Publication: Ejercicios Excéntricos en Tendinopatía Aquílea
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2013
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Abstract
El objetivo de este trabajo es revisar la eficacia de los ejercicios excéntricos en las tendinopatías aquileas, exponer los avances en cuanto a la fisiopatología de las tendinopatías y proponer un programa de ejercicios basados en la evidencia.
Se consultaron las bases de datos PubMed, PEDro y la Biblioteca Cochrane. La información se obtuvo a partir de ensayos clínicos randomizados y revisiones sistemáticas en lengua inglesa, realizados sobre sujetos diagnosticados de tendinopatía aquilea con sintomatología presente, sin patología o cirugía previa del tendón afectado.
Se ha evidenciado una mejora en cuanto a los signos y síntomas que presenta el paciente mediante el tratamiento con ejercicios excéntricos en el tendón de Aquiles frente a los resultados obtenidos con otros tratamientos conservadores o quirúrgicos.
Actualmente, siguen siendo desconocidos los mecanismos de acción por los que disminuye el dolor, la neovascularización o el volumen del tendón mediante los ejercicios excéntricos en el tendón.
En definitiva, existe evidencia moderada del ejercicio excéntrico en las tendinopatías aquileas. Los mecanismos a través de los cuales se produce alivio del dolor y la recuperación de la funcionalidad con este tipo de ejercicios siguen sin estar claros. Se necesitan más estudios para determinar los mecanismos de acción de este tipo de ejercicios para demostrar su eficacia.
The aim of this paper is to evaluate the effectiveness degree of eccentric exercises in Achilles tendinopathy, to present the advances of the tendinopathy physiopathology and to propose an exercise program based on evidence. The findings were taken from databases of PubMed, PEDro and the Cochrane Library. The information was obtained from randomized clinical trials and systematic reviews in English, performed on patients diagnosed with Achilles tendinopathy with symptoms present and no pathology or previous surgery of the affected tendon. It has shown an improvement in the signs and symptoms presented by the patient through treatment with eccentric exercise in Achilles tendon against other conservative or surgical treatments. Now a days, the mechanisms of action by which the pain, the neovascularization or the tendon thickness decrease by eccentric exercise remain unknown. Finally, there is moderate evidence of eccentric exercise in Achilles tendinopathy. The mechanisms of pain relief and functional recovery with such exercises remain unclear. Further studies are needed to determine the mechanisms of action of these exercises to demonstrate its effectiveness.
The aim of this paper is to evaluate the effectiveness degree of eccentric exercises in Achilles tendinopathy, to present the advances of the tendinopathy physiopathology and to propose an exercise program based on evidence. The findings were taken from databases of PubMed, PEDro and the Cochrane Library. The information was obtained from randomized clinical trials and systematic reviews in English, performed on patients diagnosed with Achilles tendinopathy with symptoms present and no pathology or previous surgery of the affected tendon. It has shown an improvement in the signs and symptoms presented by the patient through treatment with eccentric exercise in Achilles tendon against other conservative or surgical treatments. Now a days, the mechanisms of action by which the pain, the neovascularization or the tendon thickness decrease by eccentric exercise remain unknown. Finally, there is moderate evidence of eccentric exercise in Achilles tendinopathy. The mechanisms of pain relief and functional recovery with such exercises remain unclear. Further studies are needed to determine the mechanisms of action of these exercises to demonstrate its effectiveness.