DOI QR코드

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아킬레스 건병증의 침 치료 효과에 대한 체계적 문헌고찰 및 메타분석

The Effectiveness of Acupuncture Therapy for Achilles Tendinopathy: A Systematic Review and Meta-Analysis

  • 이유진 (광주자생한방병원 한방재활의학과) ;
  • 노정희 (분당자생한방병원 한방재활의학과) ;
  • 오은수 (울산자생한방병원 침구과) ;
  • 장동진 (분당자생한방병원 한방재활의학과) ;
  • 김시형 (분당자생한방병원 한방재활의학과) ;
  • 임슬우 (분당자생한방병원 한방재활의학과) ;
  • 설동수 (광주자생한방병원 한방내과) ;
  • 이성현 (광주자생한방병원 침구의학과) ;
  • 김수빈 (광주자생한방병원 한방재활의학과) ;
  • 김경연 (광주자생한방병원 한방재활의학과)
  • Yoo-Jin Lee (Department of Rehabilitation Medicine of Korean Medicine, Gwangju Jaseng Hospital of Korean Medicine) ;
  • Jeong-Hee Noh (Department of Rehabilitation Medicine of Korean Medicine, Bundang Jaseng Hospital of Korean Medicine) ;
  • Eun-Su Oh (Department of Acupuncture & Moxibustion Medicine of Korean Medicine, Ulsan Jaseng Hospital of Korean Medicine) ;
  • Dong-Jin Jang (Department of Rehabilitation Medicine of Korean Medicine, Bundang Jaseng Hospital of Korean Medicine) ;
  • Si-Hyoung Kim (Department of Rehabilitation Medicine of Korean Medicine, Bundang Jaseng Hospital of Korean Medicine) ;
  • Seul-Woo Leem (Department of Rehabilitation Medicine of Korean Medicine, Bundang Jaseng Hospital of Korean Medicine) ;
  • Dong-Soo Seol (Department of Internal Medicine of Korean Medicine, Gwangju Jaseng Hospital of Korean Medicine) ;
  • Seong-Hyun Lee (Department of Acupuncture & Moxibustion Medicine of Korean Medicine, Gwangju Jaseng Hospital of Korean Medicine) ;
  • Su-Bin Kim (Department of Rehabilitation Medicine of Korean Medicine, Gwangju Jaseng Hospital of Korean Medicine) ;
  • Gyeong-Yeon Kim (Department of Rehabilitation Medicine of Korean Medicine, Gwangju Jaseng Hospital of Korean Medicine)
  • 투고 : 2025.03.18
  • 심사 : 2025.03.30
  • 발행 : 2025.04.30

초록

Objectives This review was conducted to evaluate the therapeutic effects of acupuncture for Achilles tendinopathy. Methods We searched eight electronic databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, ScienceON, DBpia) to find radomized-controlled clinical trials (RCTs) using acupuncture for Achilles tendinopathy. The methodological quality of relevant RCTs was analyzed by Cochrane's risk of bias tool 2.0. Meta-analysis was performed by Review Manager website. Results Seven RCTs were analyzed. Finally, six RCTs could be statistically analyzed. As a result of meta-analysis, electroacupuncture was more effective than physical therapy for improving ankle pain (mean difference, -1.32; 95% confidence interval, -2.37 to -0.27; p<0.05, I2=94%), but showed ambiguous effect compared with conventional acupuncture, physical therapy, and sham acupuncture. Conclusions By this review, we can apply acupuncture therapy with other treatment for Achilles tendinopathy. However, because of the small sample size and the poor methodological quality of the included RCTs, higher quality studies are necessary to strengthen clinical evidence.

키워드

참고문헌

  1. d'Hooghe P, Kerkhoffs G. The ankle in football. Heidelberg:Springer. 2014:253-68.
  2. Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. International Journal of Therapeutic Massage & Bodywork. 2012;5(1):14-7.
  3. Paavola M, Kannus P, Järvinen TA, Khan K, Józsa L, Järvinen M. Achilles tendinopathy. The Journal of Bone and Joint Surgery. American Volume. 2002;84(11): 2062-76. https://doi.org/10.2106/00004623-200211000-00024
  4. Sorosky B, Press J, Plastaras C, Rittenberg J. The practical management of Achilles tendinopathy. Clinical Journal of Sport Medicine. 2004;14(1):40-4. https://doi.org/10.1097/00042752-200401000-00007
  5. Maffulli N, Longo UG, Kadakia A, Spiezia F. Achilles tendinopathy. Foot and Ankle Surgery. 2020;26(3):240-9. https://doi.org/10.1016/j.fas.2019.03.009
  6. Sleeswijk Visser TSO, van der Vlist AC, van Oosterom RF, van Veldhoven P, Verhaar JAN, de Vos RJ. Impact of chronic Achilles tendinopathy on health-related quality of life, work performance, healthcare utilisation and costs. BMJ Open Sport & Exercise Medicine. 2021;7(1): e001023. https://doi.org/10.1136/bmjsem-2020-001023
  7. Abbassian A, Khan R. Achilles tendinopathy: pathology and management strategies. British Journal of Hospital Medicine. 2009;70(9):519-23. https://doi.org/10.12968/hmed.2009.70.9.43869
  8. Vo TP, Ho GWK, Andrea J. Achilles tendinopathy, a brief review and update of current literature. Current Sports Medicine Reports. 2021;20(9):453-61.
  9. Courville XF, Coe MP, Hecht PJ. Current concepts review: noninsertional Achilles tendinopathy. Foot & Ankle International. 2009;30(11):1132-42. https://doi.org/10.3113/FAI.2009.1132
  10. Rompe JD, Furia JP, Maffulli N. Mid-portion Achilles tendinopathy-current options for treatment. Disability and Rehabilitation. 2008;30(20-22):1666-76. https://doi.org/10.1080/09638280701785825
  11. Jang EH, Lim NR, Na WM, Kim SC. Case study of oriental medicine treatment with acupotomy therapy of the Achilles tendinitis. Journal of Pharmacopuncture. 2008;11(4):87-94. https://doi.org/10.3831/KPI.2008.11.4.087
  12. Park JH, Oh EY, Lee HJ, Kim YJ, Shin YB. A case report on a patient of Achilles tendinitis treated with Gyeon-mak chuna, Korean medicine and graston technique. J Korean Med Rehabil. 2015;25(1):103-10. https://doi.org/10.18325/jkmr.2015.25.1.103
  13. Hawks M, Clauson E, Hughes P, Lauters R, Crawford P. Treatment of insertional Achilles tendinopathy using adjunct electroacupuncture therapy: a randomized controlled trial. Medical Acupuncture. 2023;35(2):76-81. https://doi.org/10.1089/acu.2022.0051
  14. Koszalinski A, Flynn T, Hellman M, Cleland JA. Trigger point dry needling, manual therapy and exercise versus manual therapy and exercise for the management of Achilles tendinopathy: a feasibility study. Journal of Manual & Manipulative Therapy. 2020;28(4):212-21. https://doi.org/10.1080/10669817.2020.1719299
  15. Solomons L, Lee JJY, Bruce M, White LD, Scott A. Intramuscular stimulation vs sham needling for the treatment of chronic midportion Achilles tendinopathy: a randomized controlled clinical trial. PLoS One. 2020; 15(9):e0238579. https://doi.org/10.1371/journal.pone.0238579
  16. Kishmishian B, Richards J, Selfe J. A randomised feasibility study using an acupuncture protocol to the Achilles tendon in Achilles tendinopathy. Physiotherapy Practice and Research. 2019;40(1):59-67. https://doi.org/10.3233/PPR-180126
  17. Zhang D, Yang T, Zhang XF. Short-term curative effect of electro acupuncture combined with triceps surae eccentric training on chronic midportion Achilles tendinopathy. Clinical Education of General Practice. 2016;14(3):260-3.
  18. Yu HL, Xu LL, Ma TM. Therapeutic effect of electroacupuncture in the treatment of Achilles tendonitis. World Journal of Acupuncture - Moxibustion. 2015;25(2):17-22. https://doi.org/10.1016/S1003-5257(15)30042-8
  19. Zhang BM, Zhong LW, Xu SW, Jiang HR, Shen J. Acupuncture for chronic Achilles tendnopathy: a randomized controlled study. Chinese Journal of Integrative Medicine. 2013;19(12):900-4. https://doi.org/10.1007/s11655-012-1218-4
  20. Yoon KY, Hwang DW, Bae IS, Youn JH, Lee YJ, Jang WS, Yoo SJ, Lee DH, Kang DH, Son JY, Yang SG, Cho HW. A narrative review of the Korean medicine treatments for Achilles tendinopathy. J Korean Med Rehabil. 2022;32(4):33-45. https://doi.org/10.18325/jkmr.2022.32.4.33
  21. Song SO, Kim SY, Lee SY. Correlations between numerical rating scale and visual analog scale pain scores in the assessment of postoperative pain. Korean Journal of Anesthesiology. 2003;45(2):238-43. https://doi.org/10.4097/kjae.2003.45.2.238
  22. Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM; Victorian Institute Of Sport Tendon Study Group. The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy. British Journal of Sports Medicine. 2001;35(5):335-41. https://doi.org/10.1136/bjsm.35.5.335
  23. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The Cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928. https://doi.org/10.1136/bmj.d5928
  24. Barber J, Lodo F, Nugent-Head A, Zeng X. Comparative techniques of acupuncture and dry needling intersecting with trigger point physiology and diagnostics: a crossdiscipline narrative review. Medical Acupuncture. 2023; 35(5):220-9. https://doi.org/10.1089/acu.2023.0031
  25. Sussmilch-Leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM. Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. Journal of Foot and Ankle Research. 2012;5(1):15. https://doi.org/10.1186/1757-1146-5-15
  26. Song MY, Choi MH, Kim KM, Lee KS. The consideration of definition of physical therapy in South Korea. Journal of the Korean Society of Physical Medicine. 2010;5(2):133-41.
  27. Rosas S, Paço M, Lemos C, Pinho T. Comparison between the visual analog scale and the numerical rating scale in the perception of esthetics and pain. International Orthodontics. 2017;15(4):543-60. https://doi.org/10.1016/j.ortho.2017.09.027
  28. Wang Y, Zhou H, Nie Z, Cui S. Prevalence of Achilles tendinopathy in physical exercise: a systematic review and meta-analysis. Sports Medicine and Health Science. 2022;4(3):152-9. https://doi.org/10.1016/j.smhs.2022.03.003
  29. Jeong JJ. Nonoperative treatment of Achilles tendinopathy. Journal of Korean Foot and Ankle Society. 2021;25(2): 66-71. https://doi.org/10.14193/jkfas.2021.25.2.66
  30. Park HW. Surgical strategies for Achilles tendinopathy. Journal of Korean Foot and Ankle Society. 2021;25(2): 95-9. https://doi.org/10.14193/jkfas.2021.25.2.95
  31. Van der Vlist AC, Winters M, Weir A, Ardern CL, Welton NJ, Caldwell DM, Verhaar JAN, De Vos RJ. Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. British Journal of Sports Medicine. 2021;55(5): 249-56. https://doi.org/10.1136/bjsports-2019-101872
  32. Kim WY, Paek ST, Park JS, Lee SD, Kim KS. The clinical study of the herbal acupuncture on tarsalgia and plantar faciitis. Journal of Acupuncture Research. 2004; 21(6):121-6.
  33. Ahn KH, Kim KH, Hwang HS, Song HS, Kwon SJ, Lee SN, Byun IJ, Kang MS. The effect of bee-venom acupuncture on heel pain. Journal of Acupuncture Research. 2002;19(5):149-60.
  34. Imaeda M, Hojo T, Kitakoji H, Tanaka K, Itoi M, Inoue M. Effect of electroacupuncture stimulation on long-term recovery following Achilles tendon rupture in a rat model. Acupuncture in Medicine. 2018;36(5):327-32. https://doi.org/10.1136/acupmed-2016-011292
  35. Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and metaanalysis. Rheumatology. 2006;45(11):1331-7. https://doi.org/10.1093/rheumatology/kel207