The additional value of a night splint to eccentric exercises in chronic midportion Achilles Tendinopathy: a randomised controlled trial

R.J. de Vos ¹, A. Weir ², R.J.A. Visser ², Th.C. de Winter ² and J.L. Tol ^2*

¹ Erasmus Medical Centre Rotterdam, Netherlands
² The Hague Medical Centre Leidschendam, Netherlands

^* To whom correspondence should be addressed. E-mail: h.tol{at}mchaaglanden.nl.

Accepted 15 November 2006

Abstract

Objective: To asses whether the use of a night splint is of added benefit on functional outcome in treating chronic midportion Achilles tendinopathy.

Design: Single blind, prospective, single centre, randomised controlled trial.

Setting: Sports medical department of the Hague medical centre.

Patients: Inclusion criteria: Age 18-70, active participation in sports, tendon pain localised at 2-7 cm from distal insertion. Exclusion criteria: Insertional disorders, partial or complete ruptures or systemic illness. Seventy tendons were included and randomised into one of two treatment groups: eccentric exercises with a night splint (Night splint group, N=36) or eccentric exercises only (Eccentric group, N=34).

Interventions: Both groups completed a 12 week heavy load eccentric training programme. One group received a night splint in addition to eccentric exercises.

Main outcome measurements: At baseline and follow-up at 12 weeks patient satisfaction, VISA-A score and reported compliance were recorded by a single blind trained researcher who was blinded to the treatment.

Results: After 12 weeks, patient satisfaction in the eccentric group was 63% compared to 48% in the night splint group. The VISA-A score significantly improved in both groups, in the eccentric group from 50.1 to 68.8 (P = 0.001) and in the night splint group from 49.4 to 67.0 (P < 0.001), although there was no significant difference between the two groups in VISA-A score (P = 0.815) and patient satisfaction (P = 0.261).

Conclusion: A night splint is not beneficial in addition to eccentric exercises in the treatment of chronic midportion Achilles tendinopathy.

Key Words: Achilles tendinopathy, eccentric exercise, night splint

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