Evidence map›Paper›PMID 22075719›Full record

Trial reportBritish journal of sports medicine2012

A 5-year follow-up study of Alfredson's heel-drop exercise programme in chronic midportion Achilles tendinopathy.

A van der Plas, S de Jonge, R J de Vos, H J L van der Heide, J A N Verhaar, A Weir, J L Tol

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of sports medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 74 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05659134 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Comparison of Alfredson Eccentric and Silbernagel Concentric-eccentric Therapeutical Protocol in Competitive Athletes With Chronic Achilles Tendinopathy

TypeinterventionalSponsorCharles University, Czech RepublicRan2022 to 2024Enrolled40ConditionsAchilles Tendinopathy, Tendon Injuries, Tendon Thickening, Pain, ChronicArmsAlfredson protocol, Silbernagel protocol
NCT07623408 narecruitingnot on this mapstarted 2026, after this paper: background citation

The Effect of Foot Positioning During a 12-week Supervised Training Program on Achilles Tendon Mechanics and Function in Individuals With Mid-portion Achilles Tendinopathy.

TypeinterventionalSponsorKU LeuvenRan2026 to 2027Enrolled60ConditionsAchilles Tendinopathy (AT)Arms12-week adaptive, load-based exercise therapy protocol for Achilles Tendinopathy
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  2. Platelet-rich plasma in chronic Achilles tendinopathy.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

A van der PlasSports Medicine Department, The Hague Medical Centre Antoniushove, Burgemeester Banninglaan 1, Leidschendam, The Netherlands.
S de Jonge
R J de Vos
H J L van der Heide
J A N Verhaar
A Weir
J L Tol

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEccentric exercises have the most evidence in conservative treatment of midportion Achilles tendinopathy. Although short-term studies show significant improvement, little is known of the long-term (>3 years) results.

aimTo evaluate the 5-year outcome of patients with chronic midportion Achilles tendinopathy treated with the classical Alfredson's heel-drop exercise programme. STUDY

designPart of a 5-year follow-up of a previously conducted randomised controlled trial. Methods 58 patients (70 tendons) were approached 5 years after the start of the heel-drop exercise programme according to Alfredson. At baseline and at 5-year follow-up, the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire score, pain status, alternative treatments received and ultrasonographic neovascularisation score were recorded.

resultsIn 46 patients (58 tendons), the VISA-A score significantly increased from 49.2 at baseline to 83.6 after 5 years (p<0.001) and from the 1-year to 5-year follow-up from 75.0 to 83.4 (p<0.01). 39.7% of the patients were completely pain-free at follow-up and 48.3% had received one or more alternative treatments. The sagittal tendon thickness decreased from 8.05 mm (SD 2.1) at baseline to 7.50 mm (SD 1.6) at the 5-year follow-up (p=0.051).

conclusionAt 5-year follow-up, a significant increase of VISA-A score can be expected. After the 3-month Alfredson's heel-drop exercise programme, almost half of the patients had received other therapies. Although improvement of symptoms can be expected at long term, mild pain may remain.

Indexed as

Achilles TendonAdultExercise TherapyFollow-Up StudiesHeelHumansInjury Severity ScoreMiddle AgedMusculoskeletal PainPatient SatisfactionTendinopathyTreatment OutcomeUltrasonography

Identifiers

PMID22075719
PMCPMC3277725

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.