Eccentric Exercise, Tendon Thickness, Pain and Function in Achilles Tendinopathy: A Systematic Review

Context:Exercise is seen as the most evidence based treatment for managing tendinopathy and although the type of exercise used to manage tendinopathy may induce adaptation in healthy tendons, it is not clear whether these adaptations occur in tendinopathy and if so whether they are associated with improved clinical outcomes.Objective:The aim of the study was to synthesise available evidence for adaptation of the Achilles tendon to eccentric exercise and the relationship between adaptation (change in tendon thickness) and clinical outcomes among people with Achilles tendinopathy.Evidence Acquisition:The search was performed in September 2018 in several databases. Studies investigating the response (clinical outcome, imaging on US/MRI) of pathological tendons (tendinopathy, tendinosis, partial rupture) to at least 12 weeks of eccentric exercise were included. Multiple studies that investigated the same interventions and outcome were pooled and presented in effect size estimates, mean difference (MD) and 95%...