining improved recovery slopes and narrowed asymmetry. Real-time visualization of oxygenation trends enhanced the athlete’s understanding of fatigue thresholds and adherence to recovery pacing. CONCLUSION: Wearable NIRS monitoring can transform complex physiological data into a dynamic, educational feedback tool. Integrating SmO₂ insights into rehabilitation enhances objective decision-making, promotes athlete engagement, and bridges the gap between physiological monitoring and clinical application.

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