Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial
Background Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave treatment (SWT) in patients suffering from chronic midportion Achilles tendinopathy. No randomized controlled trials h...
Gespeichert in:
| Veröffentlicht in: | The American journal of sports medicine 2009-03, Vol.37 (3), p.463-470 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 470 |
|---|---|
| container_issue | 3 |
| container_start_page | 463 |
| container_title | The American journal of sports medicine |
| container_volume | 37 |
| creator | Rompe, Jan D. Furia, John Maffulli, Nicola |
| description | Background
Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave treatment (SWT) in patients suffering from chronic midportion Achilles tendinopathy. No randomized controlled trials have tested whether a combined approach might lead to even better results.
Purpose
To compare the effectiveness of 2 management strategies—group 1: eccentric loading and group 2: eccentric loading plus repetitive low-energy shock-wave therapy.
Study Design
Randomized controlled trial; Level of evidence, 1.
Methods
Sixty-eight patients with a chronic recalcitrant (>6 months) noninsertional Achilles tendinopathy were enrolled in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least (1) peritendinous local injections, (2) nonsteroidal anti-inflammatory drugs, and (3) physiotherapy. A computerized random-number generator was used to draw up an allocation schedule. Analysis was on an intention-to-treat basis.
Results
At 4 months from baseline, the VISA-A score increased in both groups, from 50 to 73 points in group 1 (eccentric loading) and from 51 to 87 points in group 2 (eccentric loading plus shock-wave treatment). Pain rating decreased in both groups, from 7 to 4 points in group 1 and from 7 to 2 points in group 2. Nineteen of 34 patients in group 1 (56%) and 28 of 34 patients in group 2 (82%) reported a Likert scale of 1 or 2 points (“completely recovered” or “much improved”). For all outcome measures, groups 1 and 2 differed significantly in favor of the combined approach at the 4-month follow-up. At 1 year from baseline, there was no difference any longer, with 15 failed patients of group 1 opting for having the combined therapy as cross-over and with 6 failed patients of group 2 having undergone surgery.
Conclusion
At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment. |
| doi_str_mv | 10.1177/0363546508326983 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_771860804</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546508326983</sage_id><sourcerecordid>66973705</sourcerecordid><originalsourceid>FETCH-LOGICAL-c350t-36a951e4f75891d2b02899a5ea0489edbe850ff602c5ec8ebf77ae3a96c528f3</originalsourceid><addsrcrecordid>eNp90U1rGzEQBmBREhrn495T2UuS06Yjyfo6hpCkBYccashxkbWjWOl6tZV2A_n3lbFJoaU9CWaedwQzhHyicEWpUl-ASy7mUoDmTBrNP5AZFYLVnEtxQGbbdr3tH5HjnF8AgCqpP5IjakBrEGpGwq1z2I8puGoRbRv65-oVU55y9Xdj6Er5-zq6H_WTfcVqmdCOm4IqH1P1ENohpjHEvrp269B1mKsl9iUZBzuu307JobddxrP9e0KWd7fLm6_14vH-2831onZcwFhzaY2gOPdKaENbtgKmjbECLcy1wXaFWoD3EpgT6DSuvFIWuTXSCaY9PyGXu7FDij8nzGOzCdlh19ke45QbpaiWoGFe5MV_pZRGcQWiQNhBl2LOCX0zpLCx6a2h0Gzv0Px5hxL5vJ89rTbY_g7sF1_A-R7Y7Gznk-1dyO-OUaZAUlZcvXPZPmPzEqfUl-X9--NfXcWdfw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>66973705</pqid></control><display><type>article</type><title>Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Rompe, Jan D. ; Furia, John ; Maffulli, Nicola</creator><creatorcontrib>Rompe, Jan D. ; Furia, John ; Maffulli, Nicola</creatorcontrib><description>Background
Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave treatment (SWT) in patients suffering from chronic midportion Achilles tendinopathy. No randomized controlled trials have tested whether a combined approach might lead to even better results.
Purpose
To compare the effectiveness of 2 management strategies—group 1: eccentric loading and group 2: eccentric loading plus repetitive low-energy shock-wave therapy.
Study Design
Randomized controlled trial; Level of evidence, 1.
Methods
Sixty-eight patients with a chronic recalcitrant (>6 months) noninsertional Achilles tendinopathy were enrolled in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least (1) peritendinous local injections, (2) nonsteroidal anti-inflammatory drugs, and (3) physiotherapy. A computerized random-number generator was used to draw up an allocation schedule. Analysis was on an intention-to-treat basis.
Results
At 4 months from baseline, the VISA-A score increased in both groups, from 50 to 73 points in group 1 (eccentric loading) and from 51 to 87 points in group 2 (eccentric loading plus shock-wave treatment). Pain rating decreased in both groups, from 7 to 4 points in group 1 and from 7 to 2 points in group 2. Nineteen of 34 patients in group 1 (56%) and 28 of 34 patients in group 2 (82%) reported a Likert scale of 1 or 2 points (“completely recovered” or “much improved”). For all outcome measures, groups 1 and 2 differed significantly in favor of the combined approach at the 4-month follow-up. At 1 year from baseline, there was no difference any longer, with 15 failed patients of group 1 opting for having the combined therapy as cross-over and with 6 failed patients of group 2 having undergone surgery.
Conclusion
At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546508326983</identifier><identifier>PMID: 19088057</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Achilles Tendon - injuries ; Biological and medical sciences ; Combined Modality Therapy ; Diseases of the osteoarticular system ; Exercise Therapy - methods ; Female ; High-Energy Shock Waves - therapeutic use ; Humans ; Juxtaarticular diseases. Extraarticular rhumatism ; Male ; Medical sciences ; Middle Aged ; Pain Measurement ; Recovery of Function ; Statistics, Nonparametric ; Tendinopathy - rehabilitation ; Treatment Outcome ; Weight-Bearing</subject><ispartof>The American journal of sports medicine, 2009-03, Vol.37 (3), p.463-470</ispartof><rights>2009 American Orthopaedic Society for Sports Medicine</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c350t-36a951e4f75891d2b02899a5ea0489edbe850ff602c5ec8ebf77ae3a96c528f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546508326983$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546508326983$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21270612$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19088057$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rompe, Jan D.</creatorcontrib><creatorcontrib>Furia, John</creatorcontrib><creatorcontrib>Maffulli, Nicola</creatorcontrib><title>Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background
Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave treatment (SWT) in patients suffering from chronic midportion Achilles tendinopathy. No randomized controlled trials have tested whether a combined approach might lead to even better results.
Purpose
To compare the effectiveness of 2 management strategies—group 1: eccentric loading and group 2: eccentric loading plus repetitive low-energy shock-wave therapy.
Study Design
Randomized controlled trial; Level of evidence, 1.
Methods
Sixty-eight patients with a chronic recalcitrant (>6 months) noninsertional Achilles tendinopathy were enrolled in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least (1) peritendinous local injections, (2) nonsteroidal anti-inflammatory drugs, and (3) physiotherapy. A computerized random-number generator was used to draw up an allocation schedule. Analysis was on an intention-to-treat basis.
Results
At 4 months from baseline, the VISA-A score increased in both groups, from 50 to 73 points in group 1 (eccentric loading) and from 51 to 87 points in group 2 (eccentric loading plus shock-wave treatment). Pain rating decreased in both groups, from 7 to 4 points in group 1 and from 7 to 2 points in group 2. Nineteen of 34 patients in group 1 (56%) and 28 of 34 patients in group 2 (82%) reported a Likert scale of 1 or 2 points (“completely recovered” or “much improved”). For all outcome measures, groups 1 and 2 differed significantly in favor of the combined approach at the 4-month follow-up. At 1 year from baseline, there was no difference any longer, with 15 failed patients of group 1 opting for having the combined therapy as cross-over and with 6 failed patients of group 2 having undergone surgery.
Conclusion
At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment.</description><subject>Achilles Tendon - injuries</subject><subject>Biological and medical sciences</subject><subject>Combined Modality Therapy</subject><subject>Diseases of the osteoarticular system</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>High-Energy Shock Waves - therapeutic use</subject><subject>Humans</subject><subject>Juxtaarticular diseases. Extraarticular rhumatism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pain Measurement</subject><subject>Recovery of Function</subject><subject>Statistics, Nonparametric</subject><subject>Tendinopathy - rehabilitation</subject><subject>Treatment Outcome</subject><subject>Weight-Bearing</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90U1rGzEQBmBREhrn495T2UuS06Yjyfo6hpCkBYccashxkbWjWOl6tZV2A_n3lbFJoaU9CWaedwQzhHyicEWpUl-ASy7mUoDmTBrNP5AZFYLVnEtxQGbbdr3tH5HjnF8AgCqpP5IjakBrEGpGwq1z2I8puGoRbRv65-oVU55y9Xdj6Er5-zq6H_WTfcVqmdCOm4IqH1P1ENohpjHEvrp269B1mKsl9iUZBzuu307JobddxrP9e0KWd7fLm6_14vH-2831onZcwFhzaY2gOPdKaENbtgKmjbECLcy1wXaFWoD3EpgT6DSuvFIWuTXSCaY9PyGXu7FDij8nzGOzCdlh19ke45QbpaiWoGFe5MV_pZRGcQWiQNhBl2LOCX0zpLCx6a2h0Gzv0Px5hxL5vJ89rTbY_g7sF1_A-R7Y7Gznk-1dyO-OUaZAUlZcvXPZPmPzEqfUl-X9--NfXcWdfw</recordid><startdate>20090301</startdate><enddate>20090301</enddate><creator>Rompe, Jan D.</creator><creator>Furia, John</creator><creator>Maffulli, Nicola</creator><general>SAGE Publications</general><general>Sage Publications</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090301</creationdate><title>Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy</title><author>Rompe, Jan D. ; Furia, John ; Maffulli, Nicola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c350t-36a951e4f75891d2b02899a5ea0489edbe850ff602c5ec8ebf77ae3a96c528f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Achilles Tendon - injuries</topic><topic>Biological and medical sciences</topic><topic>Combined Modality Therapy</topic><topic>Diseases of the osteoarticular system</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>High-Energy Shock Waves - therapeutic use</topic><topic>Humans</topic><topic>Juxtaarticular diseases. Extraarticular rhumatism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pain Measurement</topic><topic>Recovery of Function</topic><topic>Statistics, Nonparametric</topic><topic>Tendinopathy - rehabilitation</topic><topic>Treatment Outcome</topic><topic>Weight-Bearing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rompe, Jan D.</creatorcontrib><creatorcontrib>Furia, John</creatorcontrib><creatorcontrib>Maffulli, Nicola</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rompe, Jan D.</au><au>Furia, John</au><au>Maffulli, Nicola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2009-03-01</date><risdate>2009</risdate><volume>37</volume><issue>3</issue><spage>463</spage><epage>470</epage><pages>463-470</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background
Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave treatment (SWT) in patients suffering from chronic midportion Achilles tendinopathy. No randomized controlled trials have tested whether a combined approach might lead to even better results.
Purpose
To compare the effectiveness of 2 management strategies—group 1: eccentric loading and group 2: eccentric loading plus repetitive low-energy shock-wave therapy.
Study Design
Randomized controlled trial; Level of evidence, 1.
Methods
Sixty-eight patients with a chronic recalcitrant (>6 months) noninsertional Achilles tendinopathy were enrolled in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least (1) peritendinous local injections, (2) nonsteroidal anti-inflammatory drugs, and (3) physiotherapy. A computerized random-number generator was used to draw up an allocation schedule. Analysis was on an intention-to-treat basis.
Results
At 4 months from baseline, the VISA-A score increased in both groups, from 50 to 73 points in group 1 (eccentric loading) and from 51 to 87 points in group 2 (eccentric loading plus shock-wave treatment). Pain rating decreased in both groups, from 7 to 4 points in group 1 and from 7 to 2 points in group 2. Nineteen of 34 patients in group 1 (56%) and 28 of 34 patients in group 2 (82%) reported a Likert scale of 1 or 2 points (“completely recovered” or “much improved”). For all outcome measures, groups 1 and 2 differed significantly in favor of the combined approach at the 4-month follow-up. At 1 year from baseline, there was no difference any longer, with 15 failed patients of group 1 opting for having the combined therapy as cross-over and with 6 failed patients of group 2 having undergone surgery.
Conclusion
At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>19088057</pmid><doi>10.1177/0363546508326983</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2009-03, Vol.37 (3), p.463-470 |
| issn | 0363-5465 1552-3365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_771860804 |
| source | SAGE Complete A-Z List; MEDLINE; Alma/SFX Local Collection |
| subjects | Achilles Tendon - injuries Biological and medical sciences Combined Modality Therapy Diseases of the osteoarticular system Exercise Therapy - methods Female High-Energy Shock Waves - therapeutic use Humans Juxtaarticular diseases. Extraarticular rhumatism Male Medical sciences Middle Aged Pain Measurement Recovery of Function Statistics, Nonparametric Tendinopathy - rehabilitation Treatment Outcome Weight-Bearing |
| title | Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-20T21%3A26%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Eccentric%20Loading%20versus%20Eccentric%20Loading%20plus%20Shock-Wave%20Treatment%20for%20Midportion%20Achilles%20Tendinopathy:%20A%20Randomized%20Controlled%20Trial&rft.jtitle=The%20American%20journal%20of%20sports%20medicine&rft.au=Rompe,%20Jan%20D.&rft.date=2009-03-01&rft.volume=37&rft.issue=3&rft.spage=463&rft.epage=470&rft.pages=463-470&rft.issn=0363-5465&rft.eissn=1552-3365&rft.coden=AJSMDO&rft_id=info:doi/10.1177/0363546508326983&rft_dat=%3Cproquest_cross%3E66973705%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=66973705&rft_id=info:pmid/19088057&rft_sage_id=10.1177_0363546508326983&rfr_iscdi=true |