7/29/2019 Vol 57 No 1 CPG

1/1

Journal of Physiotherapy 2011 Vol. 57 Australian Physiotherapy Association 201162

Appraisal Clinical Practice Guidelines

Achilles tendonitis

Achilles pain, stiffness, and muscle power decits

Latest update: August 2010.Next update: To be consideredfor review in 2014. Patient group: Patients presenting with

Achilles pain, stiffness and muscle power decits. Intendedaudience: Orthopaedic physical therapy clinicians whodiagnose and manage patients with heel pain, academicand clinical instructors, policy makers, payors and claimsreviewers. Additional versions: Nil. Expert workinggroup: The guidelines were produced by four authors and 15content experts. They consisted of 16 physical therapists andthree doctors from the USA appointed as content experts bythe Orthopaedic section of the American Physical TherapyAssociation. Funded by: Not indicated. Consultation with:Consultants from a variety of elds such as epidemiology,sports rehabilitation, and basic science in tendon pathologyand healing served as reviewers of early drafts of theguideline. In addition, several physical therapists practising

in orthopaedic and sports physical therapy settings providedfeedback on initial drafts. Approved by: Orthopaedicsection of the American Physical Therapy Association.Location: Carcia CR, Martin RL, Houck J, Wukich DK(2010) Achilles pain, stiffness, and muscle power decits:achilles tendonitis.J Orthop Sports Phys Ther40: A126.http://www.jospt.org/issues/articleID.2480,type.2/article_detail.asp

Description: This 26-page document presents evidence-based clinical practice guidelines on the risk factors,

diagnosis, classication, outcome measures, impairmentmeasures, and physical therapy interventions for achillestendonitis. The guidelines are presented within anInternational Classication of Functioning Disability andHealth (ICF) framework. It begins with a 1-page summaryof all guideline recommendations. The prevalence andpathoanatomical features are presented, followed by theevidence for intrinsic and extrinsic risk factors. Signs,symptoms, and the efcacy of imaging to assist in thediagnosis of achilles tendonitis are discussed. Potentialconditions to consider in the differential diagnosis arealso outlined. Measurement properties of tools to measurephysical impairments, activity restriction, and participationlimitations specic to a person with achilles tendonitis are

presented along with the evidence for prognosis. Evidencefor the efcacy of physical therapy interventions are detailedand include eccentric loading, laser therapy, iontophoresis,stretching, foot orthoses, manual therapy, taping, heel lifts,and night splints. All 135 cited references are listed at theend of the document.

Sandra BrauerThe University of Queensland, Brisbane