Topical Glyceryl Trinitrate (GTN) and Eccentric Exercises for Mid-Portion Achilles Tendinopathy .
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Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial.
Br J Sports Med . 2024 Sep 9;58(18):1035-1043.Seventy-six patients with chronic mid-portion Achilles tendinopathy were randomized to receive either 24 weeks of daily GTN ointment (n=37) or placebo ointment (n=39), both combined with a 12-week eccentric exercise program. The primary outcome was improvement in the Victorian Institute of Sports Assessment–Achilles (VISA-A) scores at 24 weeks. Secondary outcomes included pain severity, physical function, calf muscle function, pressure pain thresholds, and tendon thickness changes assessed at 6, 12, and 24 weeks. Overall, both groups showed significant improvements in VISA-A scores and other outcomes, but there were no statistically significant differences between the groups. The findings suggest that adding GTN does not enhance treatment outcomes compared to placebo.
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