title: Whole-body vibration versus eccentric training or a wait-and-see approach for chronic Achilles tendinopathy: a randomized clinical trial.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  To test the hypothesis that whole-body vibration training results in greater improvements in symptoms and pain, structural changes, and muscle flexibility and strength of the triceps surae muscle-tendon unit than those achieved with eccentric training or with a wait-and-see approach.
  
  
  BACKGROUND
  The potential use of vibration training for the treatment of Achilles tendinopathy has not been explored.
  
  
  METHODS
  Fifty-eight patients (mean age, 46.0 years) with Achilles tendinopathy were randomly assigned to a 12-week intervention using whole-body vibration training, eccentric training, or a wait-and-see approach. Pain, tendon structure and path, and muscle flexibility and strength were assessed at baseline and follow-up, and compared using mixed-factor analyses of variance.
  
  
  RESULTS
  Pain improvements at the midsection of the tendon were greater in the vibration- and eccentric-training groups than in the wait-and-see group (mean difference from the vibration-training group, -18.0; 95% confidence interval [CI]: -35.0, -1.1; mean difference from the eccentric-training group, -27.0; 95% CI: -50.9, -3.1). Improvements in pain at the musculotendinous junction were greater in the eccentric-training group than in the other groups (mean difference from the vibration-training group, -31.4; 95% CI: -60.7, -2.0; mean difference from the wait-and-see group, -50.2; 95% CI: -82.3, -18.1). Improvements in most participants were achieved in the vibration-training group, followed by the eccentric-training group.
  
  
  CONCLUSIONS
  Vibration training may be an alternative or a complementary treatment in patients who do not respond well to eccentric training, especially in those with insertional pain.
  
  
  METHODS
  Therapy, level 2b-.
authors.affiliation: Medical Park Bad Wiessee St Hubertus, Bad Wiessee, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Horstmann
authors.forename: Holger M
authors.initials: HM
authors.lastname: Jud
authors.forename: Vanessa
authors.initials: V
authors.lastname: Fröhlich
authors.forename: Annegret
authors.initials: A
authors.lastname: Mündermann
authors.forename: Stefan
authors.initials: S
authors.lastname: Grau
mesh_terms: D000125:Achilles Tendon; D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D052256:Tendinopathy / Q000628:therapy*; D014732:Vibration; D057832:Watchful Waiting