Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Br J Sports Med. 2021 May;55(9):486-492. doi: 10.1136/bjsports-2019-101776. Epub 2020 Sep 28.
To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy.
This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) heel lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance.
There was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the heel lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the heel lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points.
In adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions.
ACTRN12617001225303.
比较鞋内跟垫与小腿肌肉离心运动在减轻中段跟腱病疼痛和改善功能方面的疗效。
这是一项在单一中心（澳大利亚维多利亚州墨尔本拉筹伯大学健康科学诊所，足病学系）进行的平行组随机优效性试验。100 名参与者（52 名女性和 48 名男性，平均年龄 45.9 岁，标准差 9.4 岁）被临床诊断和超声证实患有中段跟腱病，随机分为（1）跟垫组（n=50）或（2）离心运动组（n=50）。主要结局测量指标是 12 周时的维多利亚州运动评估-跟腱（VISA-A）问卷。采用意向治疗和协方差分析比较两组间的差异。
12 周时，80%的参与者（n=40 人/组）进行了随访。跟垫组的 VISA-A 评分平均提高了 26.0 分（95%CI 19.6 至 32.4），而离心运动组提高了 17.4 分（95%CI 9.5 至 25.3）。平均而言，跟垫组在 VISA-A 方面优于离心运动组（调整后的平均差异为 9.6，95%CI 1.8 至 17.4，p=0.016），但接近而非达到我们预先设定的 10 分的最小临床重要差异。
在中段跟腱病的成年人中，跟垫比小腿肌肉离心运动更能在 12 周时减轻疼痛和改善功能。然而，对于这一结果，估计的效果存在不确定性，并且患者可能不会在干预措施之间体验到具有临床意义的差异。
ACTRN12617001225303。
