PICO
Patient/Population
Chronic (>= 6 month) recalcitrant insertional Achilles tendinopathy (n=50)
Intervention
- Repetitive radial low-energy shock wave therapy
Comparison
- Eccentric loading
Outcomes
- Pain
- Function
- Activity
Translatability: (3/3) Easy
Comments: Eccentric loading as applied in the present study showed inferior results to low-energy shock wave therapy at four months of follow-up.
Limitations: “Given the small size of the trial, the fact that it was not blinded, and the potential biases and confounders, this study falls under the ‘‘hypothesis- generating’’ category.”
Appraisals:
PEDro Scale – (8/10) Blind subjects: No; Blind therapists: No. (by PEDro – confirmed)
Evidence – Level I (by the authors)
BTB
Intervention
- RSWT
Dose
- 2000 pulses; pressure 2.5 bars (energy flux density of 0.12 mJ/mm2); 8Hz.
Periodicity
- 1 weekly session for 3 weeks
Local/Technic:
15-mm-diameter header; standard, commercially ultrasound gel; at the area of maximal tenderness in a circumferential pattern, starting at the point of maximum pain.
Citation: Rompe, J. D., Furia, J., & Maffulli, N. (2008). Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy. A randomized, controlled trial. The Journal of bone and joint surgery. American volume,90(1), 52–61. https://doi.org/10.2106/JBJS.F.01494