None listed
Conditions
Brief summary
The objectives of this study is to determine the most clinically effective regime of eccentric exercise for Achilles tendinopathy, and to determine if any extra benefit can be gained from adding laser therapy in combination with exercise. The hypothesis being that eccentric exercise twice per week for 12 weeks combined with laser therapy twice per week for 4 weeks will have superior outcomes and be more effective.
Interventions
The trial is a 2X2 factorial design and compares 4 groups.Two of the groups will be prescribed one regimen of exercise, and the other two groups a different regimen of exercise. In addition, two of the groups will receive placebo laser, and the other two groups active laser. The exercise protocol is heavy load eccentric exercise twice per day, 7 days per week for 12 weeks, as per Alfredson et al 1998. Two types of exercise to be used; eccentric loading of the calf muscles with knee straight, an
The trial is a 2X2 factorial design and compares 4 groups.Two of the groups will be prescribed one regimen of exercise, and the other two groups a different regimen of exercise. In addition, two of the groups will receive placebo laser, and the other two groups active laser. The exercise protocol is heavy load eccentric exercise twice per day, 7 days per week for 12 weeks, as per Alfredson et al 1998. Two types of exercise to be used; eccentric loading of the calf muscles with knee straight, and to maximize the activation of the deep calf muscle with the knee bent. Each of the exercises to include 15 repetitions done in 3 sets (3 X 15 twice per day with knee bent and knee straight). In the beginning the loading consists of body weight, subjects stand on their toes with all their body weight on the injured leg. The calf muscles are loaded by having the subject lower the heel beneath the forefoot. No following push up onto the toes is allowed; the non-injured leg is used to get back to the start position. Subjects are told to go ahead even if they experience pain and are only allowed to stop if the pain becomes disabling (greater than 4/10 on the visual analogue scale). When subjects can complete the exercise without pain they must increase the loading by adding extra weight. This can be done by filling a backpack with successively more weight or by using a weight machine. laser protocol is twice per week for 4 weeks; parameters are 10W output power, pulsed at 100Hz, for 30 Secs, delivering 150J to the medial, lateral and posterior aspects of the Achilles tendon, for a total time of 1:30 min, total energy delivered 450J.
Sponsors
Dr Steve Tumilty
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients with a diagnosis of Achilles Tendinopathy of greater than 3 months standing based upon accepted diagnostic criteria, and assessed by an experienced physiotherapist or physician; and who had not received treatment within the last 3 months. VISA-A score less than 80.
Exclusion criteria
Contraindications to LLLT to the area of the Achilles tendon; co-morbid musculoskeletal or serious conditions which may confound treatment or anticipated recovery; NSAIDs use; steroid injections or surgery for the condition; insertional tendinopathy or bursitis (retrocalcaneal or Achilles; determined by clinical examination); neurological signs; adverse neural tension affecting the sciatic or sural nerves; VISA-A score greater than 80; symptoms present less than 3 months.
Outcome results
None listed