Krämer R, Lorenzen J, Vogt P M, Knobloch K
Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover.
Sportverletz Sportschaden. 2010 Dec;24(4):204-11. doi: 10.1055/s-0029-1245820. Epub 2010 Dec 14.
Throughout the recent decade, eccentric training has become a widely accepted therapy option in the conservative treatment of chronic Achilles tendinopathy. Nevertheless, current recommendations are missing regarding dosage and duration of eccentric training as well as standardized training protocols.
Is eccentric training as a conservative treatment in chronic Achilles tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training?
Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
National library of Medicine (NLM) between the years 1950 and 2010.
Prospective randomised controlled trials (RCT).
8 RCTs included 416 subjects with a median number of 42 subjects and a range of 17 to 116 subjects per trial. Median follow-up duration was 12 weeks with a range from 12 to 54 weeks.
124 papers met the eligibility criteria in the NLM, whereas only eight randomised controlled trials were included in this review after screening titles, abstracts and full texts. All included trials demonstrated an improvement in pain after performing equivalent training protocols of eccentric training in chronic Achilles tendinopathy.
A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance.
In spite of different compliance, effects of eccentric training in conservative treatment of chronic mid-portion-Achilles tendinopathy are promising. Because of the heterogeneous outcome variables (ordinal scale, VAS, FAOS, AOFAS, VISA-A) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Achilles tendinopathy.
在过去十年中，离心训练已成为慢性跟腱病保守治疗中广泛接受的治疗选择。然而，目前关于离心训练的剂量、持续时间以及标准化训练方案的建议尚付阙如。
与其他保守治疗方法相比，离心训练作为慢性跟腱病的保守治疗是否具有有益效果？根据当前科学数据，是否有可能推荐离心训练的训练时间剂量和持续时间？
根据PRISMA指南（系统评价和荟萃分析的首选报告项目），对关于离心训练作为慢性跟腱病保守治疗的当前科学文献进行系统评价。
1950年至2010年期间的美国国立医学图书馆（NLM）。
前瞻性随机对照试验（RCT）。
8项随机对照试验纳入了416名受试者，每项试验的受试者中位数为42名，范围为17至116名。中位随访时间为12周，范围为12至54周。
NLM中有124篇论文符合入选标准，而在筛选标题、摘要和全文后，本综述仅纳入了8项随机对照试验。所有纳入的试验均表明，在慢性跟腱病中进行等效的离心训练方案后，疼痛有所改善。
由于研究设计不同以及受试者依从性记录有限，无法对纳入的试验进行汇总统计评估。
尽管依从性不同，但离心训练在慢性跟腱中部病变保守治疗中的效果很有前景。由于结果变量的异质性（序贯量表、视觉模拟评分法、踝关节功能评分系统、美国足踝外科协会评分、维多利亚州跟腱评估）以及试验的方法学局限性，无法就慢性跟腱病中离心训练的剂量和持续时间发表明确建议。
