Effectsof Laser Therapy and Eccentric Exercises in the Treatment ofRecreational Athletes With Chronic Achilles Tendinopathy
Apostolos Stergioulas, PT, PhD*, Marianna Stergioula, PT*, Reidar Aarskog, PT, MSc , Rodrigo A. B. Lopes-Martins, MPharm, PhD and Jan M. Bjordal, PT, PhD ,||,
From the * Faculty of Human Movement and Quality of Life, Peloponnese University, Sparta, Laconia, Greece, the Institute of Physical Therapy, Bergen University College, Bergen, Norway, the Laboratoryof Pharmacology and Phototherapy of Inflammation, Department ofPharmacology, Institute of Biomedical Sciences, University of SãoPaulo, São Paulo, Brazil, and the || Section of Physiotherapy Science, Department of Public Health and Primary Care, University of Bergen, Bergen, Norway Addresscorrespondence to Jan M. Bjordal, PT, PhD, Institute of PhysicalTherapy, Bergen University College, Mollendalsvn 6, 5009 Bergen, Norway(e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).Background: Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset.
Hypothesis: The addition of laser therapy to EE may cause more rapid clinical improvement.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups receiving either EE + LLLT or EE + placebo laser over 8 weeks in a blinded manner. Laser therapy ( = 820 nm) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm2 and a total dose of 5.4 J per session.
Results: The results of the intention-to-treat analysis for the primary outcome, pain intensity during physical activity on the 100-mm visual analog scale, were significantly lower in the laser group than in the placebo laser group, with 53.6 mm versus 71.5 mm (P = .0003) at 4 weeks, 37.3 mm versus 62.8 mm (P = .0002) at 8 weeks, and 33.0 mm versus 53.0 mm (P = .007) at 12 weeks after randomization. Secondary outcomes of morning stiffness, active dorsiflexion, palpation tenderness, and crepitation showed the same pattern in favor of the laser group.
Conclusion: Laser therapy, with the parameters used in this study, accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen. For the laser group, the results at 4 weeks were similar to the placebo laser group results after 12 weeks.
