Tumilty Steve, Mani Ramikrishnan, Baxter George D
Centre for Health, Activity & Rehabilitation Research, University of Otago, Dunedin, New Zealand.
Lasers Med Sci. 2016 Jan;31(1):127-35. doi: 10.1007/s10103-015-1840-4. Epub 2015 Nov 26.
The common regime of eccentric exercise in use for Achilles tendinopathy is somewhat arduous and compliance issues can arise. This is the first study to investigate the effectiveness of a regime of fewer exercise sessions combined with photobiomodulation for the treatment of Achilles tendinopathy.
A double blind randomized controlled trial and intention-to-treat analysis were performed. Eighty participants, 18-65 years with Achilles tendinopathy and symptoms for longer than 3 months, were included in the trial. Participants randomized into one of four groups; 1 (Placebo + Ex Regime 1) or 2 (Laser + Ex Regime 1) or 3 (Placebo + Ex Regime 2) or 4 (Laser + Ex Regime 2). The primary outcome measure was the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire. Outcomes were collected at baseline, week 4 and week 12.
Sixteen participants were lost to follow-up at 12 weeks, 4 of which due to adverse reactions. As per intention to treat, missing data were imputed, 80 participants were included in the final analysis. For VISA-A at 12 weeks, group 4 achieved significant gains over the other 3 groups: group 1 (18.5 [9.1, 27.9]), group 2 (10.4 [1.5, 19.2]), group 3 (11.3 [3.0, 19.6]). There was a moderate effect size in favour of exercise twice per week (7.2 [-1.8, 16.2], ES .7).
Twice-daily exercise sessions are not necessary as equivalent results can be obtained with two exercise sessions per week. The addition of photobiomodulation as adjunct to exercise can bring added benefit.
用于跟腱病的常见离心运动方案有些艰巨，可能会出现依从性问题。这是第一项研究较少运动次数结合光生物调节疗法治疗跟腱病有效性的研究。
进行了一项双盲随机对照试验和意向性分析。80名年龄在18 - 65岁、患有跟腱病且症状持续超过3个月的参与者被纳入试验。参与者被随机分为四组之一：1组（安慰剂 + 运动方案1）或2组（激光 + 运动方案1）或3组（安慰剂 + 运动方案2）或4组（激光 + 运动方案2）。主要结局指标是维多利亚运动评估 - 跟腱（VISA - A）问卷。在基线、第4周和第12周收集结果。
16名参与者在12周时失访，其中4名是由于不良反应。按照意向性分析，对缺失数据进行了插补，80名参与者被纳入最终分析。对于12周时的VISA - A，第4组比其他3组有显著改善：1组（18.5 [9.1, 27.9]），2组（10.4 [1.5, 19.2]），3组（11.3 [3.0, 19.6]）。每周锻炼两次有中等效应量（7.2 [-1.8, 16.2]，效应量0.7）。
每天进行两次锻炼并非必要，因为每周进行两次锻炼也能获得相同效果。在运动中添加光生物调节疗法可带来额外益处。
