School of Allied Health, University of Leicester, Leicester, UK.
Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):2765-2773. doi: 10.1007/s00167-018-5050-z. Epub 2018 Jul 4.
The purpose of this study was to explore the immediate effects of heavy isometric plantar flexor exercise on sensory output (pain during a functional task and mechanical pain sensitivity) and motor output (plantar flexor torque) in individuals with Achilles tendinopathy.
Sixteen subjects with Achilles tendinopathy participated in the study, mean (SD) age 48.6 (8.9) years and Victorian institute assessment-Achilles (VISA-A) score 61.3 (23.0). Sensory testing assessing pain during a functional task, mechanical pain sensitivity and motor output, and plantar flexor peak torque was completed prior to the intervention. All subjects completed a 45-s heavy isometric plantar flexor contraction and were then re-tested using the same sensory and motor tests. Motor output was assessed using isokinetic dynamometry at speeds previously identified as of interest in subjects with Achilles tendinopathy.
Only 9 of the 16 subjects experienced pain during a functional task, self-reported pain was 4.2 (1.9) numerical rating scale (NRS) pre-intervention and 4.9 (3.2) NRS postintervention (n.s.). Mechanical pressure sensitivity was 446.5 (± 248.5) g/mm pre-intervention and 411.8 (± 211.8) g/mm post-intervention (n.s.). Mean concentric plantar flexor torque at 90 and 225°/s was 47.1 (14.5) and 33.6 (11.6) Nm, respectively, pre-intervention and 53.0 (18.5) and 33.4 (6.6) Nm post-intervention (p = 0.039 and n.s.). Eccentric torque at 90°/s was 98.5 (34.2) Nm preintervention versus 106.0 (41.4) Nm post-intervention (n.s.).
In this exploratory study, patients with Achilles tendinopathy had a varied sensory and motor output response to heavy isometric contractions. Using the recommended approach of heavy 45-s isometric contractions did not offer a meaningful acute benefit for sensory or motor output for subjects with Achilles tendinopathy. Based on this study, heavy 45-s isometric contractions cannot be recommended for immediate pain relief or improved motor output for patients with Achilles tendinopathy.
IV, prospective cohort study.
本研究旨在探讨急性大强度等长跖屈肌收缩对跟腱病患者感觉输出（功能性任务时的疼痛和机械性疼痛敏感性）和运动输出（跖屈肌力矩）的即刻影响。
16 名跟腱病患者参与了本研究，平均（标准差）年龄 48.6（8.9）岁，维多利亚评估-跟腱（VISA-A）评分 61.3（23.0）。在干预前完成感觉测试，评估功能性任务时的疼痛、机械性疼痛敏感性和运动输出，以及跖屈肌峰值力矩。所有受试者均完成 45 秒的大强度等长跖屈肌收缩，然后使用相同的感觉和运动测试进行重新测试。运动输出使用等速测力计评估，速度以前被确定为跟腱病患者的感兴趣速度。
只有 9 名受试者在功能性任务中感到疼痛，自我报告的疼痛在干预前为 4.2（1.9）数字评分量表（NRS），干预后为 4.9（3.2）NRS（无统计学意义）。机械压力敏感性在干预前为 446.5（±248.5）g/mm，干预后为 411.8（±211.8）g/mm（无统计学意义）。90 和 225°/s 时的平均向心跖屈肌力矩分别为 47.1（14.5）和 33.6（11.6）Nm，干预前为 53.0（18.5）和 33.4（6.6）Nm（p=0.039，无统计学意义）。90°/s 时的离心力矩在干预前为 98.5（34.2）Nm，干预后为 106.0（41.4）Nm（无统计学意义）。
在这项探索性研究中，跟腱病患者对大强度等长收缩的感觉和运动输出有不同的反应。对于跟腱病患者，使用推荐的 45 秒大强度等长收缩方法并不能为感觉或运动输出提供有意义的急性益处。基于本研究，45 秒大强度等长收缩不能用于立即缓解疼痛或改善跟腱病患者的运动输出。
IV，前瞻性队列研究。
