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使用或不使用AirHeel护具进行离心运动治疗跟腱主体肌腱病的随机对照试验。A:对疼痛和微循环的影响

Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the AirHeel Brace. A randomized controlled trial. A: effects on pain and microcirculation.

作者信息

Knobloch Karsten, Schreibmueller Louisa, Longo Umile Giuseppe, Vogt Peter M

机构信息

Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Germany.

出版信息

Disabil Rehabil. 2008;30(20-22):1685-91. doi: 10.1080/09638280701786658.

Abstract

PURPOSE

To compare eccentric training and the combination of eccentric training with the AirHeel Brace for the management of tendinopathy of the main body of the Achilles tendon.

METHODS

We recruited 116 subjects with unilateral tendinopathy of the main body of the Achilles tendon, who were randomized in two groups. Group A performed a regimen of daily eccentric training associated with the AirHeel Brace (Donjoy Orthopedics, Vista, CA, USA). Group B performed the same eccentric training without the AirHeel Brace. Tendon microcirculatory mapping was performed using combined Laser-Doppler and spectrophotometry. Pre- and post-operative FAOS score and VAS score were used to evaluate the patients.

RESULTS

The FAOS score and the VAS score showed significant improvements from pre-operative to post-operative values in both groups (A 5.1 +/- 2 vs. 2.9 +/- 2.4, 43% reduction and B: 5.4 +/- 2.1 vs. 3.6 +/- 2.4, 33% reduction, both p = 0.0001). There were no statistically significant differences in FAOS score and VAS score when comparing the two groups after the end of the intervention. In Group A, tendon oxygen saturation in the main body of the Achilles tendon showed significant increase from pre- to post-management values (68 +/- 12 vs.74 +/- 8%, p = 0.003). Post-capillary venous filling pressures showed significant reduction from pre- to post-intervention values.

CONCLUSION

Eccentric training, associated or not with the AirHeel Brace, produces the same effect in patients with tendinopathy of the main body of the Achilles tendon. The combination of eccentric training with the AirHeel Brace can optimize tendon microcirculation, but these micro-circulator advantages do not translate into superior clinical performance when compared with eccentric training alone.

摘要

目的

比较离心训练以及离心训练与AirHeel护具联合使用对跟腱主体肌腱病的治疗效果。

方法

我们招募了116名单侧跟腱主体肌腱病患者,将他们随机分为两组。A组进行每日与AirHeel护具(美国加利福尼亚州维斯塔市Donjoy骨科公司生产)联合的离心训练方案。B组进行相同的离心训练,但不使用AirHeel护具。使用激光多普勒和分光光度法联合进行肌腱微循环图谱分析。术前和术后采用FAOS评分和VAS评分对患者进行评估。

结果

两组患者的FAOS评分和VAS评分从术前到术后均有显著改善(A组:5.1±2对2.9±2.4,降低43%;B组:5.4±2.1对3.6±2.4,降低33%,两者p = 0.0001)。干预结束后比较两组时,FAOS评分和VAS评分无统计学显著差异。在A组中,跟腱主体的肌腱氧饱和度从治疗前到治疗后显著增加(68±12对74±8%,p = 0.003)。毛细血管后静脉充盈压从干预前到干预后显著降低。

结论

离心训练,无论是否与AirHeel护具联合使用,对跟腱主体肌腱病患者产生相同的效果。离心训练与AirHeel护具联合使用可优化肌腱微循环,但与单独的离心训练相比,这些微循环优势并未转化为更优的临床效果。

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