Abstract
Achilles tendinopathy, both insertional and noninsertional, is a common cause of posterior
ankle pain. Although the condition of most patients improves with simple conservative
measures, a proportion will go on develop chronic symptoms. This study examines the
outcomes of patients following extracorporeal shock wave therapy plus a home exercise
program. This prospective case series study involves a total of 39 patients, with
a mean follow-up duration of 163 (range 65 to 385) days. This has demonstrated significant
benefits in pain, stiffness, and a range of measures of local and global function.
Median (interquartile range [IQR]) values for average self-reported pain improved
from 6.5 of 10 (IQR 5.0 to 7.8) at baseline to 3.5 of 10 (IQR 2.0 to 5.1) at 3 months
and to 2.0 of 10 (IQR 0.6 to 4.8) at 6 months for patients with insertional Achilles
tendinopathy. This compares to improvements from 7.0 of 10 (IQR 7.0 to 8.0) at baseline
to 6.0 of 10 (IQR 5.6 to 6.8) at 3 months and to 6.0 of 10 (IQR 3.0 to 7.0) at 6 months
for patients with noninsertional Achilles tendinopathy. Statistically significant
improvements were seen in insertional tendinopathy across a range of outcome measures;
however, these were less apparent for patients with noninsertional tendinopathy. Despite
these figures, no significant differences were seen in the outcomes for patients with
insertional and noninsertional tendinopathy. Despite the improvements seen in the
aspects of pain and function, physical activity levels had not increased following
the treatment.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: March 23, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
