Vibration increases multifidus cross-sectional area versus cryotherapy added to chronic non-insertional Achilles tendinopathy eccentric exercise.

OBJECTIVE: To assess multifidus muscle thickness, cross-sectional area (CSA) and disability in patients with chronic non-insertional Achilles tendinopathy (AT) who developed an eccentric exercise (EE) vibration program compared to an EE program with cryotherapy. DESIGN: Single-blinded randomized clinical trial. SETTING: Outpatient clinic. PARTICIPANTS: A total sample of 61 patients diagnosed with chronic non-insertional AT was recruited and randomly divided into two groups. A group (n = 30) developed the EE program plus vibration and B group (n = 31) received the EE program plus cryotherapy for 12 weeks. Multifidus thickness and CSA were measured at rest and during maximal isometric contraction by ultrasound imaging. The Victorian Institute for Sport Assessment (VISA-A) was used to asses functionality. RESULTS: Multifidus CSA was statistically significant increased (P < 0.05) for the EE vibration program group with respect to EE plus cryotherapy during maximal isometric contraction and at rest at 12-weeks after intervention in individuals with chronic non-insertional AT. Despite both interventions showed differences for the multifidus thickness and AT disability variables over time, there were not between-groups differences. CONCLUSIONS: Authors encourage the use of vibration with respect to cryotherapy added to EE programs in order to enhance multifidus CSA in addition to lower limb functionality in individuals who suffer from chronic non-insertional AT.

Intrinsic foot muscles morphological modifications in patients with Achilles tendinopathy: A novel case-control research study.

OBJECTIVE: To compare the thickness and cross-sectional area (CSA) of the Abductor Hallucis Brevis (AHB), Flexor Digitorum Brevis (FDB) and Flexor Hallucis Brevis (FHB) in subjects with and without chronic mid-portion Achilles tendinopathy (AT). DESIGN: A case-control research study. SETTING: A private clinic. PARTICIPANTS: A total sample of 143 subjects was recruited for the study and divided in two groups, such as chronic mid-portion AT group (n = 71) and healthy group (n = 72). MAIN OUTCOME MEASURES: Ultrasound B-Mode imaging was used to measure the thickness and CSA of the AHB, FDB and FHB in subjects with and without chronic mid-portion AT at rest. RESULTS: USI measurements of the AHB (p < .001) and FDB (p < .001) thicknesses, as well as FDB (p = .005) and FHB CSA (p = .048), were increased for the tendinopathy group with respect to healthy group. However, FHB muscle thickness (p < .001) increases were showed for the control group with respect the tendinopathy group. CONCLUSIONS: USI measurements of ABH and FDB thicknesses, as well as FDB and FHB CSA, were increased in patients who suffered from AT with respect to healthy group.

Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study.

PURPOSE: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). METHODS: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. RESULTS: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. CONCLUSION: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

Ultrasound evaluation of extrinsic foot muscles in patients with chronic non-insertional Achilles tendinopathy: A case-control study.

AIM: The purpose of the present study was to compare and quantify with ultrasound imaging (USI) the extensor digitorum longus (EDL), tibialis anterior (TA) and peroneus muscles (PER) muscle thickness and cross-sectional area (CSA) between chronic non-insertional Achilles tendinopathy (AT) and healthy subjects. METHODS: a sample of 143 individuals was recruited and divided in two groups: chronic non-insertional AT group (n = 71) and a healthy group (n = 72). The thickness and CSA were assessment by USI for EDL, TA and PER muscles in both groups. RESULTS: The thickness evaluation for the TA muscle increased showing statistically significant differences (P = 0.018) as well as for the thickness of the PER muscles significant differences (P = 0.001) were observed in favor the tendinopathy group. The CSA measurements showed statistically significant differences for a decrease in EDL (P = 0.000), TA (P = 0.001) and PER muscles (P = 0.011) for the tendinopathy group with respect to the control group. CONCLUSIONS: The CSA of the EDL, TA and PER muscles is reduced in participants with chronic non-insertional AT. The thickness for TA muscle is increased as well as a decrease of PER muscles thickness is presented for the AT group with respect to the control group.

Comparison of the sonographic features of the Achilles Tendon complex in patients with and without achilles tendinopathy: A case-control study.

AIM: The aim of the present study was to evaluate and quantify with ultrasound imaging (USI) the Achilles tendon thickness, cross-sectional area (CSA), Kager's fat pad length and gastrocnemius-soleus pennation angle (PA) between chronic mid-portion Achilles tendinopathy (AT) and healthy subjects. METHODS: A total sample of 143 individuals (age: 41.3 ±â€¯12.0 y; height: 1.74 ±â€¯0.0 m; weight: 75.0 ±â€¯11.4 kg; body mass index, BMI: 24.4 ±â€¯2.6 kg/m2) was recruited and divided in two groups: chronic mid-portion AT group (n = 71) and a healthy group (n = 72). RESULTS: The thickness and CSA at 4 cm and 6 cm from the calcaneus was increased showing statistically significant differences (P < .01) in favor the tendinopathy group. For the gastrocnemius-soleus PA and Kager's fat pad length, significant differences (P < .01) were observed for a decrease in favor of the tendinopathy group. CONCLUSIONS: This study reported an increase of Achilles tendon thickness and CSA at 4 cm and 6 cm from the calcaneus as well as a decrease in gastrocnemius-soleus PA and Kager's fat pad length in patients with chronic mid-portion AT.

Effectiveness of Eccentric Exercise and a Vibration or Cryotherapy Program in Enhancing Rectus Abdominis Muscle Thickness and Inter-Rectus Distance in Patients with Chronic Mid-Portion Achilles Tendinopathy: A Randomized Clinical Trial.

Purpose: Abdominal muscles are key in maintaining body stability and balance and an improvement in the functioning of these muscles could influence the rehabilitation process in lower limb pathologies such as Achilles Tendinopathy (AT). The aim was to explore whether calf eccentric exercise (EE) with vibration training was more effective at causing adaptation to the rectus anterior (RA) thickness and inter-rectus distance (IRD) than calf EE with cryotherapy. Methods: The investigation was a single-blinded, randomized, controlled clinical trial (NCT03515148). Sixty-one individuals diagnosed with mid-portion AT were recruited and divided in two groups: group A (n = 30) followed an EE with vibration program and group B (n = 31) an EE program with cryotherapy, for 12-weeks. RA muscle thickness and IRD were measured in maximal isometric contraction and at rest as an indication of superficial abdominal muscle activation. Results: IRD measures showed a significant (P < 0.05) decrease at baseline, 4 and at 12-weeks in both groups, but no significant differences were observed between the intervention groups. RA thickness was significantly increased (P < 0.05) in measures at baseline, 4 and 12-weeks showed a significant increase in maximal isometric contraction and at rest in favor of the EE vibration program group. Conclusions: The present study showed a RA thickness increase in both groups in favor of the EE vibration program with respect to cryotherapy added to EE in short and mid term in maximal isometric contraction and at rest in subjects with chronic mid-portion AT. IRD was decreased in both groups without between-groups differences.