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    Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: A systematic review and meta-analysis

    Access Status
    Fulltext not available
    Authors
    Murphy, M.
    Travers, Merv
    Chivers, P.
    Debenham, J.
    Docking, S.
    Rio, E.
    Gibson, W.
    Date
    2019
    Type
    Journal Article
    
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    Citation
    Murphy, M. and Travers, M. and Chivers, P. and Debenham, J. and Docking, S. and Rio, E. and Gibson, W. 2019. Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: A systematic review and meta-analysis. British Journal of Sports Medicine.
    Source Title
    British Journal of Sports Medicine
    DOI
    10.1136/bjsports-2018-099934
    ISSN
    0306-3674
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/73981
    Collection
    • Curtin Research Publications
    Abstract

    Published by BMJ. Objective: To assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy. Design: A systematic review and meta-analysis were conducted as per the PRISMA guidelines. Data sources: PUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018. Eligibility criteria: Randomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles. Results: Seven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of -5.65 (-10.51 to -0.79, three studies). However, this difference is unlikely to be clinically significant. Conclusion: Current evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different. Systematic review registry: PROSPERO registration number: CRD4201804493 Protocol reference: This protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? Systematic Reviews 2018; 7: 58

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