Identifying characteristics of resistance-based therapeutic exercise interventions for Achilles tendinopathy: A scoping review

Phys Ther Sport. 2023 Sep:63:73-94. doi: 10.1016/j.ptsp.2023.06.002. Epub 2023 Jul 1.

Abstract

Objective: This scoping review describes resistance-based therapeutic exercise intervention characteristics for Achilles tendinopathy (AT) treatment (e.g., therapeutic dose, underlying mechanisms targeted by exercise) and assesses participant reporting characteristics.

Methods: Seven electronic databases were searched; studies delivering a resistance exercise-focused treatment for individuals with AT were included. The Template for Intervention Description and Replication (TIDieR) and the ICON 2019 'Recommended standards for reporting participant characteristics in tendinopathy research' checklists framed data extraction, and study quality was assessed using the Mixed Methods Appraisal Tool 2018 version.

Results: 68 publications (describing 59 studies and 72 exercise programs) were included. Results demonstrate that therapeutic exercise interventions for AT are well reported according to the TIDieR checklist, and participant characteristics are well reported according to the ICON checklist. Various underlying therapeutic mechanisms were proposed, with the most common being increasing tendon strength, increasing calf muscle strength, and enhancing collagen synthesis.

Conclusions: While evidence suggests that resistance-based therapeutic exercise interventions are effective in treating AT, more reporting on program fidelity, adherence, and compliance is needed. By summarizing currently published AT exercise programs and reporting key intervention characteristics in a single location, this review can assist clinicians in developing individualized resistance training programs for people with AT.

Keywords: Achilles tendon; Exercise therapy; Physical therapy modalities; Rehabilitation; Tendon injuries.

Publication types

  • Review

MeSH terms

  • Achilles Tendon*
  • Exercise
  • Exercise Therapy / methods
  • Humans
  • Resistance Training*
  • Tendinopathy* / therapy