The effects of conventional physical therapy and eccentric strengthening for insertional achilles tendinopathy.
The effects of conventional physical therapy and eccentric strengthening for insertional achilles tendinopathy.
复制标题
常规物理疗法和离心强化对插入跟腱病的影响。
DOI：
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发表时间：
2014
影响因子：
1.7
通讯作者：
G. Murphy
中科院分区：
文献类型：
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作者：
Margaret Kedia;Michael Williams;Lisa Jain;Marie Barron;Nick P. Bird;B. Blackwell;D. Richardson;Susan N. Ishikawa;G. Murphy
研究设计
单盲随机临床试验。
背景
偏心训练对跟腱中段病变的影响已有充分的文献记载，然而，其对跟腱止点病变的影响尚无定论。本研究的主要目的是调查离心训练对跟腱止点病患者疼痛和功能的影响。
方法
所有患者均接受为期12周的常规强化方案。随机分配到实验组的患者接受额外的离心运动。患者在初始评估时、治疗6周后和治疗12周后完成了健康和身体疼痛调查简表-36、足踝结局问卷和视觉模拟量表。
结果
36名患者（20名对照组和16名实验组;平均年龄54岁; 72%为女性）完成了研究。两组的疼痛和功能改善都有统计学显著性降低。两组之间的任何结局指标均无统计学显著差异。
结论
传统的物理治疗包括腓肠肌，比目鱼肌和腘绳肌拉伸，跟腱上的冰按摩，以及使用脚跟升降机和夜间夹板，有或没有离心训练，对治疗插入性跟腱病是有效的。
证据等级
2级
STUDY DESIGN
Single-blind, randomized, clinical trial.
BACKGROUND
The effect of eccentric training for mid-portion Achilles tendinopathy is well documented; however, its effect on insertional Achilles tendinopathy is inconclusive. The primary purpose of this study was to investigate the effect of eccentric training on pain and function for individuals with insertional Achilles tendinopathy.
METHODS
All patients received a 12-week conventional strengthening protocol. Patients who were randomly assigned to the experimental group received additional eccentric exercises. Patients completed the Short Form-36 Health and Bodily Pain Surveys, the Foot and Ankle Outcomes Questionnaire, and the Visual Analog Scale at initial evaluation, after 6 weeks of therapy, and at 12 weeks after therapy.
RESULTS
Thirty-six patients (20 control and 16 experimental; average age 54 years; 72% women) completed the study. Both groups experienced statistically significant decreases in pain and improvements in function. No statistically significant differences were noted between the groups for any of the outcome measures.
CONCLUSION
Conventional physical therapy consisting of gastrocnemius, soleus and hamstring stretches, ice massage on the Achilles tendon, and use of heel lifts and night splints with or without eccentric training is effective for treating insertional Achilles tendinopathy.
LEVEL OF EVIDENCE
Level 2.