Effectiveness of the Alfredson Protocol Compared With a Lower Repetition-Volume Protocol for Midportion Achilles Tendinopathy: A Randomized Controlled Trial

Stevens, Marc; Tan, Chee-Wee

doi:10.2519/jospt.2014.4720

Cited by 81 publications

(114 citation statements)

References 35 publications

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“…Tendinopathies can take 6-12 weeks to show improvement. 16,55,56 However, this short time to improvement is similar to the time reported by Cushman 51 in his study of eccentric training in rehabilitating hamstring tendinopathy, and is possibly due to neural changes at this early period. 33,57 The subject was also performing exercises to improve the kinetic chain.…”

Section: Discussionmentioning

confidence: 55%

The Rehabilitation of a Runner With Iliopsoas Tendinopathy Using an Eccentric-Biased Exercise-a Case Report

Rauseo

2017

Intl J Sports Phys Ther

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Background and Purpose: While there is much discussion about tendinopathy in the literature, there is little reference to the less common condition of iliopsoas tendinopathy, and no documentation of the condition in runners. The iliopsoas is a major decelerator of the hip and eccentric loading of the iliopsoas is an important component of energy transfer during running. Eccentric training is a thoroughly researched method of treating tendinopathy but has shown mixed results. The purpose of this case report is to describe the rehabilitation of a runner with iliopsoas tendinopathy, and demonstrate in a creative eccentric-biased technique to assist with treatment. A secondary objective is to illustrate how evidence on intervention for other tendinopathies was used to guide rehabilitation of this seldom described condition.Case Description: The subject was a 39-year-old female middle distance runner diagnosed with iliopsoas tendinopathy via ultrasound, after sudden onset of left anterior groin pain. Symptoms began after a significant increase in running load, and persisted, despite rest, for three months. The intervention consisted of an eccentric-biased hip flexor exercise, with supportive kinetic chain exercises and progressive loading in a return to running program. Outcomes:The Copenhagen Hip and Groin Outcome Score, the Visual Analogue Scale, the Global Rating of Change Scale and manual muscle testing scores all improved after 12 weeks of intervention with further improvement at the five-year follow up. After 12 weeks of intervention, the subject was running without restriction and had returned to her pre-injury running mileage at the five-year follow up. Discussion:The eccentric-biased exercise in conjunction with exercises addressing the kinetic chain and a progressive tendon loading program, were successful in the rehabilitation of this subject with iliopsoas tendinopathy. This case report is the first to provide a description on the rehabilitation of iliopsoas tendinopathy, and offers clinicians suggestions and guidance for treatment and exercise choice in the clinical environment. Level of Evidence: 5

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Section: Discussionmentioning

confidence: 55%

The Rehabilitation of a Runner With Iliopsoas Tendinopathy Using an Eccentric-Biased Exercise-a Case Report

Rauseo

2017

Intl J Sports Phys Ther

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“…Frequently prescribed exercise parameters proven successful are 3 sets of 15 repetitions, knee straight and knee bent, twice daily. Stevens and Tan 59 suggested that completing 2 sessions of the exercises daily as tolerated resulted in similar improvements at 6 weeks when compared with patients completing all 180 repetitions daily. Regardless of the protocol, the frequency of eccentric exercise targeting the tendon is much different than utilized for muscle, as with the tendon, the goal is to provide a frequent dose of mechanical stimulus to the tendon cell.…”

Section: Achilles Tendon Loadingmentioning

confidence: 94%

Treating Tendinopathy

Joseph

Denegar

2015

Clinics in Sports Medicine

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“…Em pelo menos um dos grupo foi realizado o EFE, e todos os estudos obtiveram pontuação superior a 6 na escala de qualidade PEDro com média de 7. Todos os estudo cumpriram com os critérios 10 e 11 referentes as informações metodológicas estatísticas, no entanto falharam em critérios de validade interna como Alocação aleatória 39 , similaridade no início do tratamento 40 , acompanhamento apropriado 41,42 e análise por intuito de tratar 43,44 . Todos os estudos fracassaram em pelo menos um critério de cegueira, critérios 5, 6 e 7.…”

Section: Qualidade Metodológica Dos Estudosunclassified

Fortalecimento Muscular Excêntrico No Tratamento Da Tendinopatia De Aquiles: Uma Revisão Sistemática

Silva¹,

Rocha²,

Filho³

et al. 2017

Rev Pesq Fisio

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INTRODUÇÃO: A Fisioterapia, no manejo da tendinopatia de Aquiles, utiliza-se de recursos físicos moduladores da inflamação e analgésicos. Como parte do tratamento fisioterapêutico a literatura tem sugerido o exercício de fortalecimento excêntrico com eficaz na resolução de tendinopatias. OBJETIVO: O presente estudo teve como objetivo a busca de evidências científicas sobre o uso do exercício de fortalecimento excêntrico no manejo da Tendinopatia de Aquiles. MÉTODOS: Para a composição da revisão foi realizada busca por estudos nas base de dados virtuais Pubmed e PEDro. Os descritores utilizados foram as seguintes: Eccentric, tendinopathy, Achilles Tendonitis. Para compor o estudo os artigos deveriam obedecer os seguintes critérios de elegibilidade: artigos publicados na língua inglesa, intervalo de publicação entre 2013 a 2017, ensaios clínicos randomizados, com pontuação superior a 6 na escala de qualidade PEDro. RESULTADOS: Foram localizados um total de 87 artigos, dos quais apenas 21 referiam-se a temática em questão. Dos 21 artigos 14 foram excluídos pelos seguintes motivos: 3 por consistirem em relatos de caso, 1 classificado como revisão de literatura, 1 caracterizava-se como comentário clinico, 1 envolvia um estudo com modelo animal, 1 era um projeto de pesquisa, 5 não classificavam-se com ensaios clínicos randomizados, 1 obteve nota inferior a 6 na escala de qualidade PEDro e 1 deles proporcionava descrição incompleta dos resultados. CONCLUSÃO: O fortalecimento muscular excêntrico caracteriza-se como uma modelo terapêutico de escolha para o manejo da tendinopatia de aquiles, a combinação com outras modalidades potencializa seus efeitos fisiológicos.

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Effectiveness of the Alfredson Protocol Compared With a Lower Repetition-Volume Protocol for Midportion Achilles Tendinopathy: A Randomized Controlled Trial

Cited by 81 publications

References 35 publications

The Rehabilitation of a Runner With Iliopsoas Tendinopathy Using an Eccentric-Biased Exercise-a Case Report

The Rehabilitation of a Runner With Iliopsoas Tendinopathy Using an Eccentric-Biased Exercise-a Case Report

Treating Tendinopathy

Fortalecimento Muscular Excêntrico No Tratamento Da Tendinopatia De Aquiles: Uma Revisão Sistemática

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