One article on PainSci cites Stevens 2014: Achilles Tendinitis Treatment Science
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
STUDY DESIGN: Randomized clinical trial.
OBJECTIVES: To compare the effectiveness of the Alfredson eccentric heel-drop protocol with a "do-as-tolerated" protocol for nonathletic individuals with midportion Achilles tendinopathy.
BACKGROUND: The Alfredson protocol recommends the completion of 180 eccentric heel drops a day. However, completing this large number of repetitions is time consuming and potentially uncomfortable. There is a need to investigate varying exercise dosages that minimize the discomfort yet retain the clinical benefits.
METHODS: Twenty-eight individuals from outpatient physiotherapy departments were randomized to either the standard (n = 15) or the do-as-tolerated (n = 13) 6-week intervention protocol. Apart from repetition volume, all other aspects of management were standardized between groups. Tendinopathy clinical severity was assessed with the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire. Pain intensity was assessed using a visual analog scale (VAS). Both were assessed at baseline, 3 weeks, and 6 weeks. Treatment satisfaction was assessed at week 6. Adverse effects were also monitored.
RESULTS: There was a statistically significant within-group improvement in VISA-A score for both groups (standard, P = .03; do as tolerated, P<.001) and VAS pain for the do-as-tolerated group (P = .001) at week 6, based on the intention-to-treat analysis. There was a statistically significant between-group difference in VISA-A scores at week 3, based on both the intention-to-treat (P = .004) and per-protocol analyses (P = .007), partly due to a within-group deterioration at week 3 in the standard group. There were no statistically significant between-group differences for VISA-A and VAS pain scores at week 6, the completion of the intervention. There was no significant association between satisfaction and treatment groups at week 6. No adverse effects were reported.
CONCLUSION: Performing a 6-week do-as-tolerated program of eccentric heel-drop exercises, compared to the recommended 180 repetitions per day, did not lead to lesser improvement for individuals with midportion Achilles tendinopathy, based on VISA-A and VAS scores.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.
- No effect of creatine monohydrate supplementation on inflammatory and cartilage degradation biomarkers in individuals with knee osteoarthritis. Cornish 2018 Nutr Res.
- The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Bebee 2021 Med J Aust.
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.