Table 1.
The main findings of the studies. ECC= eccentric loading exercise; COE= concentric loading exercise; PRP= platelet rich plasma; L-PRP= leukocyte- and platelet-rich plasma; ESWT= extracorporeal shockwave therapy; ultrasonography= US; GCS= glucocorticoids; HA= hyaluronic acid.
| Ref | Authors (Year of Publication) | No. Of Patients | Treatment Groups | Results Summery |
|---|---|---|---|---|
| [15] | Beyer et al. (2015) | 58 | ECC vs. heavy slow resistance training (HSR) | Both groups had improvement in the short- and long-term ranges over the baseline (p < 0.05), but no differences between the treatments were recorded. |
| [16] | Stasinopoulos et al. (2013) | 41 | Alfredson ECC vs. Stanich ECC | Alfredson protocol was superior to Stanish model in reducing pain and improving function outcomes. Both groups had improvements at the 6-month follow-up over the baseline. |
| [17] | Hutchison et al. (2013) | 47 | Intense pulsed light vs. ECC | No differences between the groups at 1 year follow-up. |
| [18] | Hostmman et al. (2013) | 58 | Vibration traning vs. ECC vs. control | Pain reduction in the vibration training and ECC groups compared to the control. In the musculotendinous junction, ECC cohort had a 66.6% reduction in pain. The vibration-training group did not experience any change in pain at the musculotendinous junction, therefore, vibration training 0%, while the control group had an increase of the 73.3%. |
| [19] | Zhang et al. (2012) | 64 | Acupuncture vs. ECC | At the 8-week follow-up, there was superior improvement of the pain score acupuncture group compared to ECC (67.1 points and 48.5, respectively). |
| [20] | Yelland et al.(2009) | 43 | Proloteraphy + ECC vs. ECC | At the short- and long-term follow-up, there was a superior increase amongproloteraphy + ECC compared to the others. At the 1 year follow-up, the proloteraphy + ECC group had an improvement of 86% for the functional score, with 73% for ECC. In combined treatment there was early recovery. |
| [21] | Tumilty et al. (2015) | 80 | Photobiomodulation +ECC vs. ECC | Photobiomodulation + ECC group showed statistically significant improvements over ECC only in functional score. |
| [22] | Praet et al (2019) | 18 | ECC + Oral supplementation (OS) | In the OS group, there was an early return to sport and improvements in functional outcome. |
| [23] | McCormack et al. (2016) | 16 | ECC vs. ECC + Astym Treatment | After 12-, 26- and 52-week follow-ups, Astym + ECC patients showed better outcomes than ECC groups for insertional tendinopathy. Both groups recorded significant improvements in pain over the baseline, but there was no difference between cohorts, except at the 12-week intervention period in the combined group. |
| [24] | de Jorge et al. (2010) | 58 | ECC vs. ECC + Night splint | There was an improvement in functional score in at the 3-month and 1-year follow-ups over the baseline in the ECC group and the ECC + night splint group. There was no significant difference found in increases in pain score. |
| [25] | Verral et al. (2011) | 190 | ECC | There was a reduction of pain after 12 weeks, in 6 to 14 months of treatment (p < 0.01 compared to the baseline). |
| [26] | Ram et al. (2013) | 45 | ECC vs. Control | There was superior patient satisfaction for the ECC group compared to the control. No statistically significant assessments at 12 weeks in groups of the satisfied and not satisfied patients were made, nor were improvements recorded at the subsequent follow-up. There was better color Doppler activity during their second ultrasound. |
| [27] | Yu et al, (2013) | 32 | ECC vs. COE | Both groups had improvements over the baseline (p < 0.05) |
| [28] | Stevens et al. (2014) | 28 | ECC vs. “Do-as-tolerated” protocol | Both groups presented clinically and statistically significant improvements at the 6-week follow-up over the baseline. |
| [29] | Van der Plas et al. (2011) | 46 | ECC | There was improvement of pain and functional scores after 1 year of treatment (p < 0.001), and at the 5-year follow-up (p < 0.01). 39.7% of the patients were completely pain-free at the follow-up and 48.3% had received one or more alternative treatments. |
| [30] | Deans et al. (2012) | 26 | PRP | There was improve quality of life and functional outcomes. 5 had worse symptoms, there was 1 rupture, and 2 found it difficult to work. |
| [31] | de Vos et al. (2010) | 54 | PRP vs. ECC+Placebo | At the 6-, 12-, and 24-week follow-ups, there was no significant difference in the improvement of functional outcomes between the 2 treatment groups. |
| [32] | de Jonge et al (2011) | 54 | PRP+ECC vs. ECC+Placebo | At the 6-month and 1-year follow-ups, there was not a significant difference in clinical or sonographic assessments after a PRP injection. In both groups, neovascularization continued decreasing after the increase at the 12-week follow-up. |
| [33] | Filardo et al. (2014) | 27 | L-PRP | 89% returned to sport and 93% were satisfied patients. In the unsatisfied patients, 1 patient had a corticosteroid injection and 2 patients had surgical intervention. |
| [34] | Guelfi et al. (2014) | 83 | L-PRP | At the final follow-up there was an improvement of functional outcome (p < 00.1 respect baseline). 91.6% were satisfied after 1 injection, the remaining 8.4% had a second PRP injection. No reported Achilles tendon ruptures. |
| [35] | Njawaya et al (2017) | 27 | US+ESWT vs. ESWT | Similar results were recorded in the 2 groups with, no major advantage seen in the addition of an ultrasound for guiding shock waves. |
| [36] | Pavone et al. (2016) | 40 | ESWT+ ECC vs. ECC |
At the 12-month follow-up, 65.0% of patients did not complain about pain, 27.5% of patients got back to normal daily activities and sports despite residual pain, and 3 patients still complained about pain (VAS > 4). Statistically significant differences in the pain score and in the functional outcome results were observed as well as in the functional outcome. |
| [37] | Rompe et al. (2008) | 50 | ESWT vs. ECC | At the 4-month follow-up, no significant difference was seen in the functional assessments between the two groups. ESWT patients showed better outcomes than ECC subjects (p < 0.020) |
| [38] | Vulpiani et al. (2009) | 105 | ESWT | 60 days after the end of the treatment, there was a significant improvement over the baseline in pain score. |
| [39] | Saxena (2011) | 60 | ESWT | At least 1 year after treatment, there were significant improvements (78.38%) of satisfied patients treated with the low-energy radial shockwave devices. |
| [40] | Taylor et al. (2016) | 56 | ESWT | In both non- and insertional tendinopathies, there were improvements in the mean pain scores at rest and on activity. |
| [41] | Wetke et al. (2014) | 113 | GCS vs. training | There were good short-term effects, but no significant long-term effects. 26% of patients had training only, 58% had one supplementary injection, 14% had two injections, and 2% had three injections. 2 subjects had flare-ups more than 24 h after GCS injection |
| [42] | Lynen et al. (2016) | 59 | HA vs. ESWT | 90 days after the treatment, the HA group had greater treatment satisfaction than the standard ESWT in terms of pain (p = 0.0030). Similar findings for HA were also observed at 4 weeks (p = 0.0304) and 6 months (p = 0.0018). |
| [43] | Maquirriain et al. (2013) | 56 | Eterocoxib vs. Diclofenac | Over the 7-day treatment period, both groups had improvements over the baseline (p < 0.001). The analgesic effect averaged etoricoxib= 56.4% and diclofenac 50.6% (p = 0.64). The etericoxib groups recorded less side effects than those in the diclofenac group (0% and 14.2%, respectively, p = 0.037) |