Short- and Intermediate-Term Results of Extracorporeal Shockwave Therapy for Noninsertional Achilles Tendinopathy
Short- and Intermediate-Term Results of Extracorporeal Shockwave Therapy for Noninsertional Achilles Tendinopathy
复制标题
DOI：
10.1177/1071100720982613
复制
发表时间：
2021-06-01
影响因子：
2.7
通讯作者：
Saweeres, Emad S. B.
中科院分区：
文献类型：
--
作者：
Abdelkader, Nasr Awad;Helmy, Mohamed Nasser Kise;Saweeres, Emad S. B.
背景：早期随机对照试验（RCT）仅报告了体外冲击波治疗（ESWT）治疗非插入性跟腱病（NAT）的中期（3-4个月）结果。本研究比较了离心负荷计划后拉伸运动联合ESWT（研究组）或假ESWT（对照组）治疗慢性NAT的短期和长期有效性。方法：本双盲RCT于2018年至2020年进行。将标准保守治疗失败的单侧NAT成人患者随机分配至两组。分别在基线、1个月和16个月时使用维多利亚运动评估研究所-阿基里斯问卷（VISA-A）和视觉模拟量表（VAS）评估功能和疼痛。进行混合设计方差分析和非参数统计。22名男性和28名女性，年龄在18至40岁，被分配到2个相等匹配的groups.Results：功能和疼痛评分在研究组与对照组的分数在基线没有显着差异（VISA-A：22.2 +/- 6.5比21.0 +/- 5.2和VAS：8 +/- 1比8 +/- 1，分别）。两组治疗后均显著改善（VISA-A：85 +/- 6.2 vs 53.4 +/- 7.7，VAS：1 +/- 2 vs 7 +/- 2）。在16个月的随访中，研究组的结局评分略有下降但显著（VISA-A：80 +/- 5.3; VAS：3 +/- 2），对照组有所改善（VISA-A：67 +/- 5.6; VAS：5 +/- 1）。然而，两组均显著优于基线。在这两个时间点，研究组有显着的上级分数（统计学和临床）比对照组（P = .0001）。结论：小腿偏心负荷与拉伸运动相结合，导致显着改善疼痛和功能评分的NAT患者。添加ESWT到这个组合方案，导致显着更大的改善，在短期和长期。
Background:Earlier randomized controlled trials (RCTs) reported only midterm (3-4 months) results of extracorporeal shockwave therapy (ESWT) as a treatment for noninsertional Achilles tendinopathy (NAT). This study compared the effectiveness of an eccentric loading program followed by stretching exercises combined with ESWT (study group) or sham ESWT (control group) for treating chronic NAT in both the short and long term.Methods:This double-blind RCT was conducted between 2018 and 2020. Adult patients with unilateral NAT who failed standard conservative treatment were randomly allocated to either group. Function and pain were assessed at baseline, 1 month, and 16 months using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) and visual analog scale (VAS), respectively. Mixed-design analysis of variance and nonparametric statistics were performed. Twenty-two men and 28 women aged 18 to 40 years were allocated into 2 equally matched groups.Results:Function and pain scores in the study group were not significantly different from control group scores at baseline (VISA-A: 22.2 +/- 6.5 vs 21.0 +/- 5.2 and VAS: 8 +/- 1 vs 8 +/- 1, respectively). Both groups significantly improved posttreatment (VISA-A: 85 +/- 6.2 vs 53.4 +/- 7.7 and VAS: 1 +/- 2 vs 7 +/- 2, respectively). At the 16-month follow-up, outcome scores declined slightly but significantly in the study group (VISA-A: 80 +/- 5.3; VAS: 3 +/- 2) and improved in the control group (VISA-A: 67 +/- 5.6; VAS: 5 +/- 1). However, both groups were significantly better than baseline. At both time points, the study group had significantly superior scores (statistically and clinically) than the control group (P = .0001).Conclusion:Combining calf eccentric loading with stretching exercises resulted in significant improvements in the pain and functional scores in patients with NAT. Adding ESWT to this combined protocol resulted in significantly greater improvements in both the short and long term.