Effectiveness of isolated eccentric strengthening exercise compared to combination muscle contraction exercise in reducing dysfunction in patients with achilles tendinopathy: A critically appraised topic

Clinical Scenario: Achilles tendinopathy (AT) is a prevalent overuse injury affecting the Achilles tendon and rehabilitation frequently incorporates eccentric contraction exercises. This critically appraised topic assesses the comparative effectiveness of isolated eccentric exercises and a combination of contraction types in reducing dysfunction, utilizing the Victorian Institute of Sport Assessment-Achilles (VISA-A) scale as a measure.

Clinical Question: For AT patients, are isolated eccentric strengthening exercises as effective as combination with concentric or isometric muscle contraction to decrease dysfunction?

Summary of Key Findings: A literature search was conducted on the effectiveness of an eccentric-only exercise protocol and an eccentric with concentric or isometric exercise protocol to improve the VISA-A Scale score of AT patients. All studies demonstrated that there was no significant difference in VISA-A Scale score improvement between the eccentric exercise only group and the eccentric and concentric exercise group or the eccentric and isometric exercise group.

Clinical Bottom Line: The evidence suggests that eccentric exercise alone can reduce dysfunction in patients with AT.

Strength of Recommendation: There is a grade B recommendation to support the effectiveness of isolated eccentric exercise for improving dysfunction in AT patients.