A 5-year follow-up study of Alfredson%26apos;s heel-drop exercise programme in chronic midportion Achilles tendinopathy

作者：van der Plas A; de Jonge S; de Vos R J; van der Heide H J L; Verhaar J A N; Weir A; Tol J L^*

来源：British Journal of Sports Medicine, 2012, 46(3): 214-218.

DOI：10.1136/bjsports-2011-090035

Background Eccentric exercises have the most evidence in conservative treatment of midportion Achilles tendinopathy. Although short-term studies show significant improvement, little is known of the long-term (%26gt;3 years) results. %26lt;br%26gt;Aim To evaluate the 5-year outcome of patients with chronic midportion Achilles tendinopathy treated with the classical Alfredson%26apos;s heel-drop exercise programme. %26lt;br%26gt;Study design Part of a 5-year follow-up of a previously conducted randomised controlled trial. %26lt;br%26gt;Methods 58 patients (70 tendons) were approached 5 years after the start of the heel-drop exercise programme according to Alfredson. At baseline and at 5-year follow-up, the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire score, pain status, alternative treatments received and ultrasonographic neovascularisation score were recorded. %26lt;br%26gt;Results In 46 patients (58 tendons), the VISA-A score significantly increased from 49.2 at baseline to 83.6 after 5 years (p%26lt;0.001) and from the 1-year to 5-year follow-up from 75.0 to 83.4 (p%26lt;0.01). 39.7% of the patients were completely pain-free at follow-up and 48.3% had received one or more alternative treatments. The sagittal tendon thickness decreased from 8.05 mm (SD 2.1) at baseline to 7.50 mm (SD 1.6) at the 5-year follow-up (p=0.051). %26lt;br%26gt;Conclusion At 5-year follow-up, a significant increase of VISA-A score can be expected. After the 3-month Alfredson%26apos;s heel-drop exercise programme, almost half of the patients had received other therapies. Although improvement of symptoms can be expected at long term, mild pain may remain.

• 出版日期2012-3