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One-year follow-up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy
  1. Suzan de Jonge (s.de.jonge{at}umail.leidenuniv.nl)
  1. Sports Medicine Department. The Hague Medical Centre. Leidschendam, Netherlands
    1. Robert-Jan de Vos (r.devos{at}erasmusmc.nl)
    1. Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, Netherlands
      1. Hans T.M. van Schie (schie154{at}planet.nl)
      1. Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, Netherlands
        1. Jan A.N. Verhaar (j.verhaar{at}erasmusmc.nl)
        1. Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, Netherlands
          1. Adam Weir (adsinoz{at}hotmail.com)
          1. Sports Medicine Department. The Hague Medical Centre. Leidschendam, Netherlands
            1. Johannes L. Tol (h.tol{at}mchaaglanden.nl)
            1. Sports Medicine Department. The Hague Medical Centre. Leidschendam, Netherlands

              Abstract

              Objective: The study examined whether the addition of a night splint to eccentric exercises is beneficial for functional outcome in chronic mid-portion Achilles tendinopathy.

              Design: One-year follow-up of a randomised controlled single blinded clinical trial.

              Setting: Sports medicine department in a general hospital.

              Patients: 58 patients (70 tendons) were included.

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

              Main outcome measurements: Outcome scores were: Victorian Institute of Sport Assessment – Achilles (VISA-A) score, subjective patient satisfaction and neovascularisation score measured with Power Doppler Ultrasonography.

              Results: For both groups the VISA-A score increased significantly (from 50 to 76 (P < 0.01) in the eccentric group and from 49 to 78 (P < 0.01) in the night splint group). No significant differences in VISA-A score were found between the groups from baseline to one year (P = 0.32). Presence of neovessels at baseline did not predict change in VISA-A score after one year in the whole group (P = 0.71).

              Conclusion: Eccentric exercises with or without a night splint improved functional outcome at one-year follow-up. At follow-up there was no significant difference in clinical outcome when a night splint was used in addition to an eccentric exercise program. Between three months and one year follow-up, a continuing increase in VISA-A score was found. Assessment of the neovascularisation score with PDU at baseline has no prognostic value on long-term clinical outcome.

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