Učinkovitost ekscentrične vadbe pri zdravljenju tendinopatije Ahilove tetive: pregled literature : diplomsko delo

Bogataj, Izabela (author), Hiti, Nina (mentor), Brezovar, Tjaž (comentor), Kacin, Alan (reviewer)

Uvod: Tendinopatija je najpogostejša preobremenitvena poškodba Ahilove tetive, ki se izraža z močno bolečino, oteklino in okorelostjo. Nastane zaradi neuspešnega celjenja tetive, česar posledica je zmanjšana toleranca na obremenitve in večja možnost za nastanek ruptur. Zdravljenje se prične s konzervativnimi postopki, če se stanje ahilarne tendinopatije ne izboljša, se izvede operativno zdravljenje. Alfredsonov protokol je specializiran program vadbe za terapijo ahilarne tendinopatije, ki je sestavljen iz preprostih ekscentričnih vaj spuščanja pete. Ta oblika vadbe ne vpliva le na zmanjšanje bolečine, temveč tudi na izboljšanje živčno-mišičnega nadzora in zmanjšanje obremenitve tetive. Namen: Na osnovi pregleda strokovne in znanstvene literature ugotoviti učinkovitost ekscentrične vadbe pri zdravljenju ahilarne tendinopatije. Metode dela: Literaturo smo iskali v podatkovnih zbirkah PubMed, PEDro, ScienceDirect, Web of Science in COBISS+. Uporabljene so bile naslednje ključne besede in njihove kombinacije: achilles tendinopathy, achilles tendinopathy AND eccentric exercise, achilles tendinopathy AND treatment, conservative treatment AND achilles tendinopathy. Rezultati: V pregled literature je bilo vključenih 6 raziskav. Ekscentrična vadba za mečne mišice je bila v vseh raziskavah izvedena po Alfredsonovem protokolu. V vseh izbranih raziskavah so ugotovili pozitiven učinek ekscentrične vadbe pri zdravljenju ahilarne tendinopatije. Vadba je namreč povzročila zmanjšanje bolečine in simptomov, povečala obseg giba dorzalne fleksije in posledično izboljšala funkcioniranje posameznika pri vsakdanjih dejavnostih. Ugotovili so, da ekscentrična vadba ni vplivala na spremembo debeline tetive in neovaskularizacije. Razprava in zaključek: Rezultati kažejo, da je ekscentrična vadba učinkovita intervencija za zdravljenje ahilarne tendinopatije, saj zmanjša bolečino, pospeši regeneracijo Ahilove tetive in izboljša funkcijske sposobnosti posameznikov. Vadba je lahko kombinirana tudi z drugimi intervencijami – terapijo z laserjem, terapijo z udarnimi globinskimi valovi ali z manualno obravnavo mišično prožilnih točk, ki še dodatno izboljšajo njeno učinkovitost.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, Ahilova tetiva, ahilarna tendinopatija, ekscentrična vadba, konzervativno zdravljenje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [I. Bogataj]
• Year: 2022
• Number of pages: 29 str., [5] str. pril.
• PID: 20.500.12556/RUL-136680
• UDC: 615.8
• COBISS.SI-ID: 107973379
• Publication date in RUL: 15.05.2022

Secondary language

• Language: English
• Title: Effects of eccentric exercise on the treatment of Achilles tendinopathy: literature review : diploma work

Abstract

Introduction: Tendinopathy is the most common Achilles tendon overload injury, which causes severe pain, swelling, and stiffness. It occurs due to unsuccessful tendon healing, which leads to reduced load tolerance and a greater chance of rupture. Treatment begins with conservative treatment. If the condition of achilles tendinopathy does not improve, surgical treatment is performed. The Alfredson Protocol is a specialized exercise program for the treatment of achilles tendinopathy, which consists of simple eccentric heel drops exercises. This form of exercise does not only affect pain reduction but also improves neuromuscular control and reduces tendon strain. Purpose: To establish effectiveness of eccentric exercise training for treating achilles tendinopathy based on review of professional and scientific literature. Methods: We searched the literature in the databases PubMed, PEDro, ScienceDirect, Web of Science and COBISS +. The following keywords and their combinations were used: achilles tendinopathy, achilles tendinopathy AND eccentric exercise, achilles tendinopathy AND treatment, conservative treatment AND achilles tendinopathy. Results: Six studies were included in the literature review. Eccentric exercises were performed according to the Alfredson protocol in all studies. In all selected studies, they found a positive effect of eccentric exercise on the treatment of achilles tendinopathy. Namely, it caused a reduction in pain and symptoms, increased the range of motion of dorsiflexion and consequently improved the functioning of the individual in daily activities. They found that eccentric exercise did not affect tendon thickness and its neovascularization. Discussion and conclusion: The results show that eccentric exercise is an effective intervention to treat achilles tendinopathy, as it reduces pain, accelerates Achilles tendon regeneration, and improves the functional abilities of individuals. Exercise can also be combined with other interventions - laser therapy, shock wave therapy or massage of muscle trigger points, which further enhance its effectiveness.

• Keywords: diploma theses, physiotherapy, Achilles tendon, achilles tendinopathy, eccentric exercise, conservative treatment