Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review

Kingma, Jackie J.; Knikker, R de; Wittink, Harriët; Takken, Tim

doi:10.1136/bjsm.2006.030916

Cited by 173 publications

(147 citation statements)

References 33 publications

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“…Unlike other studies, the patient population varied with regards to their activity level (most of the literature is based on runners and o en semi-competitive to competitive runners) [10,12,13]. Results are consistent with recent reviews questioning the e ectiveness of eccentric training for Achilles tendinopathy [16,24,25].…”

Section: Discussionsupporting

confidence: 69%

“…e VAS scales were included to compare with most of the other eccentric exercise studies that used pain measured by VAS as an outcome measure. Nonetheless, pain intensity alone as a primary outcome measure has been questioned, with one review stating that it would be more clinically relevant to use an outcome measure that takes into consideration the function of the Achilles tendon, patient's activity level, and patient's participation level [16]. is was taken into consideration and accounts for the use of the VISA-A.…”

Section: Discussionmentioning

confidence: 99%

“…ere is an absence of RCT/level 1 evidence with respect to the existing studies on this topic [16]. Eccentric exercises' success requires a high level of patient motivation and may not be suitable for elderly or frail patients [17].…”

mentioning

confidence: 99%

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The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

Ram

Meeuwisse²,

Patel³

et al. 2013

CIM

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Purpose: Objective was to evaluate the outcome of a standardized heavy load eccentric training program in adults with chronic painful Achilles tendinopathy, and the presence of increased Colour Doppler activity in diseased and non-diseased adults. e hypothesis was that patient satisfaction would fall within the range of average satisfaction present in the literature (60 to 90%).Methods: Twenty patients were instructed on a training program based on the Alfredson protocol of straight leg followed by bent knee heel drops and raises. Patient satisfaction was recorded as the primary outcome. Secondary outcomes included the VISA-A and Tegner scales. Twenty one subjects without present or history of lower extremity pain and seven patients presenting at the clinic but without Achilles tendinopathy were included as controls.Results: Patient satisfaction was signi cantly lower when compared to the literature as two patients reported that they were satis ed with the treatment while the remaining 15 reported that they were unsatis ed. ree patients were excluded from the analysis as they were unable to complete the exercises. Increased Colour Doppler activity was present in only one participant without the disease and in all patients with the disease at the end of the study (increased Colour Doppler activity was present in 40% of patients with the disease at the beginning of the study). Conclusion:Although some patients' symptoms improved over time, eccentric training did not satisfy patient expectations of improvement following treatment despite compliance with the home based program. Although it is a mainstay of treatment, other options, which are both e cacious and e ective, need to be provided for patients who prefer a conservative and relatively non-invasive treatment option from the start.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

Ram

Meeuwisse²,

Patel³

et al. 2013

CIM

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“…1). In order to stimulate collagen production and optimize fibres alignment (Alves et al 2001;Kingma et al 2007) without applying unnecessary stresses to a still fragile tendon, a reliable prognosis is required to determine the most appropriate time to start controlled exercise and its intensity (Dowling et al 2000;Gillis 1997). Quantitative ultrasound is being applied to noninvasively evaluate tendon load Roux and Defontaine 2005), since it has been demonstrated that axial speed of sound (SOS) in tendon varies with the tendon loading .…”

Section: Introductionmentioning

confidence: 99%

First Application of Axial Speed of Sound to Follow Up Injured Equine Tendons

Vergari¹,

Pourcelot²,

Ravary-Plumioën³

et al. 2012

Ultrasound in Medicine & Biology

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“…Training where ECC actions were overload (ECC overload [EO] training), performed with more load than during CON action it was verified after training an increase on the size of type IIX fibres 7 , a higher increase at isokinetic and isometric force production 8 and higher neuromuscular activation [8][9][10] . Owing to the importance of ECC actions in neuromuscular activation 11 and the benefits of EO training, machines have been developed to increased load during the ECC action [12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Acute neuromuscular response during eccentric overload protocol by using a mechanical device to increase the load

Lanza

Pertence

Andrade

et al. 2017

Rev. Bras. Cineantropom. Desempenho Hum.

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-The aim of this study was to propose a mechanical device that could increase the mechanical load during the entire eccentric (ECC) action on a knee flexor machine and to compare the muscular activity when the device was used during a testing protocol. Fifteen physically active women were recruited, and they performed two protocols: control and eccentric overload. Control protocol was performed with concentric (CON) and ECC actions with similar load (60% of one repetition maximum) whilst eccentric overload protocol consisted of ECC actions with 40% more load than CON actions. Muscular activation was measured using surface electromyography of the biceps femoris (BF) and the gastrocnemius medialis (GM) muscles. ECC actions presented a higher muscular activation during eccentric overload protocol than control protocol for BF (p = 0.032), but not for the GM (p = 0.439). The mechanical device increased the mechanical load during the ECC muscle action and consequently increased the amplitude of the neural drive to the BF muscle; however, it did not increase the amplitude of the neural drive to the GM muscle.Key words: Electromyography; Muscle contraction; Resistance training. Resumo -O objetivo deste estudo foi propor um dispositivo mecânico que acoplado a uma cadeira flexora aumente a carga mecânica durante toda a ação excêntrica (ECC) e comparar a atividade muscular durante a utilização do dispositivo proposto. Quinze mulheres fisicamente ativas foram recrutadas e realizaram dois diferentes protocolos (controle e sobrecarga ECC). O protocolo controle foi realizado com ações concêntricas (CON) e ECC com carga iguais (60% de uma repetição máxima), enquanto o protocolo de sobrecarga ECC consistiu em ações ECC com 40% mais de carga do que as ações CON. A ativação muscular dos músculos biceps femoris (BF) e gastrocnemius medialis (GM

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Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review

Cited by 173 publications

References 33 publications

The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

First Application of Axial Speed of Sound to Follow Up Injured Equine Tendons

Acute neuromuscular response during eccentric overload protocol by using a mechanical device to increase the load

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