de Vos R J, Weir A, Visser R J A, de Winter ThC, Tol J L
Erasmus Medical Centre, Rotterdam, The Netherlands.
Br J Sports Med. 2007 Jul;41(7):e5. doi: 10.1136/bjsm.2006.032532. Epub 2006 Dec 18.
To assess whether the use of a night splint is of added benefit on functional outcome in treating chronic midportion Achilles tendinopathy.
This was a single-blind, prospective, single centre, randomised controlled trial set in the Sports Medical Department, The Hague Medical Centre, The Netherlands. Inclusion criteria were: age 18-70 years, active participation in sports, and tendon pain localised at 2-7 cm from distal insertion. Exclusion criteria were: insertional disorders, partial or complete ruptures, or systemic illness. 70 tendons were included and randomised into one of two treatment groups: eccentric exercises with a night splint (night splint group, n = 36) or eccentric exercises only (eccentric group, n = 34).
Both groups completed a 12-week heavy-load eccentric training programme. One group received a night splint in addition to eccentric exercises. At baseline and follow-up at 12 weeks, patient satisfaction, Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) score and reported compliance were recorded by a single-blind trained researcher who was blinded to the treatment.
After 12 weeks, patient satisfaction in the eccentric group was 63% compared with 48% in the night splint group. The VISA-A score significantly improved in both groups; in the eccentric group from 50.1 to 68.8 (p = 0.001) and in the night splint group from 49.4 to 67.0 (p<0.001). There was no significant difference between the two groups in VISA-A score (p = 0.815) and patient satisfaction (p = 0.261).
A night splint is not beneficial in addition to eccentric exercises in the treatment of chronic midportion Achilles tendinopathy.
评估使用夜间夹板对治疗慢性跟腱中部肌腱病的功能结局是否具有额外益处。
这是一项单盲、前瞻性、单中心随机对照试验，在荷兰海牙医疗中心运动医学科开展。纳入标准为：年龄18 - 70岁，积极参与体育运动，肌腱疼痛位于距远侧止点2 - 7厘米处。排除标准为：止点疾病、部分或完全断裂或全身性疾病。纳入70条肌腱并随机分为两个治疗组之一：进行带夜间夹板的离心运动（夜间夹板组，n = 36）或仅进行离心运动（离心组，n = 34）。
两组均完成为期12周的重负荷离心训练计划。一组除离心运动外还接受夜间夹板治疗。在基线和12周随访时，由一位对治疗不知情的单盲训练研究人员记录患者满意度、维多利亚运动评估 - 跟腱问卷（VISA - A）评分及报告的依从性。
12周后，离心组患者满意度为63%，而夜间夹板组为48%。两组的VISA - A评分均显著改善；离心组从50.1提高到68.8（p = 0.001），夜间夹板组从49.4提高到67.0（p<0.001）。两组在VISA - A评分（p = 0.815）和患者满意度（p = 0.261）方面无显著差异。
在治疗慢性跟腱中部肌腱病时，除离心运动外，夜间夹板并无益处。
