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Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review
  1. J J Kingma1,*,
  2. R de Knikker1,*,
  3. H M Wittink2,
  4. T Takken3
  1. 1Physiotherapy Research, Utrecht University, Utrecht, The Netherlands
  2. 2Faculty of Health Care, University of Professional Education, Utrecht, The Netherlands
  3. 3Department of Pediatric Physical Therapy & Exercise Physiology, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to:
 Dr T Takken
 Department of Pediatric Physical Therapy & Exercise Physiology, University Medical Center Utrecht, Room kb.02.056.0, P O Box 85090, 3508 AB Utrecht, The Netherlands;t.takken{at}umcutrecht.nl

Abstract

Background: Eccentric overload training seems to be a promising conservative intervention in patients with chronic Achilles tendinopathy. The efficacy of eccentric overload training on the outcome measures of pain and physical functioning are not exactly clear.

Study design: Systematic review of the literature.

Methods: Electronic databases were searched for randomised clinical trials concerning eccentric overload training in patients with chronic Achilles tendinopathy. The Delphi list was used to assess the methodological quality of the studies.

Results: Nine clinical trials were included. Only one study had sufficient methodological quality. The included trials showed an improvement in pain after eccentric overload training. Because of the methodological shortcomings of the trials, no definite conclusion can be drawn concerning the effects of eccentric overload training in patients with chronic Achilles tendinopathy.

Conclusion: The effects of eccentric exercise training in patients with chronic Achilles tendinopathy on pain are promising; however, the magnitude of the effects cannot be determined. Large, methodologically sound studies from multiple sites in which functional outcome measures are included are warranted.

  • VISA-A, Victorian Institute of Sport Assessment-Achilles tendon

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Footnotes

  • * JJK and RK contributed equally to this work.

  • Published Online First 11 October 2006

  • Competing interests: None declared.