title: Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy.
abstract: OBJECTIVE
  To assess the relationship between muscle-tendon function and symptoms in patients with Achilles tendinopathy using a validated test battery.
  
  
  METHODS
  A prospective non-randomised trial.
  
  
  METHODS
  Orthopaedic Department, Sahlgrenska University Hospital, Sweden.
  
  
  METHODS
  37 patients with a clinical diagnosis of Achilles tendinopathy in the midportion of the tendon, with symptoms for >2 months, were evaluated at the initiation of the study and after 1 year.
  
  
  METHODS
  The patients were treated using a rehabilitation programme, under the supervision of a physical therapist, for 6 months.
  
  
  METHODS
  The patients were evaluated using the Swedish version of the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A-S) for symptoms, and a test battery for evaluation of the lower leg muscle-tendon function.
  
  
  RESULTS
  There were significant improvements in the VISA-A-S score (p<0.00, n = 37) and the test battery (p<0.02, n = 19) at the 1-year follow-up. The VISA-A-S questionnaire had an effect size of 2.1 and the test battery had an effect size of 0.73. A low correlation (r = 0.178, p>0.05) was found between the VISA-A-S score and the test battery. A high correlation (r = 0.611, p<0.05) was found between the drop counter movement jump and the VISA-A-S score. All other tests in the test battery had low correlations (r = -0.305 to 0.155, p>0.05) with the VISA-A-S score. Only 25% (4/16) of the patients who had full symptomatic recovery had achieved full recovery of muscle-tendon function as measured by the test battery.
  
  
  CONCLUSIONS
  Full symptomatic recovery in patients with Achilles tendinopathy does not ensure full recovery of muscle-tendon function. The VISA-A-S questionnaire and the test battery are sensitive to clinically relevant changes with treatment and can be recommended for use in both the clinic and research.
authors.affiliation: Sportrehab--Physical Therapy & Sports Medicine Clinic, Göteborg, Sweden. karin.gravare-silbernagel@orthop.gu.se
authors.forename: Karin Grävare
authors.initials: KG
authors.lastname: Silbernagel
authors.forename: Roland
authors.initials: R
authors.lastname: Thomeé
authors.forename: Bengt I
authors.initials: BI
authors.lastname: Eriksson
authors.forename: Jon
authors.initials: J
authors.lastname: Karlsson
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000503:physiopathology*; D000328:Adult; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D055502:Secondary Prevention; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000503:physiopathology* / Q000534:rehabilitation