Eccentric exercise is more effective than other exercises in the treatment of mid-portion Achilles tendinopathy: systematic review and meta-analysis

BMC Sports Science, Medicine and Rehabilitation

Research

Filippo Migliorini¹  Nicola Maffulli²  Luis Felipe Nunes³  Luciana Sayuri Sanada⁴  Rodrigo Okubo⁴  Thiago Teixeira Serafim⁴  Diego Ailton Prudêncio⁴ 

[1] Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany;Department of Orthopaedics, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy;School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke On Trent, UK;Centre for Sports and Exercise Medicine at Queen, Mary University of London, London, UK;Department of Pharmacy, Federal University of Santa Catarina, Florianópolis, Brazil;Department of Physiotherapy, Physiotherapy Postgraduation Program (PPGF), Santa Catarina State University, Florianópolis, Brazil;

关键词: Ankle injuries;    Achilles tendinopathy;    Review;    Physiotherapy modalities;    Exercise therapy;   

DOI  :  10.1186/s13102-023-00618-2

 received in 2022-08-31, accepted in 2023-01-16,  发布年份 2023

来源: Springer

【 摘 要 】

Achilles tendinopathy (AT) is one of the most frequent overuse injuries in the ankle. The evidence base for its conservative management AT continues to evolve, but there is still a gap in the evidence for the efficacy of any modality of treatment in high-quality studies. This systematic review and meta-analysis investigated the efficacy of EE in improving pain and function in adult patients with mid-portion Achilles tendinopathy compared to other forms of exercise. A search was performed in PubMed, BIREME, SportDiscus, Cinahl, Web of Science and PEDro, in November 2022. The methodological quality was evaluated using the Risk of Bias 2 tool (RoB2) of the Cochrane collaboration, and the meta-analysis was performed using the Review Manager 5.1 program. 2024 articles were identified and eight fulfilled the inclusion criteria. RoB2 presented a final score with 62.5% of the studies presented “some concerns”, and 37.5% (five and three articles, respectively) presenting “high risk” of bias. EE was effective for the managment of AT. The only variable for which a meta-analysis was possible was pain (five articles), analysed with the visual analogue scale/numerical visual scale. The mean difference (MD) in treatment effect using EE was − 1.21 (− 2.72 to − 0.30) with a 95% of confidence interval (CI), thus identifying a significant positive effect for the improvement of pain in patients with AT in whom EE was used. EE is effective in the management of AT. The meta-analysis shows the need for appropriately powered randomized controlled trials with better design, the use of standard outcome measures and well-planned protocols for conservative management of AT.Level of evidence: Level 1.Registration: CRD42018118016.

【 授权许可】

CC BY   
© The Author(s) 2023

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