The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: a randomised controlled trial

Br J Sports Med. 2007 Jul;41(7):e5. doi: 10.1136/bjsm.2006.032532. Epub 2006 Dec 18.

Abstract

Aim: To assess whether the use of a night splint is of added benefit on functional outcome in treating chronic midportion Achilles tendinopathy.

Methods: This was a single-blind, prospective, single centre, randomised controlled trial set in the Sports Medical Department, The Hague Medical Centre, The Netherlands. Inclusion criteria were: age 18-70 years, active participation in sports, and tendon pain localised at 2-7 cm from distal insertion. Exclusion criteria were: insertional disorders, partial or complete ruptures, or systemic illness. 70 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. At baseline and follow-up at 12 weeks, patient satisfaction, Victorian Institute of Sport Assessment-Achilles questionnaire (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 with 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). 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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Achilles Tendon / injuries*
  • Adolescent
  • Adult
  • Aged
  • Athletic Injuries / therapy*
  • Chronic Disease
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Compliance
  • Patient Satisfaction
  • Prospective Studies
  • Single-Blind Method
  • Splints*
  • Tendinopathy / therapy*
  • Treatment Outcome