An Examination of Achilles Tendinopathy Treatment in Physically Active Patients
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Presenter(s)
Haily Doherty
Abstract
An Examination of Achilles Tendinopathy Treatment in Physically Active Patients.
Clinical Question: What is the effect of eccentric loading exercises versus platelet-rich plasma on pain in physically active adults with a history of Achilles tendinopathy?
Context: Limited research and studies are found for Achilles tendinopathy treatment. This study aims to discuss the best treatment option to reduce pain for these conditions. This study compares eccentric exercise training to platelet-rich plasma. Achilles tendinopathy can be treated by rest, NSAIDs, and avoiding activities that aggravate the condition, however, this study relates to physically active individuals such as athletes. Because of this, rest and avoiding activity may not be an option for them, so implementing other treatments such as eccentric exercise training and platelet-rich plasma may be the best choices. The purpose of this study is to determine the best treatment to reduce pain in physically active individuals with Achilles tendinopathy by comparing eccentric exercise training to platelet-rich plasma.
Data Sources: The author searched the following databases: PubMed and Physiotherapy Evidence Database (PEDro). The following keywords were used individually and in combination: eccentric exercises, platelet-rich plasma (PRP), physically active, and pain.
Study Selection: Studies were included according to the following criteria: (1) randomized control trial, (2) chronic Achilles pain for 3-6months, (3) physically active adult aged 18 years or older, (4) the intervention group received platelet-rich plasma (PRP) injection or eccentric training compared the control group that received saline or no training, and (5) the effect of pain from each intervention was reported as the main outcome.
Data Extraction: Data included the number and sex of participants, type of condition being treated, length of pain for the condition, treatment used, control group, outcome measures, and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine’s Levels of Evidence Scale. PEDro scores for all studies were recorded at a 10, except for the randomized control trial discussing the exercise therapy program for Achilles tendinopathy which recorded a score of 7.4 The OCEBM Levels of Evidence for all studies were recorded as level 2 evidence.
Main Results: Seven articles fit the criteria and were reviewed for a total of 302 participants. There was no statistically significant difference between the scores when comparing platelet-rich plasma injection with an eccentric loading program (p = 0.171).1 When platelet-rich plasma was compared to a placebo group, there was no significant difference between the groups (VISA-A score at 6, 12, and 24 weeks had a difference of 2.5, -1.6, and -0.9, respectively).2 When platelet-rich plasma was combined with exercise, significant improvements were noted (p < 0.001).3 When eccentric exercise training was compared to no training, reduction in pain and improved function of daily living and sporting activities were demonstrated in the eccentric exercise training group (p < 0.001).4 There was no statistically significant difference between the PRP and saline group shown between the two groups at 6 months (mean difference, -1.3 [95% CI, -17.8 to 15.2, P = 0.868]).5
Conclusions: Eccentric loading exercises are the best treatment for physically active adults who have chronic Achilles tendinopathy regarding pain reduction compared to platelet-rich plasma (PRP).
Key Words: eccentric loading exercises, platelet-rich plasma, randomized control trials.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Campus
Winona
First Advisor/Mentor
Brian Zeller
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
An Examination of Achilles Tendinopathy Treatment in Physically Active Patients
An Examination of Achilles Tendinopathy Treatment in Physically Active Patients.
Clinical Question: What is the effect of eccentric loading exercises versus platelet-rich plasma on pain in physically active adults with a history of Achilles tendinopathy?
Context: Limited research and studies are found for Achilles tendinopathy treatment. This study aims to discuss the best treatment option to reduce pain for these conditions. This study compares eccentric exercise training to platelet-rich plasma. Achilles tendinopathy can be treated by rest, NSAIDs, and avoiding activities that aggravate the condition, however, this study relates to physically active individuals such as athletes. Because of this, rest and avoiding activity may not be an option for them, so implementing other treatments such as eccentric exercise training and platelet-rich plasma may be the best choices. The purpose of this study is to determine the best treatment to reduce pain in physically active individuals with Achilles tendinopathy by comparing eccentric exercise training to platelet-rich plasma.
Data Sources: The author searched the following databases: PubMed and Physiotherapy Evidence Database (PEDro). The following keywords were used individually and in combination: eccentric exercises, platelet-rich plasma (PRP), physically active, and pain.
Study Selection: Studies were included according to the following criteria: (1) randomized control trial, (2) chronic Achilles pain for 3-6months, (3) physically active adult aged 18 years or older, (4) the intervention group received platelet-rich plasma (PRP) injection or eccentric training compared the control group that received saline or no training, and (5) the effect of pain from each intervention was reported as the main outcome.
Data Extraction: Data included the number and sex of participants, type of condition being treated, length of pain for the condition, treatment used, control group, outcome measures, and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine’s Levels of Evidence Scale. PEDro scores for all studies were recorded at a 10, except for the randomized control trial discussing the exercise therapy program for Achilles tendinopathy which recorded a score of 7.4 The OCEBM Levels of Evidence for all studies were recorded as level 2 evidence.
Main Results: Seven articles fit the criteria and were reviewed for a total of 302 participants. There was no statistically significant difference between the scores when comparing platelet-rich plasma injection with an eccentric loading program (p = 0.171).1 When platelet-rich plasma was compared to a placebo group, there was no significant difference between the groups (VISA-A score at 6, 12, and 24 weeks had a difference of 2.5, -1.6, and -0.9, respectively).2 When platelet-rich plasma was combined with exercise, significant improvements were noted (p < 0.001).3 When eccentric exercise training was compared to no training, reduction in pain and improved function of daily living and sporting activities were demonstrated in the eccentric exercise training group (p < 0.001).4 There was no statistically significant difference between the PRP and saline group shown between the two groups at 6 months (mean difference, -1.3 [95% CI, -17.8 to 15.2, P = 0.868]).5
Conclusions: Eccentric loading exercises are the best treatment for physically active adults who have chronic Achilles tendinopathy regarding pain reduction compared to platelet-rich plasma (PRP).
Key Words: eccentric loading exercises, platelet-rich plasma, randomized control trials.
