Physiotherapy management of Achilles tendinopathy

Malliaras, Peter

doi:10.1016/j.jphys.2022.09.010

Cited by 16 publications

(13 citation statements)

References 149 publications

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“…non-steroidal anti-inflammatory drugs, and corticosteroids), and surgical repair (i.e. autografts, allografts, and xenografts) [ 1 , 2 , [4] , [5] , [6] , [7] ], are frequently suboptimal since they provide a limited functional recovery, exposing the repaired tissue to a high risk of re-injury.…”

Section: Introductionmentioning

confidence: 99%

Assessing the functional potential of conditioned media derived from amniotic epithelial stem cells engineered on 3D biomimetic scaffolds: An in vitro model for tendon regeneration

Russo,

Prencipe,

Mauro

et al. 2024

Materials Today Bio

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Section: Introductionmentioning

confidence: 99%

Assessing the functional potential of conditioned media derived from amniotic epithelial stem cells engineered on 3D biomimetic scaffolds: An in vitro model for tendon regeneration

Russo,

Prencipe,

Mauro

et al. 2024

Materials Today Bio

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“…Achilles tendinopathy (AT), characterised by persistent tendon pain and loss of function related to mechanical loading,1 can negatively impact quality of life, participation in daily activities, and lead to depression and anxiety 2. AT is typically managed through rehabilitation guided by physical therapists (PTs) with the goal of returning to preinjury activities and mitigating recurrence 3. The Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association and the Dutch Association for Sports Medicine recently published two clinical practice guidelines (CPGs) for AT that advocate for patient education (eg, regarding aetiology, prognosis, activity modifications) and therapeutic exercise (eg, mechanical loading in the form of progressive calf muscle strengthening exercises) 4 5…”

Section: Introductionmentioning

confidence: 99%

Current practice, guideline adherence, and barriers to implementation for Achilles tendinopathy rehabilitation: a survey of physical therapists and people with Achilles tendinopathy

Merry,

MacPherson,

Blazey

et al. 2024

BMJ Open Sport Exerc Med

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ObjectiveTo explore clinical practice patterns of physical therapists (PTs) who treat people with Achilles tendinopathy (AT), and identify perceived barriers and facilitators for prescribing and engaging with therapeutic exercise among PTs and people with AT.MethodsTwo cross-sectional surveys were electronically distributed between November 2021 and May 2022; one survey was designed for PTs while the second was for people with AT. Survey respondents answered questions regarding their physical therapy training and current practice (PTs), injury history and management (people with AT), and perceived barriers and facilitators (PTs and people with AT).Results341 PTs and 74 people with AT completed the surveys. In alignment with clinical practice guidelines, more than 94% of PTs surveyed (97% of whom had some form of advanced musculoskeletal training) prioritise patient education and therapeutic exercise. Patient compliance, patient knowledge, and the slow nature of recovery were barriers to prescribing therapeutic exercise reported by PTs, while time, physical resources, and a perceived lack of short-term treatment effectiveness were barriers for people with AT.ConclusionsConsistent with clinical practice guidelines, PTs with advanced training reported prioritising therapeutic exercise and education for managing AT. However, both PTs and people with AT identified many barriers to prescribing or engaging with therapeutic exercise. By addressing misconceptions about the time burden and ineffectiveness of exercise, and by overcoming access issues to exercise space and equipment, PTs may be able to improve intervention adherence and subsequently outcomes for people with AT.

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“…Among them, Achilles tendinopathy (AT) is one of the most common tendinopathies of the lower extremities with an estimated prevalence of 2–3 cases per 1000 patients in the general population. However prevalence rates can reach 50% in specific populations, such as athletes [ 3 , 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Conservative treatment in AT includes medical and physical therapy. Physiotherapy includes electrophysical means and manual techniques [ 7 , 15 , 16 , 17 , 18 , 19 ]. Exercise seems to be the intervention with the highest level of evidence [ 10 , 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Exercise provides mechanical load to the tendon in order to manage symptoms and promote strength, endurance, and satisfactory leg function [ 21 ]. However, in most trials, diverse interventions were screened while the optimal load, the duration of intervention, or the speed vary, not to mention the different outcome measures used, which all together limit the certainty of conclusions [ 7 , 21 ]. Historically, one of the most established exercise regimens for AT is eccentric strengthening, which as part of the rehabilitation of tendon injuries was created by Curwin and Stanish [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparability of the Effectiveness of Different Types of Exercise in the Treatment of Achilles Tendinopathy: A Systematic Review

et al. 2023

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Achilles tendinopathy (AT) is a common condition both in athletes and the general population. The purpose of this study is to highlight the most effective form of exercise in managing pain-related symptoms and functional capacity as well as in a return to life activities, ensuring the quality of life of patients with AT, and creating a protocol to be used in rehabilitation. We conducted a systematic review of the published literature in Pubmed, Scopus, Science Direct, and PEDro for Randomised Controlled Trials concerning interventions that were based exclusively on exercise and delivered in patients 18–65 years old, athletes and non-athletes. An amount of 5235 research articles generated from our search. Five met our inclusion criteria and were included in the review. Research evidence supports the effectiveness of a progressive loading eccentric exercise program based on Alfredson’s protocol, which could be modified in intensity and pace to fit the needs of each patient with AT. Future research may focus on the optimal dosage and load of exercise in eccentric training and confirm the effectiveness of other type of exercise, such as a combination of eccentric–concentric training or heavy slow resistance exercise. Pilates could be applied as an alternative, useful, and friendly tool in the rehabilitation of AT.

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Physiotherapy management of Achilles tendinopathy

Cited by 16 publications

References 149 publications

Assessing the functional potential of conditioned media derived from amniotic epithelial stem cells engineered on 3D biomimetic scaffolds: An in vitro model for tendon regeneration

Assessing the functional potential of conditioned media derived from amniotic epithelial stem cells engineered on 3D biomimetic scaffolds: An in vitro model for tendon regeneration

Current practice, guideline adherence, and barriers to implementation for Achilles tendinopathy rehabilitation: a survey of physical therapists and people with Achilles tendinopathy

Comparability of the Effectiveness of Different Types of Exercise in the Treatment of Achilles Tendinopathy: A Systematic Review

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