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慢性跟腱病:一项比较离心训练、AirHeel支具及两者联合治疗效果的前瞻性随机研究。

Chronic Achilles tendinopathy: a prospective randomized study comparing the therapeutic effect of eccentric training, the AirHeel brace, and a combination of both.

作者信息

Petersen Wolf, Welp Robert, Rosenbaum Dieter

机构信息

Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

出版信息

Am J Sports Med. 2007 Oct;35(10):1659-67. doi: 10.1177/0363546507303558. Epub 2007 Jun 14.

Abstract

BACKGROUND

Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace.

HYPOTHESIS

AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect.

STUDY DESIGN

Randomized controlled clinical trial; Level of evidence, 1.

METHODS

One hundred patients were randomly assigned to 1 of 3 treatment groups: (1) eccentric training, (2) AirHeel brace, and (3) combination of eccentric training and AirHeel brace. Patients were evaluated at 6, 12, and 54 weeks after the beginning of the treatment protocol with ultrasonography, visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and Short Form-36 (SF-36).

RESULTS

The VAS score for pain, AOFAS score, and SF-36 improved significantly in all 3 groups at all 3 follow-up examinations. At the 3 time points (6 weeks, 12 weeks, and 54 weeks) of follow-up, there was no significant difference between all 3 treatment groups. In all 3 groups, there was no significant difference in tendon thickness after treatment.

CONCLUSIONS

The AirHeel brace is as effective as eccentric training in the treatment of chronic Achilles tendinopathy. There is no synergistic effect when both treatment strategies are combined.

CLINICAL RELEVANCE

The AirHeel brace is an alternative treatment option for chronic Achilles tendinopathy.

摘要

背景

既往研究表明,离心训练对慢性跟腱病有积极作用。一种治疗慢性跟腱病的新策略是使用AirHeel支具。

假设

AirHeel支具治疗可改善慢性跟腱病患者的临床疗效。AirHeel支具与离心训练计划相结合具有协同作用。

研究设计

随机对照临床试验;证据等级,1级。

方法

100例患者被随机分配至3个治疗组中的1组:(1)离心训练组,(2)AirHeel支具组,(3)离心训练与AirHeel支具联合组。在治疗方案开始后的6周、12周和54周,采用超声检查、疼痛视觉模拟量表(VAS)、美国矫形足踝协会(AOFAS)踝关节评分以及简明健康状况调查量表(SF-36)对患者进行评估。

结果

在所有3次随访检查中,所有3组的VAS疼痛评分、AOFAS评分和SF-36均有显著改善。在随访的3个时间点(6周、12周和54周),所有3个治疗组之间均无显著差异。在所有3组中,治疗后肌腱厚度无显著差异。

结论

AirHeel支具在治疗慢性跟腱病方面与离心训练同样有效。两种治疗策略联合使用时没有协同作用。

临床意义

AirHeel支具是慢性跟腱病的一种替代治疗选择。

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