“Does isometric exercise improve leg stiffness and hop pain in subjects with Achilles tendinopathy? A feasibility study”

Mantovani, Lisa; Maestroni, Luca; Bettariga, Francesco; Gobbo, Massimiliano; Lopomo, N.; McLean, Sionnadh

doi:10.1016/j.ptsp.2020.09.005

Cited by 6 publications

(9 citation statements)

References 44 publications

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“…Table 9 provides an overview of the 17 included cross-sectional studies, with 10 studies (De Jonge et al, 2011;De Marchi et al, 2018;Divani et al, 2010;Finnamore et al, 2019;Praet et al, 2018;Santamato et al, 2019;Scholes et al, 2018;Wang et al, 2012) investigating midportion Achilles tendinopathy, four studies Kragsnaes et al, 2014;Turner et al, 2020;Vallance et al, 2020) investigating both insertional and midportion Achilles tendinopathy, and three studies (Aiyegbusi, Tella & Sanusi, 2020;Mantovani et al, 2020) not specifying tendinopathy location. Once again, location of pain was the most common subjective measure to diagnose Achilles tendinopathy, with 12 studies utilising it as a diagnostic criteria (De Jonge et al, 2011;De Marchi et al, 2018;Kragsnaes et al, 2014;Mantovani et al, 2020;Praet et al, 2018;Chester et al, 2008;Scholes et al, 2018;Turner et al, 2020;Vallance et al, 2020;Wang et al, 2012). Midportion Achilles tendinopathy was defined as 2-6 cm above the calcaneal insertion in four studies (De Marchi et al, 2018;Praet et al, 2018; Wang et al, 2012), and 2-7 cm above the calcaneal insertion in one study .…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

“…Midportion Achilles tendinopathy was defined as 2-6 cm above the calcaneal insertion in four studies (De Marchi et al, 2018;Praet et al, 2018; Wang et al, 2012), and 2-7 cm above the calcaneal insertion in one study . Similarly, 12 studies included duration of symptoms as a diagnostic criteria, with durations of symptoms including greater than four weeks (Santamato et al, 2019), greater than two months (Praet et al, 2018;, greater than three months (Finnamore et al, 2019;Mantovani et al, 2020;Scholes et al, 2018;Turner et al, 2020;Vallance et al, 2020;Wang et al, 2012), greater than four months (Kragsnaes et al, 2014), and greater than six months (De Marchi et al, 2018). Pain with tendon loading was the next most common subjective diagnostic measure, with nine studies including it as a diagnostic measure (De Marchi et al, 2018;Finnamore et al, 2019;Scholes et al, 2018;Turner et al, 2020;Vallance et al, 2020;Wang et al, 2012).…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

“…One study (Divani et al, 2010) did not report subjective measures to confirm the diagnosis of Achilles tendinopathy. The most common clinical test included palpation, with nine studies using palpation to clinically diagnose Achilles tendinopathy (Divani et al, 2010;Finnamore et al, 2019;Kragsnaes et al, 2014;Mantovani et al, 2020;Praet et al, 2018;Wang et al, 2012). Four studies (Aiyegbusi, Tella & Sanusi, 2020;Santamato et al, 2019;Wang et al, 2012) included the Royal London Hospital Test as a clinical measure of Achilles tendinopathy, with four studies (De Jonge et al, 2011;De Marchi et al, 2018;Scholes et al, 2018;Turner et al, 2020) not specifying the clinical tests utilised to confirm the diagnosis.…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

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The clinical diagnosis of Achilles tendinopathy: a scoping review

Matthews

Ellis

Furness

et al. 2021

PeerJ

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Background Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. The primary aim of this scoping review is to provide a method for clinically diagnosing Achilles tendinopathy that aligns with the nine core health domains. Methodology A scoping review was conducted to synthesise available evidence on the clinical diagnosis and clinical outcome measures of Achilles tendinopathy. Extracted data included author, year of publication, participant characteristics, methods for diagnosing Achilles tendinopathy and outcome measures. Results A total of 159 articles were included in this scoping review. The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). Further objective tests used to assess Achilles tendinopathy included tendon pain during loading activities (single-leg heel raises and hopping) and the Royal London Hospital Test and the Painful Arc Sign. The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured. Conclusions There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy.

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Section: Cross-sectional Studiesmentioning

confidence: 99%

Section: Cross-sectional Studiesmentioning

confidence: 99%

Section: Cross-sectional Studiesmentioning

confidence: 99%

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The clinical diagnosis of Achilles tendinopathy: a scoping review

Matthews

Ellis

Furness

et al. 2021

PeerJ

View full text Add to dashboard Cite

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“…e isometric training approach is implemented in all four stages of the protocol and plays a crucial role in the initial stages. Current knowledge regarding AT and isometric rehabilitation is centered on only a few studies [20][21][22][23]. Based on exploratory studies and studies assessing pain and stiffness immediately after isometric exercises, there is no evidence that supports an immediate pain relief in AT following isometric exercises [21][22][23], which is contrary to what has been reported in patellar tendinopathy [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…Current knowledge regarding AT and isometric rehabilitation is centered on only a few studies [20][21][22][23]. Based on exploratory studies and studies assessing pain and stiffness immediately after isometric exercises, there is no evidence that supports an immediate pain relief in AT following isometric exercises [21][22][23], which is contrary to what has been reported in patellar tendinopathy [24][25][26]. An AT trial assessing the effect of combining isometric exercises with eccentric training after 3 months found that adding isometric exercises to eccentric training provided no extra benefit [20].…”

Section: Introductionmentioning

confidence: 99%

An Isometric and Functionally Based 4-Stage Progressive Loading Program in Achilles Tendinopathy: A 12-Month Pilot Study

Krogh

Jensen

Madsen

et al. 2022

Translational Sports Medicine

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Background. Achilles tendinopathy (AT) is a common musculoskeletal disorder, and its management remains challenging. Hypothesis/Purpose. By conducting a pilot study, we aimed to assess the feasibility, safety, and clinical improvement of a new home-based 4-stage rehabilitation program with progressive loading including isometric exercises on a small scale prior to setting up a randomized controlled trial. Methods. Ten recreational athletes with chronic midportion AT were included. The primary outcome was change in VISA-A score after 1, 2, 3, 6, and 12 months. Secondary outcomes included tenderness on palpation of the tendon and ultrasonographic changes after 6 months. Results. Average VISA-A improvements of 26.9 points ( P = 0.004 ) and 35.4 points ( P = 0.006 ) were observed at 6- and 12-month follow-up, respectively. Tenderness on palpation of the tendon (0–10) was reduced from 5.5 to 2.5 ( P < 0.001 ). Color Doppler ultrasound activity (0–4) was reduced by 50%, from an average of grade 2 to grade 1 ( P = 0.023 ). The hypoechoic cross-sectional area of the Achilles tendon was reduced from an average of 29.1% to 8.5% ( P = 0.001 ). Tendon thickness showed no statistically significant change ( P = 0.415 ). Conclusion. Following the 4-stage rehabilitation program for AT based on isometric training and progressive loading, we observed improvement in both VISA-A score and ultrasonography in a group of athletes who had previously failed to benefit from standard AT rehabilitation. The study was feasible in terms of high adherence to the program and with no observed safety issues. The results of this pilot study support a further assessment of this specific approach for rehabilitation in a future randomized controlled trial.

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Oefentherapie bij achillespees tendinopathie: praktische implementatie in de podotherapeutische praktijk

Caarels

2021

Podosophia

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“Does isometric exercise improve leg stiffness and hop pain in subjects with Achilles tendinopathy? A feasibility study”

Cited by 6 publications

References 44 publications

The clinical diagnosis of Achilles tendinopathy: a scoping review

The clinical diagnosis of Achilles tendinopathy: a scoping review

An Isometric and Functionally Based 4-Stage Progressive Loading Program in Achilles Tendinopathy: A 12-Month Pilot Study

Oefentherapie bij achillespees tendinopathie: praktische implementatie in de podotherapeutische praktijk

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