Effectiveness of the Alfredson's Protocol Compared With a Lower Repetition Volume Protocol for Mid-portion Achilles Tendinopathy: A Randomized Controlled Trial.
The Alfredson’s protocol for Mid-portion Achilles Tendinopathy recommends the completion of 180 eccentric heel drops a day. However, completing this large number of repetitions is time-consuming and potentially uncomfortable. There is a need to investigate varying exercise dosages that minimize the discomfort yet retain the clinical benefits.
28 patients were randomised to either the standard (n=15) or the ‘do-as-tolerated’ (n=13) 6 week intervention protocol. Apart from repetition volume all other aspects of management were standardized between groups. There was a statistically significant within-group improvement in VISA-A score for both groups and VAS pain for the ‘do-as-tolerated group’ at week 6 based on the intention-to-treat analysis.
There was no statistically significant between-group difference for VISA-A and VAS pain scores at week 6, completion of the intervention.
Formal comparison of loading programmes for Tendinopathy is lacking. Performing a 6-week ‘do-as-tolerated’ program of eccentric heel drop exercises, compared to the recommended 180 repetitions per day, did not lead to lesser improvement for individuals with mid-portion Achilles tendinopathy based on the VISA-A and VAS scores. No indication is given on the stage of the Tendinopathy. > From: Stevens & Tan, J Orthop Sports Phys Ther (2013) (Epub ahead of print). All rights reserved to the Journal of Orthopaedic & Sports Physical Therapy.
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