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Title: EFFECTS OF ULTRASOUND THERAPY VERSUS TRANSVERSE FRICTION MASSAGE ALONG WITH ECCENTRIC EXERCISE PROGRAM ON CHRONIC ACHILLES TENDINOPATHY
Authors: Raheela Kousar, Muhammad Sanaullah, Mehwish Ikram, Asma Aleem, Aamir Gul Memon, Syed Shakil ur Rehman
Journal: The Rehabilitation Journal
Publisher: Human Easement Foundation
Country: Pakistan
Year: 2022
Volume: 6
Issue: 2
Language: English
Background: Achilles tendinopathy is highly prevalent and caused by intrinsic or extrinsic factors. The multiple minor traumas can lead to achilles tendinopathy. Physical therapy treatment includes soft tissue mobilization and exercises. Objective: To compare ultrasound and transverse friction massage in chronic Achilles tendinopathy. Methodology: The study was a randomized control trial from 1st March 2019 to 15th August 2019. The non-probability convenient sampling technique was used to include n=76 patients having pain and activity limitation of Achilles tendon and randomly allocated into groups A and B by lottery method. The outcome measuring tools were numeric pain rating scale (NPRS) for pain, the Victorian Institute of Sports Assessment- Achilles questionnaire (VISA-A) for severity and goniometry for ROM. The Group A was treated with transverse friction massage and the group B was treated with ultrasound therapy. Both groups also performed eccentric exercises. The assessment was done at the baseline on the 1st session, at end of the 9th and 18th session. The data was analysed by SPSS 23 using independent t-test and repeated measures ANOVA. Results: The results of RM-ANOVA with pairwise comparison showed that both groups improve significantly (p<0.05) throughout the treatment duration with large effect size for all variables. While comparing the groups with independent t-test, TFM group showed more improvement in all variables as compared to UST group (p<0.05) after 3rd week as well as after 6th week of intervention. Conclusion: The Transverse friction massage (TFM) was more effective than ultrasound therapy (UST) when combined with eccentric exercises in improving pain severity of tendinopathy and ROM of ankle.
Keywords: Achilles tendon, eccentric exercises, pain stretching, myofascial release, ultrasonic therapy, tendinopathy.
To compare the effectiveness of ultrasound therapy versus transverse friction massage, when both are combined with an eccentric exercise program, in treating chronic Achilles tendinopathy.
A randomized control trial was conducted from March 1, 2019, to August 15, 2019, involving 76 patients with chronic Achilles tendinopathy. Patients were randomly allocated into two groups: Group A (transverse friction massage + eccentric exercises) and Group B (ultrasound therapy + eccentric exercises). Outcome measures included the Numeric Pain Rating Scale (NPRS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A), and goniometry for range of motion (ROM). Assessments were performed at baseline, end of the 9th session, and end of the 18th session. Data were analyzed using SPSS 23 with independent t-test and repeated measures ANOVA.
graph TD;
A["Patient Recruitment n=76"] --> B["Random Allocation"];
B --> C["Group A: TFM + EE"];
B --> D["Group B: UST + EE"];
C --> E["Treatment 6 weeks, 3 sessions/week"];
D --> E;
E --> F["Assessments Baseline, Week 3, Week 6"];
F --> G["Data Analysis SPSS 23"];
G --> H["Compare Within-Group Changes RM-ANOVA"];
G --> I["Compare Between-Group Differences Independent t-test"];
H --> J["Results"];
I --> J;
J --> K["Conclusion"];
The study found that both transverse friction massage and ultrasound therapy, when combined with eccentric exercises, significantly improved pain, functional status, and range of motion in patients with chronic Achilles tendinopathy. However, transverse friction massage showed superior results compared to ultrasound therapy. The findings suggest that the combination of eccentric exercises with manual therapy like TFM may be more effective than with modalities like UST.
Both treatment groups showed significant improvement (p<0.05) in pain, severity, and ankle ROM throughout the treatment duration, with large effect sizes. The Transverse Friction Massage (TFM) group demonstrated greater improvement in all measured variables compared to the Ultrasound Therapy (UST) group (p<0.05) after both 3 and 6 weeks of intervention.
Transverse friction massage, when combined with eccentric exercises, was more effective than ultrasound therapy combined with eccentric exercises in improving pain severity and ankle range of motion in patients with chronic Achilles tendinopathy.
1. Study Duration: The study was conducted from March 1, 2019, to August 15, 2019. (Confirmed)
2. Sample Size: A total of n=76 patients were initially included, with n=73 included in the final data analysis. (Confirmed)
3. Treatment Frequency: Both groups received treatment sessions 3 times per week for 6 weeks. (Confirmed)
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