Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without an AirHeel Brace. A randomized controlled trial. B: Effects of compliance

Karsten Knobloch, Louisa Schreibmueller, Umile Giuseppe Longo, Peter M Vogt
Disability and Rehabilitation 2008, 30 (20): 1692-6

PURPOSE: To evaluate microcirculatory variables in and around the Achilles tendon (AT) in patients undergoing a programme of daily eccentric training for the management of tendinopathy of the main body of the AT in non-compliant in contrast to compliant patients.

METHODS: A total of 116 patients with tendinopathy of the AT were enrolled for prospective eccentric training. Non-compliant patients were defined following drop-out due to less than 80% participation in the daily eccentric training regimen.

RESULTS: Overall 12-week-compliance was 79% (92/116). The reasons for non-compliance were moving out of town (21%, 5/24), overwhelming pain (25%, 6/24), limited discipline (29%, 7/24), and surgery (17%, 4/24). Capillary blood flow, tendon and paratendon oxygen saturation as well as postcapillary venous filling pressures were not significantly different between compliant and non-compliant patients. Gender, age, BMI, non steroidal anti inflammatory drugs, corticosteroid medication and smoking habits were not significantly different. Only the use of oral contraceptives (non- vs. compliant: 54% vs. 10%, p = 0.0001) and walking/swimming (46% vs. 70%, p = 0.041) were significantly different. Pain level was reduced (5.6 +/- 1.9 to 2.9 +/- 1.2, p < 0.05) following eccentric training.

CONCLUSIONS: In patients undergoing eccentric training for tendinopathy of the main body of the AT, there is no difference in microcirculatory variables regardless of compliance with the eccentric exercises programme. With the exception of the more frequent use of oral contraceptive medication and less often walking/swimming, no predictive factors could be identified in non-compliant patients.

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