Vol 35 | Issue 3 | September-December 2020 | page: 21-27 | Vikram Sharma, Vivek Chandak
Authors: Vikram Sharma , Vivek Chandak 
 Professor in Orthopaedics, KD medical college and hospitals, Mathura, UP, India.
 Senior Resident in Orthopaedics, KD medical college and hospitals, Mathura, UP, India.
Address of Correspondence
Dr. Vivek Chandak,
Senior Resident in Orthopaedics, KD medical college and hospitals, Mathura.
Background: To compare eccentric training, AirHeel Brace and the combination of eccentric training with the AirHeel Brace for the management of tendinopathy of the main body of the Achilles tendon.
Methods: 108 patients were randomly assigned to 1 of 3 treatment groups: (A) Eccentric training, (B) AirHeel brace, and (C) Combination of eccentric training and AirHeel brace. Patients were evaluated at 6, 12, and 24 weeks after the beginning of the treatment protocol with visual analog scale (VAS) for pain and Revised Foot functional Index (FFI-R) for functional improvement.
Results: The VAS score for pain, FFI-R improved significantly in all 3 groups at all 3 follow-up examinations. Group C had significantly better results than the other two groups.
Conclusion: The AirHeel brace is as effective as eccentric training in the treatment of chronic Achilles tendinopathy. There is synergistic effect when both treatment strategies are combined.
Keywords: Achilles tendon, Achilles tendinopathy, AirHeel brace, Eccentric training, Tibia.
1. Astrom, M; Rausing, A: Chronic Achilles tendinopathy: a survey of surgical and histopathological findings. Clin Ortho Related Res. 316:151 –164, 1995.
2. Clement, DB; Taunton, JE; Smart, GW: Achilles tendonitis and peritendonitis: etiology and treatment. Am J Sports Med. 12:179 – 184, 1984.
3. Maffulli N,Longo UG. Conservative management for tendinopathy: Is there enough scientific evidence ? Rheumatology (Oxford).2008:47:390-391
4. De Jonge, S; de Vos, RJ; van Schie, HT; et al.: One-year follow- up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy .brjsportsmed. 44:673 –677, 2010.
5. Knobloch, K; Schreibmueller, L; Longo, UG; Vogt, PM: Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the airheel Brace. A randomized controlledtrial.A:effectsonpainandmicrocirculation.disabilrehabil. 30:1685 –91, 2008.
6. Petersen,W;Welp,R;Rosenbaum,D:chronicachillestendinopathy: a prospective randomized study comparing the therapeutic effect of eccentric training, the airheel brace, and a combination of both. The Am J Sports Med, 2007 Oct;35(10):1659-67
7. Chester, R; Costa, ML; Shepstone, L; et al.: Eccentric calf muscle training compared with therapeutic ultrasound for chronic Achilles tendonpain–apilotstudy.manther.13:484–91,2008.
8. Rompe, JD; Furia, J; Maffulli, N: Eccentric loading compared with shockwave treatmentfor chronic insertional Achilles tendinopathy. A randomized controlled trial. J Bone Joint Surg Am. 90:52 – 61, 2008.
9. Yelland, MJ; Sweeting, KR; Lyftogt, JA; et al.: Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial. Br J Sports Med. Jul 6. [Epub ahead of print],2010
10. Mc Lauchlan GJ, Handoll HH. Interventions for treating acute and chronicachilles Tendinitis. Cochrane Database Syst Rev. 2001;2: CD000232.
11. Stanish WD, Curwin S, Mandel S. Tendinitis: Its Etiology and Treatment. Oxford: Oxford University Press, 2000.
12. Stanish WD, Rubinovich RM, Curwin S. Eccentric exercise in chronic tendinitis. Clin Orthop 1986: 65–68.
13. Alfredson H, Cook J. A treatment algorithm for managing Achilles tendinopathy: new treatment options. Br J Sports Med.2007;41:211-216.
14. Alfredson H, Pietila T, Jonsson P, Lorentzon R. Heavy-load eccentric calf Muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med.1998;26:360-366.
15. Fahlstrom M, Jonsson P, Lorentzon R, Alfredson H. Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surg Sports Traumatol Arthrosc.2003;11:327-333.
16. Ohberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up. Br J Sports Med.2004;38:8-11.
17. Maffulli N, Walley G, Sayana M, Longo UG, Denaro V. Eccentric calf muscle training in athletic patients with Achilles tendinopathy. Disabil Rehabil. 2008 May 10. [Epub ahead ofprint]
18. Rompe JD, Nafe B, Furia JP, Maffulli N. Eccentric loading, shock- wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis: a randomized controlled trial. Am J Sports Med.2007;35:374-383.
19. Sayana MK, Maffulli N. Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy. J Sci Med Sport.2007;10:52-58.
20. Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Sports Med.1999;27:393-408.
21. Paavola M, Kannus P, Järvinen TAH, Khan K, Jozsa L, Jarvinen M. Achilles tendinopathy. J Bone Joint Surg Am.2002;84:2062-2076.
22. Leadbetter JD. The effect of therapeutic modalities on tendinopathy. In: Mafulli N, Renström P, Leadbetter WB, eds. Tendon Injuries. New York, NY: Springer;2005:233-241
23. Budiman –Mac E,Conrad K,Stuck R,Matters M.Theorotical model and Rasch analysis to develop a revised a Foot Function Index.Foot Ankle Int 2006;27:519-27
24. Walmsley S,Williams A Ravey M,Graham A.The rheumatoid foot:a systemic literature review of patient reported outcome measures. Jfoot Ankle Res2100:3:12.
25. Rompe, JD; Furia, J; Maffulli, N: Eccentric loading versus eccentric
loadingplusshock-wavetreatmentformidportionachillestendinopathy: a randomized controlled trial. Am J Sports Med. 37:463 – 70, 2009.
26. Mafi N, Lorentzon R, Alfredson H (2001) Superior short-term results with eccentric calf-muscle training compared to concentric training in a randomized prospective study on patients With chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 9:42– 47
27. Alfredson H, Forsgren S, Thorsen K, Fahlstrom M, Johansson H, Lorentzon R. Glutamate NMDAR1 receptors localised to nerves in human Achilles tendons. Implications for treatment? Knee Surg Sports Traumatol Arthrosc 2001;9:123 – 126.
|How to Cite this Article: Sharma V, Chandak V | Achilles Tendinopathy: Functional Results In Patients Treated With Eccentric Exercises, Air Heel Brace And A Combination Of Both | Journal of Bone and Joint Diseases | September-December 2020; 35(3): 21-27.