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Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy
  1. Karin G Silbernagel (karin.gravare-silbernagel{at}
  1. Sahlgrenska University Hospital, Sweden
    1. Roland Thomeé (roland.thomee{at}
    1. Sahlgrenska University Hospital, Sweden
      1. Bengt I Eriksson (b.eriksson{at}
      1. Sahlgrenska University hospital, Sweden
        1. Jon Karlsson (jon.karlsson{at}
        1. Sahlgrenska University Hosptial, Sweden


          Objective: The primary purpose of this study was to assess the relationship between muscle-tendon function and symptoms in patients with Achilles tendinopathy using a validated test battery.

          Design: A prospective non-randomized trial.

          Setting: Orthopaedic Department, University Hospital

          Patients: Thirty-seven patients with clinical diagnosis of Achilles tendinopathy in the midportion of the tendon, with symptoms for more than 2 months, were evaluated at the initiation of the study and after one year.

          Intervention: The patients were treated with a rehabilitation program, under the supervision by a physical therapist, for 6 months.

          Main outcome measurements: The patients were evaluated with the Swedish version of the Victorian Institute of Sports Assessment – Achilles questionnaire (VISA-A-S) for symptoms and a test battery for the evaluation of lower leg muscle-tendon function.

          Results: There were significant improvements in the VISA-A-S score (p<0.00, n=37) and the test battery (p<0.02, n=19) at the one-year follow-up. The VISA-A-S questionnaire had an effect size of 2.1 and the test battery had an effect size of 0.73. A low correlation (r=0.178, p>0.05) was found between the VISA-A-S score and the test battery. A high correlation (r=0.611, p<0.05) was found between the Drop CMJ and the VISA-A-S score. All other tests in the test battery had low correlations (r=-0.305-0.155, p>0.05) with the VISA-A-S score. Only 25 % (4 out of 16) of the patients who had full symptomatic recovery had achieved full recovery of muscle/tendon function as measured with the test battery.

          Conclusion: Full symptomatic recovery in patients with Achilles tendinopathy does not ensure full recovery of muscle/tendon function. The VISA-A-S questionnaire and the test battery are sensitive to clinically relevant changes with treatment and can be recommended to be used in both the clinic and in research.

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