COMPARATIVE EFFECTS OF ACCELERATED REHABILITATION AND ECCENTRIC STRENGTHENING EXERCISES IN PATIENTS WITH ACHILLES TENDINOPATHY

Abstract

Background: Achilles tendinopathy is a degenerative condition of the tendon characterized by pain, swelling, and functional impairment, particularly among active individuals. It commonly affects the Achilles tendon, which connects the gastrocnemius and soleus muscles to the calcaneus. With prevalence rates reaching up to 18% in runners and athletes, its management remains a clinical challenge. Traditional approaches focus on eccentric strengthening, while newer accelerated rehabilitation programs emphasize progressive loading, yet evidence comparing their relative efficacy is limited.

Objective: The aim of this study was to compare the effectiveness of an accelerated rehabilitation protocol and eccentric strengthening exercises in reducing pain and improving quality of life among patients with Achilles tendinopathy.

Methods: A single-blinded randomized controlled trial was conducted on 34 patients clinically diagnosed with Achilles tendinopathy. Participants were randomly allocated into two groups: Group A received an accelerated rehabilitation protocol, while Group B underwent eccentric strengthening exercises. Both interventions were delivered over 12 weeks, following standardized baseline therapy. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), and quality of life was measured using the WHOQOL-BREF at baseline and after intervention. Data were analyzed using the Mann–Whitney U test, with p ≤ 0.05 considered statistically significant.

Results: At baseline, both groups reported comparable pain levels (Pre-NPRS median 9.00, U = 144.5, p = 1.000, r = 0.000). Post-treatment, Group B achieved greater improvements, with NPRS significantly reduced to a median of 2.00 compared to 6.00 in Group A (U = 0.000, p < 0.001, r = 0.868). Quality of life scores also improved more in Group B, rising from a median of 67.00 to 82.00, compared to Group A’s increase from 53.00 to 61.00 (U = 0.000, p < 0.001, r = 0.859).

Conclusion: Both interventions were effective, but eccentric strengthening produced superior reductions in pain and greater improvements in quality of life compared to accelerated rehabilitation. These findings support the preferential use of eccentric exercises as a primary treatment for Achilles tendinopathy.