EFFECTS OF ULTRASOUND THERAPY VERSUS TRANSVERSE FRICTION MASSAGE ALONG WITH ECCENTRIC EXERCISE PROGRAM ON CHRONIC ACHILLES TENDINOPATHY

Background: Achilles tendinopathy is highly prevalent and caused by intrinsic or extrinsic factors. The multiple minor traumas can lead to achilles tendinopathy. Physical therapy treatment includes soft tissue mobilization and exercises. Objective: To compare ultrasound and transverse friction massage in chronic Achilles tendinopathy. Methodology: The study was a randomized control trial from 1st March 2019 to 15th August 2019. The non-probability convenient sampling technique was used to include n=76 patients having pain and activity limitation of Achilles tendon and randomly allocated into groups A and B by lottery method. The outcome measuring tools were numeric pain rating scale (NPRS) for pain, the Victorian Institute of Sports Assessment- Achilles questionnaire (VISA-A) for severity and goniometry for ROM. The Group A was treated with transverse friction massage and the group B was treated with ultrasound therapy. Both groups also performed eccentric exercises. The assessment was done at the baseline on the 1st session, at end of the 9th and 18th session. The data was analysed by SPSS 23 using independent t-test and repeated measures ANOVA. Results: The results of RM-ANOVA with pairwise comparison showed that both groups improve significantly (p<0.05) throughout the treatment duration with large effect size for all variables. While comparing the groups with independent t-test, TFM group showed more improvement in all variables as compared to UST group (p<0.05) after 3rd week as well as after 6th week of intervention. Conclusion: The Transverse friction massage (TFM) was more effective than ultrasound therapy (UST) when combined with eccentric exercises in improving pain severity of tendinopathy and ROM of ankle. Keywords: Achilles tendon, eccentric exercises, pain stretching, myofascial release, ultrasonic therapy, tendinopathy.