title: The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: a randomised controlled trial.
abstract: OBJECTIVE
  To assess whether the use of a night splint is of added benefit on functional outcome in treating chronic midportion Achilles tendinopathy.
  
  
  METHODS
  This was a single-blind, prospective, single centre, randomised controlled trial set in the Sports Medical Department, The Hague Medical Centre, The Netherlands. Inclusion criteria were: age 18-70 years, active participation in sports, and tendon pain localised at 2-7 cm from distal insertion. Exclusion criteria were: insertional disorders, partial or complete ruptures, or systemic illness. 70 tendons were included and randomised into one of two treatment groups: eccentric exercises with a night splint (night splint group, n = 36) or eccentric exercises only (eccentric group, n = 34).
  
  
  METHODS
  Both groups completed a 12-week heavy-load eccentric training programme. One group received a night splint in addition to eccentric exercises. At baseline and follow-up at 12 weeks, patient satisfaction, Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) score and reported compliance were recorded by a single-blind trained researcher who was blinded to the treatment.
  
  
  RESULTS
  After 12 weeks, patient satisfaction in the eccentric group was 63% compared with 48% in the night splint group. The VISA-A score significantly improved in both groups; in the eccentric group from 50.1 to 68.8 (p = 0.001) and in the night splint group from 49.4 to 67.0 (p<0.001). There was no significant difference between the two groups in VISA-A score (p = 0.815) and patient satisfaction (p = 0.261).
  
  
  CONCLUSIONS
  A night splint is not beneficial in addition to eccentric exercises in the treatment of chronic midportion Achilles tendinopathy.
authors.affiliation: Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: R J
authors.initials: RJ
authors.lastname: de Vos
authors.forename: A
authors.initials: A
authors.lastname: Weir
authors.forename: R J A
authors.initials: RJ
authors.lastname: Visser
authors.forename: ThC
authors.initials: T
authors.lastname: de Winter
authors.forename: J L
authors.initials: JL
authors.lastname: Tol
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000628:therapy*; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance; D017060:Patient Satisfaction; D011446:Prospective Studies; D016037:Single-Blind Method; D013165:Splints; D052256:Tendinopathy / Q000628:therapy*; D016896:Treatment Outcome