The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: a randomised controlled trial.
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.
de Vos
R J
RJ
Erasmus Medical Centre, Rotterdam, The Netherlands.
Weir
A
A
Visser
R J A
RJ
de Winter
ThC
T
Tol
J L
JL
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