Mafi N, Lorentzon R, Alfredson H
Department of Surgical and Perioperative Science, Umeå University, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2001;9(1):42-7. doi: 10.1007/s001670000148.
In a previous uncontrolled pilot study we demonstrated very good clinical results with eccentric calf muscle training on patients with painful chronic Achilles tendinosis located at the 2-6 cm level in the tendon. In the present prospective multicenter study (Sundsvall and Umeå) patients with painful chronic Achilles tendinosis at the 2-6 cm level in the tendon were randomized to treatment with either an eccentric or a concentric training regimen for the calf muscles. The study included 44 patients, with 22 patients (12 men, 10 women; mean age 48 years) in each treatment group. The amount of pain during activity (jogging or walking) was recorded by the patients on a visual analogue scale, and patient satisfaction was assessed before and after treatment. The patients were instructed to perform their eccentric or concentric training regimen on a daily basis for 12 weeks. In both types of treatment regimen the patients were told to do their exercises despite experiencing pain or discomfort in the tendon during exercise. The results showed that after the eccentric training regimen 82% of the patients (18/22) were satisfied and had resumed their previous activity level (before injury), compared to 36% of the patients (8/22) who were treated with the concentric training regimen. The results after treatment with eccentric training was significantly better (P<0.002) than after concentric training. The good clinical results previously demonstrated in the pilot study with eccentric calf muscle training on patients with chronic Achilles tendinosis, were thus reproduced in this multicenter, showing superior results to treatment with concentric training.
在之前一项非对照的初步研究中，我们证明了对肌腱2 - 6厘米水平处患有疼痛性慢性跟腱炎的患者进行离心性小腿肌肉训练可取得非常好的临床效果。在当前这项前瞻性多中心研究（ Sundsvall和Umeå ）中，肌腱2 - 6厘米水平处患有疼痛性慢性跟腱炎的患者被随机分为接受小腿肌肉离心训练方案或向心训练方案治疗。该研究纳入了44例患者，每个治疗组有22例患者（ 12名男性，10名女性；平均年龄48岁） 。患者通过视觉模拟量表记录活动（慢跑或行走）时的疼痛程度，并在治疗前后评估患者满意度。患者被指示每天进行离心或向心训练方案，为期12周。在两种训练方案中，都告知患者即使在运动过程中肌腱出现疼痛或不适也要进行锻炼。结果显示，接受离心训练方案后，82%的患者（ 18/22 ）感到满意并恢复到了之前的活动水平（受伤前） ，相比之下，接受向心训练方案治疗的患者中有36% （ 8/22 ）达到此效果。离心训练治疗后的结果明显优于向心训练（ P<0.002 ） 。因此，在这项多中心研究中再现了之前初步研究中对慢性跟腱炎患者进行离心性小腿肌肉训练所取得的良好临床效果，且显示出比向心训练治疗效果更优。
