Aphale Sawani, Shinde Sandeep, Kale Harshal Y, Ambali Manoj P
Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth (Deemed to Be University), Karad, IND.
Department of Critical Care Medicine, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to Be University), Karad, IND.
Cureus. 2025 Aug 3;17(8):e89304. doi: 10.7759/cureus.89304. eCollection 2025 Aug.
Chronic Achilles tendinopathy is characterized by persistent pain, swelling, and functional limitations, particularly in overweight middle-aged women. This demographic is predisposed to tendon degeneration due to biomechanical overload and hormonal fluctuations.
This study aimed to compare the effectiveness of an aquatic neuromuscular exercise program vs. a conventional land-based exercise program in overweight middle-aged women with chronic Achilles tendinopathy, using pain intensity (visual analogue scale), ankle dorsiflexion range of motion (weight-bearing lunge test, WBLT), and functional performance (patient-specific functional scale, PSFS).
A randomized controlled study was conducted on 102 overweight women aged 40-50 years (body mass index 25-29.9 kg/m²), clinically diagnosed with chronic Achilles tendinopathy. Participants were randomly assigned to Group A (aquatic neuromuscular program) or Group B (conventional exercise therapy). Both groups underwent supervised exercise sessions four times weekly for four weeks, with progressive intensity. Outcome measures included the visual analog scale for pain, the WBLT for ankle dorsiflexion, and the PSFS. Data were analyzed using paired and unpaired t-tests. Mean differences, standard deviations, p values, and effect sizes were reported.
Group A showed superior improvements across all outcome measures. Pain during activity reduced from 5.96 ± 1.26 to 1.36 ± 0.88 (effect size: 4.23), dorsiflexion improved from 15.24 ± 1.47° to 27.34 ± 1.77° (effect size: 7.44), and PSFS scores improved from 15.21 ± 2.86 to 28.65 ± 2.74 (effect size: 4.80). Group B showed statistically significant but comparatively smaller gains. Statistical significance (p < 0.0001) was observed in all outcomes.
This four-week aquatic neuromuscular exercise program proved superior to conventional exercises in reducing pain, improving ankle dorsiflexion, and enhancing functional performance in overweight middle-aged women with chronic Achilles tendinopathy. These findings support the use of aquatic-based neuromuscular rehabilitation as a clinically beneficial and low-impact intervention for this population.
慢性跟腱病的特征是持续疼痛、肿胀和功能受限，在超重中年女性中尤为常见。由于生物力学负荷过重和激素波动，这一人群易患肌腱退变。
本研究旨在比较水上神经肌肉锻炼计划与传统陆上锻炼计划对患有慢性跟腱病的超重中年女性的有效性，采用疼痛强度（视觉模拟量表）、踝关节背屈活动范围（负重弓步试验，WBLT）和功能表现（患者特定功能量表，PSFS）进行评估。
对102名年龄在40 - 50岁（体重指数25 - 29.9 kg/m²）、临床诊断为慢性跟腱病的超重女性进行了一项随机对照研究。参与者被随机分配到A组（水上神经肌肉计划）或B组（传统运动疗法）。两组均接受每周四次、为期四周的有监督的锻炼课程，强度逐渐增加。结果测量包括疼痛视觉模拟量表、踝关节背屈的WBLT和PSFS。使用配对和非配对t检验分析数据。报告了平均差异、标准差、p值和效应大小。
A组在所有结果测量中均显示出更优的改善。活动时的疼痛从5.96±1.2
