Format

Send to

Choose Destination
Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):2765-2773. doi: 10.1007/s00167-018-5050-z. Epub 2018 Jul 4.

Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy.

Author information

1
School of Allied Health, University of Leicester, Leicester, UK. so59@leicester.ac.uk.
2
School of Allied Health, University of Leicester, Leicester, UK.
3
Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
4
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg University, Aalborg, Denmark.
5
Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Clinical Research Center, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
6
Department of Orthopedic Surgery, Clinical Research Center, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
7
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark.
8
Sport Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre University Hospital, Copenhagen, Denmark.

Abstract

PURPOSE:

The purpose of this study was to explore the immediate effects of heavy isometric plantar flexor exercise on sensory output (pain during a functional task and mechanical pain sensitivity) and motor output (plantar flexor torque) in individuals with Achilles tendinopathy.

METHODS:

Sixteen subjects with Achilles tendinopathy participated in the study, mean (SD) age 48.6 (8.9) years and Victorian institute assessment-Achilles (VISA-A) score 61.3 (23.0). Sensory testing assessing pain during a functional task, mechanical pain sensitivity and motor output, and plantar flexor peak torque was completed prior to the intervention. All subjects completed a 45-s heavy isometric plantar flexor contraction and were then re-tested using the same sensory and motor tests. Motor output was assessed using isokinetic dynamometry at speeds previously identified as of interest in subjects with Achilles tendinopathy.

RESULTS:

Only 9 of the 16 subjects experienced pain during a functional task, self-reported pain was 4.2 (1.9) numerical rating scale (NRS) pre-intervention and 4.9 (3.2) NRS postintervention (n.s.). Mechanical pressure sensitivity was 446.5 (± 248.5) g/mm2 pre-intervention and 411.8 (± 211.8) g/mm2 post-intervention (n.s.). Mean concentric plantar flexor torque at 90 and 225°/s was 47.1 (14.5) and 33.6 (11.6) Nm, respectively, pre-intervention and 53.0 (18.5) and 33.4 (6.6) Nm post-intervention (p = 0.039 and n.s.). Eccentric torque at 90°/s was 98.5 (34.2) Nm preintervention versus 106.0 (41.4) Nm post-intervention (n.s.).

CONCLUSION:

In this exploratory study, patients with Achilles tendinopathy had a varied sensory and motor output response to heavy isometric contractions. Using the recommended approach of heavy 45-s isometric contractions did not offer a meaningful acute benefit for sensory or motor output for subjects with Achilles tendinopathy. Based on this study, heavy 45-s isometric contractions cannot be recommended for immediate pain relief or improved motor output for patients with Achilles tendinopathy.

LEVEL OF EVIDENCE:

IV, prospective cohort study.

KEYWORDS:

Achilles; Isometrics; Loading; Pain; Rehabilitation; Tendinopathy

PMID:
29974171
PMCID:
PMC6706360
DOI:
10.1007/s00167-018-5050-z
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center