Shahabi S1, Nazari B2, Fathi B3, Hosseinabadi M4
1Iran University of Medical Sciences, Health Policy, Health Management and Economics Research Center, Tehran, Iran, 2Iran University of Medical Sciences, Physiotherapist, Tehran, Iran, 3Tabriz University of Medical Sciences, Health Policy, Tehran, Iran, 4Iran University of Medical Sciences, Prosthetics & Orthotics, Tehran, Iran
Background: Achilles tendinopathy is a pathological state resulting from repetitive loading or stress on the tendon. Different conservative treatments are used such as eccentric exercises and shockwave therapy.
Purpose: This systematic review investigated the effectiveness of eccentric exercises and shockwave therapy in the treatment of insertional and noninsertional Achilles tendinopathies.
Methods: Articles were electronically searched from PubMed, Scopus, Embase, CENTRAL, PEDro (the Physiotherapy Evidence Database), Google Scholar, ProQuest, RehabData, Web of Sciences from 1th January 2000 until 31th April 2018. The ISRCTN registry, WHO clinical trial registration and ClinicalTrials registry (ClinicalTrials.gov) also were searched. Grey literature was searched from F1000Research, Allconferences.com, and OpenGrey. Clinical trials were if they were examining the effectiveness of eccentric exercises and shockwave therapy for insertional or noninsertional Achilles tendinopathies. The quality of the included trials was assessed using the PEDro scale. Finally, nine studies were selected for in-depth review.
Results: Nine clinical trials were included. The included trials showed an improvement in pain after eccentric overload training and shockwave therapy. Recently, high-quality controlled trials have confirmed excellent results of shockwave therapy in chronic Achilles tendinopathy. Our review showed satisfactory evidence for the effectiveness of shock wave therapy in the treatment of chronic Achilles tendinopathies.
Conclusion(s): There is currently more evidence in support of eccentric exercises than the other interventions included in this review. Further research investigation is needed into the utility of shockwave therapy.
Implications: Evidence was strong for eccentric loading exercises and shockwave therapy.
Keywords: Achilles, tendinopathy, shockwave therapy
Funding acknowledgements: non
Purpose: This systematic review investigated the effectiveness of eccentric exercises and shockwave therapy in the treatment of insertional and noninsertional Achilles tendinopathies.
Methods: Articles were electronically searched from PubMed, Scopus, Embase, CENTRAL, PEDro (the Physiotherapy Evidence Database), Google Scholar, ProQuest, RehabData, Web of Sciences from 1th January 2000 until 31th April 2018. The ISRCTN registry, WHO clinical trial registration and ClinicalTrials registry (ClinicalTrials.gov) also were searched. Grey literature was searched from F1000Research, Allconferences.com, and OpenGrey. Clinical trials were if they were examining the effectiveness of eccentric exercises and shockwave therapy for insertional or noninsertional Achilles tendinopathies. The quality of the included trials was assessed using the PEDro scale. Finally, nine studies were selected for in-depth review.
Results: Nine clinical trials were included. The included trials showed an improvement in pain after eccentric overload training and shockwave therapy. Recently, high-quality controlled trials have confirmed excellent results of shockwave therapy in chronic Achilles tendinopathy. Our review showed satisfactory evidence for the effectiveness of shock wave therapy in the treatment of chronic Achilles tendinopathies.
Conclusion(s): There is currently more evidence in support of eccentric exercises than the other interventions included in this review. Further research investigation is needed into the utility of shockwave therapy.
Implications: Evidence was strong for eccentric loading exercises and shockwave therapy.
Keywords: Achilles, tendinopathy, shockwave therapy
Funding acknowledgements: non
Topic: Musculoskeletal: lower limb
Ethics approval required: No
Institution: Iran University of Medical Sciences
Ethics committee: Research Ethics Committee of the Iran University of Medical Sciences
Reason not required: because of systematic review
All authors, affiliations and abstracts have been published as submitted.
