School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
SportsMed Subiaco, St John of God Health Care, Subiaco, Western Australia, Australia.
Br J Sports Med. 2019 Sep;53(17):1070-1077. doi: 10.1136/bjsports-2018-099934. Epub 2019 Jan 13.
To assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy.
A systematic review and meta-analysis were conducted as per the PRISMA guidelines.
PUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018.
Randomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles.
Seven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of -5.65 (-10.51 to -0.79, three studies). However, this difference is unlikely to be clinically significant.
Current evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different.
PROSPERO registration number: CRD4201804493 PROTOCOL REFERENCE: This protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? 2018; 7: 58.
评估重度离心小腿训练（HECT）在改善中段跟腱病疼痛和功能方面与自然史、传统物理治疗、假干预或其他运动干预的效果。
按照 PRISMA 指南进行系统评价和荟萃分析。
从建库开始至 2018 年 9 月 24 日，在 PUBMED、CINAHL（Ovid）和 CINAHL（EBSCO）中进行检索。
比较 HECT 与自然史、假运动、传统物理治疗和其他运动干预的随机对照试验均纳入。主要评估疼痛和功能的结局是维多利亚运动评估-跟腱。
7 项研究符合纳入标准。本综述表明，HECT 可能优于自然史（一项研究，MD（95%CI）为 20.6（11.7 至 29.5））和传统物理治疗（两项研究，MD（95%CI）为 17.70（3.75 至 31.66））。在一项因预先计划的敏感性分析而高偏倚风险的研究被剔除后，本综述表明，HECT 可能劣于其他运动干预（三项研究，MD（95%CI）为-5.65（-10.51 至-0.79））。然而，这种差异可能没有临床意义。
目前的证据表明，HECT 可能优于自然史和传统物理治疗，而 HECT 可能劣于其他运动干预。然而，由于方法学上的限制、样本量小以及缺乏数据，我们无法对估计效果的结果有信心，因为真实效果可能有很大的不同。
PROSPERO 注册号：CRD4201804493；方案参考：本方案已公开获取：Murphy M、Travers MJ、Gibson W. 重度离心小腿训练在改善中段跟腱病疼痛和功能方面是否优于自然史、假康复、传统物理治疗和其他运动干预？2018；7：58。
