One-year follow-up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy (original) (raw)
One-year follow-up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy
- S de Jonge1,
- R J de Vos2,
- H T M Van Schie2,
- J A N Verhaar2,
- A Weir1,
- J L Tol1
- 1Sports Medicine Department, The Hague Medical Centre, Leidschendam, The Netherlands
- 2Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands
- Correspondence to Dr J L Tol, The Hague Medical Centre Antoniushove, Sports Medicine Department, PO Box 411, Burgemeester Banninglaan 1, 2260 AK Leidschendam, The Netherlands; h.tol{at}mchaaglanden.nl
Abstract
Objective The study examined whether the addition of a night splint to eccentric exercises is beneficial for functional outcome in chronic midportion 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 (VISAA) score, subjective patient satisfaction and neovascularisation score measured with power Doppler ultrasonography (PDU).
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 the VISA-A score were found between the groups from baseline to one year (p = 0.32). The presence of neovessels at baseline did not predict a change in the 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 programme. Between 3 months and one year follow-up, a continuing increase in the 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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