Ultrasonography effectiveness of the vibration vs cryotherapy added to an eccentric exercise protocol in patients with chronic mid‐portion Achilles tendinopathy: A randomised clinical trial

Abstract

Tendinopathy is a very common disease in the general population as well as in athletes. The aim of the present study was to examine the tendon thickness and cross‐sectional area (CSA) in subjects with chronic mid‐portion Achilles tendinopathy (AT) who engaged in either an eccentric exercise (EE) programme with vibration training or an EE programme combined with cryotherapy. A sample of 61 patients with chronic mid‐portion AT were recruited and divided into two groups: EE programme vibration training (n = 30) and EE programme combined with cryotherapy (n = 31). Three ultrasound assessments were performed: pre‐intervention and at 4, and at 12 weeks. The comparison of thickness and CSA measures at baseline, 4, and 12 weeks showed a significant (P < 0.05) increase at 0, 2, 4, and 6 cm in maximal isometric contraction and at rest in subjects with chronic mid‐portion AT. The EE vibration training resulted in a statistically significant CSA increase compared with the cryotherapy group in patients with chronic mid‐portion AT.

An Overview of Achilles Tendinopathy Management

“…The use of heat in the management of AT lead to an improvement of blood flow and oxygen saturation in the Achilles tendon [64]. The use of thermotherapies such as hyperthermia and capacitive-resistive electric transfer would appear to be effective in the treatment of AT [64][65][66].…”

“…The use of cryotherapy is debated, it seems to be effective in increasing tendon oxygenation [67] and improving tendon thickness [65], but there is insufficient evidence to prove its efficacy as a treatment for AT. A recent work by Dubois et al [66] which presents a new acronym guiding management PEACE and LOVE for soft-tissue injuries, has raised doubts about the use of ice indeed there is no high-quality evidence to support the effectiveness of ice.…”