Achilles Tendinopathy Toolkit: Section C - Summary of Evidence and Recommendations for Interventions: Difference between revisions
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== Achilles Tendinopathy (mid-substance): <br>Summary of the Evidence for Physical Therapy Interventions == | == Achilles Tendinopathy (mid-substance): <br>Summary of the Evidence for Physical Therapy Interventions == | ||
==== Purpose, Scope and Disclaimer ==== | ==== Purpose, Scope and Disclaimer ==== | ||
The purpose of this document is to provide physical therapists with a summary of the evidence for interventions commonly used to manage mid‐substance Achilles tendinopathy. This decision‐making tool is evidence‐informed and where there is insufficient evidence, expert‐informed. It is not intended to replace the clinician’s clinical reasoning skills<br>and inter‐professional collaboration. ‘Acute’ refers primarily to the stage with the cardinal signs of heat, redness, pain, swelling and loss of function and a very recent onset of symptoms. | The purpose of this document is to provide physical therapists with a summary of the evidence for interventions commonly used to manage mid‐substance Achilles tendinopathy. This decision‐making tool is evidence‐informed and where there is insufficient evidence, expert‐informed. It is not intended to replace the clinician’s clinical reasoning skills<br>and inter‐professional collaboration. ‘Acute’ refers primarily to the stage with the cardinal signs of heat, redness, pain, swelling and loss of function and a very recent onset of symptoms. | ||
== Manual Therapy<br> == | == Manual Therapy<br> == | ||
Revision as of 19:39, 21 July 2012
Achilles Tendinopathy (mid-substance):
Summary of the Evidence for Physical Therapy Interventions[edit | edit source]
Purpose, Scope and Disclaimer[edit | edit source]
The purpose of this document is to provide physical therapists with a summary of the evidence for interventions commonly used to manage mid‐substance Achilles tendinopathy. This decision‐making tool is evidence‐informed and where there is insufficient evidence, expert‐informed. It is not intended to replace the clinician’s clinical reasoning skills
and inter‐professional collaboration. ‘Acute’ refers primarily to the stage with the cardinal signs of heat, redness, pain, swelling and loss of function and a very recent onset of symptoms.
Manual Therapy
[edit | edit source]
'Clinical research evidence'Stage of pathology
|
Joint mobs | ||
| Stage of pathology | Acute | Chronic |
| Clinical research evidence | ||
| Published expert opinion | ||
| Take home message | ||
| Clinical implication* | ||
|
Soft-tissue techniques | ||
| Acute | Chronic | |
| Clinical research evidence | ||
| Published expert opinion | ||
| Take home message | ||
| Clinical implication* | ||
see final page for description of categories
Exercise[edit | edit source]
| Stage of pathology | Acute | Chronic |
|---|---|---|
| Clinical research evidence | No | Yes 14 OS 6 SR 5 RCT |
| Published expert opinion | Yes | Yes |
| Take home message | There is a small amount of expert opinion to support the use of stretches in the acute stage. |
There is a large amount of clinical evidence to support the use of exercise in the chronic stage but the precise parameters to ensure effectiveness are not clear. Eccentric exercise in particular is supported although some protocols use both concentric and eccentric exercise. Males appear to benefit slightly more than females from eccentric exercise. |
| Clinical implication* |
May consider using stretching exercises in acute stage. No prescription parameters are provided. ACSM recommends 10‐30 sec hold, 2‐4 repetitions. |
Strongly consider using eccentric exercise in the chronic stage using the following general parameters of a gradual progression to 3 sets of 15 repetitions, twice per day with the knee extended and with the knee flexed. *See Appendix A for further details on exercise prescription. |
- see final page for description of categories
References[edit | edit source]
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