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The additional value of a night splint to eccentric exercises in chronic midportion Achilles Tendinopathy: a randomised controlled trial
  1. R.J. de Vos (rj_devos{at}hotmail.com)
  1. Erasmus Medical Centre Rotterdam, Netherlands
    1. A. Weir (a.weir{at}mchaaglanden.nl)
    1. The Hague Medical Centre Leidschendam, Netherlands
      1. R.J.A. Visser (rjavisser{at}hotmail.com)
      1. The Hague Medical Centre Leidschendam, Netherlands
        1. Th.C. de Winter (t.de.winter{at}mchaaglanden.nl)
        1. The Hague Medical Centre Leidschendam, Netherlands
          1. J.L. Tol (h.tol{at}mchaaglanden.nl)
          1. The Hague Medical Centre Leidschendam, Netherlands

            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.

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