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SportsMedUpdate
  1. Martin P Schwellnus
  1. University of Cape Town, South Africa

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In a randomized controlled trial, a combination of eccentric training and low energy shock wave therapy reduced pain and improved function more than eccentric training alone in patients with chronic (> 6 months) Achilles tendinopathy

Background

Both eccentric loading training and repetitive low-energy shock wave (SW) treatment have been shown to be effective treatment modalities for patients with chronic mid-portion Achilles tendinopathy.

Research question/s

Does combined eccentric loading and repetitive low-energy shock-wave therapy improve pain and function more than eccentric training alone in patients with chronic mid-portion Achilles tendinopathy?

Methodology

Subjects Sixty-eight subjects (18–70 years) with chronic (>6 months) non-insertional Achilles tendinopathy (clinical and ultrasound diagnosis).

Experimental procedure Following assessment, subjects were randomly assigned to two treatment groups for 12 weeks: (1) eccentric training alone (ECC=34, 59% female, increasing to 3 sets of 15 loads, 2/day, 7 days/week), and (2) an eccentric training and low-intensity shock wave treatment group (ECC+SW=34, eccentric training and three-weekly sessions of shock wave treatment, 2000 pulses at three bar, the VISA score, Likert scale (1–6), load-induced pain (0–10) and side effects were recorded at baseline and at 4 months follow-up.

Measures of outcome Pain and function (VISA), general assessment (Likert), load-induced pain.

Main finding/s

Likert scale 56% of the subjects in the ECC group and 82% of the patients in the ECC+SW group reported a Likert scale of one or two points (‘completely recovered’ or ‘much improved’) (p<0.05).

Conclusion/s

In a randomised controlled trial, a combination of eccentric training and low-energy shock wave therapy reduced pain and improved …

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