Eccentric and Isometric Exercises in Achilles Tendinopathy Evaluated by the VISA-A Score and Shear Wave Elastography.
Achilles tendinopathy
eccentric exercises
isometric exercises
muscle
shear wave elastography
tendon
Journal
Sports health
ISSN: 1941-0921
Titre abrégé: Sports Health
Pays: United States
ID NLM: 101518422
Informations de publication
Date de publication:
Historique:
pubmed:
1
2
2020
medline:
10
7
2020
entrez:
1
2
2020
Statut:
ppublish
Résumé
Apart from eccentric exercises (EE), isometric exercises (ISO) might be a treatment option for Achilles tendinopathy. Shear wave elastography (SWE) provides information for diagnosis and for monitoring tissue elasticity, which is altered in symptomatic tendons. Isometric exercises will have a beneficial effect on patients' outcome scores. Based on SWE, insertional and midportion tendon parts will differ in their elastic properties according to current symptoms. Randomized clinical trial. Level 2. Group 1 (EE; n = 20; 12 males, 8 females; mean age, 52 ± 8.98 years) and group 2 (EE + ISO; n = 22; 15 males, 7 females; mean age, 47 ± 15.11 years) performed exercises for 3 months. Measurement points were before exercises were initiated as well as after 1 and 3 months using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, American Orthopaedic Foot & Ankle Society score, and SWE (insertion and midportion). Both groups improved significantly, but there were no significant interindividual differences (VISA-A; Isometric exercises do not have additional benefit when combined with eccentric exercises, as assessed over a 3-month intervention period. SWE is able to distinguish between insertional and midportion tendon parts in a symptomatic and asymptomatic state. The present study shows no additional effect of ISO when added to baseline EE in treating Achilles tendinopathy. Different elastic properties of the insertional and midportion tendon have to be taken into consideration when rating a tendon as pathologic.
Sections du résumé
BACKGROUND
BACKGROUND
Apart from eccentric exercises (EE), isometric exercises (ISO) might be a treatment option for Achilles tendinopathy. Shear wave elastography (SWE) provides information for diagnosis and for monitoring tissue elasticity, which is altered in symptomatic tendons.
HYPOTHESIS
OBJECTIVE
Isometric exercises will have a beneficial effect on patients' outcome scores. Based on SWE, insertional and midportion tendon parts will differ in their elastic properties according to current symptoms.
STUDY DESIGN
METHODS
Randomized clinical trial.
LEVEL OF EVIDENCE
METHODS
Level 2.
METHODS
METHODS
Group 1 (EE; n = 20; 12 males, 8 females; mean age, 52 ± 8.98 years) and group 2 (EE + ISO; n = 22; 15 males, 7 females; mean age, 47 ± 15.11 years) performed exercises for 3 months. Measurement points were before exercises were initiated as well as after 1 and 3 months using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, American Orthopaedic Foot & Ankle Society score, and SWE (insertion and midportion).
RESULTS
RESULTS
Both groups improved significantly, but there were no significant interindividual differences (VISA-A;
CONCLUSION
CONCLUSIONS
Isometric exercises do not have additional benefit when combined with eccentric exercises, as assessed over a 3-month intervention period. SWE is able to distinguish between insertional and midportion tendon parts in a symptomatic and asymptomatic state.
CLINICAL RELEVANCE
CONCLUSIONS
The present study shows no additional effect of ISO when added to baseline EE in treating Achilles tendinopathy. Different elastic properties of the insertional and midportion tendon have to be taken into consideration when rating a tendon as pathologic.
Identifiants
pubmed: 32003647
doi: 10.1177/1941738119893996
pmc: PMC7787566
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
373-381Références
J Musculoskelet Neuronal Interact. 2005 Mar;5(1):22-34
pubmed: 15788868
Arch Orthop Trauma Surg. 2014 Sep;134(9):1205-10
pubmed: 25012530
Int J Sports Phys Ther. 2012 Feb;7(1):76-84
pubmed: 22319681
Br J Sports Med. 2002 Jun;36(3):173-5; discussion 176-7
pubmed: 12055110
Clin J Sport Med. 2017 May;27(3):253-259
pubmed: 27513733
Am J Sports Med. 1998 May-Jun;26(3):360-6
pubmed: 9617396
J Orthop Translat. 2018 Jul 04;15:9-20
pubmed: 30258782
Am J Sports Med. 2009 Mar;37(3):463-70
pubmed: 19088057
Foot Ankle Surg. 2013 Jun;19(2):112-7
pubmed: 23548453
Br J Sports Med. 2008 Sep;42(9):746-9
pubmed: 18184750
Br J Sports Med. 2015 Oct;49(19):1277-83
pubmed: 25979840
J Appl Physiol (1985). 2001 Dec;91(6):2628-34
pubmed: 11717228
Eur J Radiol. 2015 Mar;84(3):458-462
pubmed: 25577603
Scand J Med Sci Sports. 2017 Jul;27(7):746-753
pubmed: 27367438
Ann Rehabil Med. 2014 Aug;38(4):534-40
pubmed: 25229032
PeerJ. 2017 Jul 19;5:e3592
pubmed: 28740756
BMC Musculoskelet Disord. 2009 Oct 30;10:134
pubmed: 19878572
Br J Sports Med. 2014 Mar;48(6):469-75
pubmed: 24100290
Trials. 2010 Mar 24;11:32
pubmed: 20334632
Muscles Ligaments Tendons J. 2017 May 10;7(1):88-97
pubmed: 28717616
Knee Surg Sports Traumatol Arthrosc. 2016 Jul;24(7):2103-11
pubmed: 25366192
J Ultrasound Med. 2017 Mar;36(3):565-570
pubmed: 28108983
BMJ Open Sport Exerc Med. 2018 Feb 7;4(1):e000298
pubmed: 29527321
Clin J Sport Med. 2019 May;29(3):188-192
pubmed: 31033611
Acad Radiol. 2018 Mar;25(3):265-272
pubmed: 29153963
Acad Radiol. 2016 Oct;23(10):1204-13
pubmed: 27318786
Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):2765-2773
pubmed: 29974171