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The majority of patients with achilles tendinopathy recover fully when treated with exercise alone: a 5-year follow-up.
MedLine Citation:
PMID:  21084657     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Systematic reviews indicate that exercise has the most evidence of effectiveness in treatment of midportion Achilles tendinopathy. However, there is a lack of long-term follow-ups (>4 years).
PURPOSE: To evaluate the 5-year outcome of patients treated with exercise alone and to examine if certain characteristics, such as level of kinesiophobia, age, and sex, were related to the effectiveness of the treatment.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Thirty-four patients (47% women), 51 ± 8.2 years old, were evaluated 5 years after initiation of treatment. The evaluation consisted of a questionnaire regarding recovery of symptoms and other treatments, the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) for symptoms, the Tampa Scale for Kinesiophobia, and tests of lower leg function.
RESULTS: Twenty-seven patients (80%) fully recovered from the initial injury; of these, 22 (65%) had no symptoms, and 5 (15%) had a new occurrence of symptoms. Seven patients (20%) had continued symptoms. Only 2 patients received another treatment (acupuncture and further exercise instruction). When compared with the other groups, the continued-symptoms group had lower VISA-A scores (P = .008 to .021) at the 5-year follow-up and the previous 1-year follow-up but not at any earlier evaluations. There were no significant differences among the groups in regard to sex, age, or physical activity level before injury. There was a significant (P = .005) negative correlation (-0.590) between the level of kinesiophobia and heel-rise work recovery.
CONCLUSION: The majority of patients with Achilles tendinopathy in this study fully recovered in regard to both symptoms and function when treated with exercise alone. Increased fear of movement might have a negative effect on the effectiveness of exercise treatment; therefore, a pain-monitoring model should be used when patients are treated with exercise.
Authors:
Karin Grävare Silbernagel; Annelie Brorsson; Mari Lundberg
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Publication Detail:
Type:  Journal Article     Date:  2010-11-17
Journal Detail:
Title:  The American journal of sports medicine     Volume:  39     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  607-13     Citation Subset:  IM    
Affiliation:
Karin Grävare Silbernagel, 126 Spencer Laboratory, Newark, DE 19716. kgs@udel.edu.
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