重度离心性小腿训练在缓解中段跟腱腱病的疼痛和功能方面优于静观、假康复、传统物理治疗和其他运动干预吗？
Is heavy eccentric calf training superior to wait-and-see, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy?
机构信息
School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, Western Australia, 6959, Australia.
SportsMed Subiaco, St John of God Health Care, Subiaco, Australia.
出版信息
Syst Rev. 2018 Apr 13;7(1):58. doi: 10.1186/s13643-018-0725-6.
BACKGROUND
Mid-portion Achilles tendinopathy (AT) is prevalent amongst athletic and non-athletic populations with pain, stiffness and impaired function typically reported. While different management options exist, loading protocols remain the best available intervention and have been shown to be effective in the management of AT. Trials investigating loading in AT have used a variety of different protocols, and recent narrative reviews suggest that no protocol is superior to another when comparing outcomes in pain and function. However, there has been no systematic review or meta-analysis completed to determine this. Furthermore, the narrative review did not consider wait-and-see or sham interventions, thus a systematic review and met-analysis which includes wait-and-see or sham interventions is warranted.
METHODS
A systematic review and meta-analyses will be conducted as per the PRISMA guidelines. The databases PUBMED, CINAHL (Ovid) and CINAHL (EBSCO) will be searched for articles published from inception to 31 December 2017. Our search focuses on studies examining the improvement of pain and function when completing a loading program for mid-portion AT. Only randomised/ quasi-randomised trials will be included while case reports and case series will be excluded. The primary outcome assessing pain and function will be the Victorian Institute Sports Assessment - Achilles (VISA-A). Two reviewers will screen articles, extract data and assess the risk of bias independently with a third reviewer resolving any disagreements between the two reviewers. A meta-analysis will then be performed on the data (if appropriate) to determine if the traditional heavy load calf training protocol described by Alfredson is superior to wait-and-see, sham intervention, traditional physiotherapy, and other forms of exercise rehabilitation.
DISCUSSION
This systematic review and meta-analysis will allow us to investigate if there are difference in pain and function when comparing wait-and-see, sham interventions, traditional physiotherapy and different exercise interventions to the traditional heavy eccentric calf training protocol for mid-portion Achilles tendon pain.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number CRD42018084493 .
背景
中段跟腱病（AT）在运动员和非运动员人群中都很常见，通常会出现疼痛、僵硬和功能障碍。虽然有不同的治疗选择，但负荷方案仍然是最好的干预措施，并且已经证明在 AT 的管理中是有效的。研究 AT 负荷的试验使用了各种不同的方案，最近的叙述性综述表明，在比较疼痛和功能结果时，没有一种方案比另一种方案更优越。然而，目前还没有完成系统评价或荟萃分析来确定这一点。此外，叙述性综述没有考虑等待观察或假干预，因此需要进行一项系统评价和荟萃分析，其中包括等待观察或假干预。
方法
将根据 PRISMA 指南进行系统评价和荟萃分析。将在 PUBMED、CINAHL（Ovid）和 CINAHL（EBSCO）数据库中搜索从开始到 2017 年 12 月 31 日发表的文章。我们的搜索重点是研究完成中段 AT 负荷方案时疼痛和功能改善的文章。只有随机/准随机试验将被包括，而病例报告和病例系列将被排除。评估疼痛和功能的主要结果将是维多利亚运动评估-跟腱（VISA-A）。两名评审员将独立筛选文章、提取数据和评估偏倚风险，由第三名评审员解决两名评审员之间的任何分歧。然后将对数据进行荟萃分析（如果合适），以确定 Alfredson 描述的传统重负荷小腿训练方案是否优于等待观察、假干预、传统物理治疗和其他形式的运动康复。
讨论
这项系统评价和荟萃分析将使我们能够研究在比较等待观察、假干预、传统物理治疗和不同运动干预与传统重偏心小腿训练方案治疗中段跟腱疼痛时，疼痛和功能是否存在差异。
系统评价注册
PROSPERO 注册号 CRD42018084493。
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