Acupuncture for Insertional Achilles Tendinopathy Effectiveness

NCT ID: NCT03747549

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-12

Study Completion Date

2021-03-16

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to compare acupuncture plus a prescribed home exercise program versus a prescribed home exercise program alone to determine which has better outcomes at improving pain relief and physical function in adult patients with insertional Achilles tendinopathy.

The investigators want to compare a combination of two standard of care treatments (acupuncture plus a prescribed home exercise program) versus a single standard of care treatment (a prescribed home exercise program) to determine which has better outcomes with improving pain relief and physical function in patients with insertional Achilles tendinopathy. The investigators hypothesize that there will be a significant improvement in pain and functional outcomes, both acutely and over time, in the acupuncture plus a prescribed home exercise program group versus the group performing a prescribed home exercise program alone. The investigators will measure Achilles pain relief and physical function immediately prior to treatment (baseline), immediately after the initial treatment at day 1, 2 weeks, 4 weeks, 6 weeks, and 12 weeks using the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A). After 3 months, patients with continuing pain in the non-acupuncture arm will be given the option to crossover to the acupuncture arm of the study for an additional 12 weeks of treatment with the subject's concurrence.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Screening Visit (research-related):

* Obtain and document signed Informed Consent document and HIPAA Authorization.
* Review past medical history in Armed Forces Health Longitudinal Technology Application (AHLTA) to verify the inclusion/exclusion criteria including previous encounter, vital signs review, co-morbidities, demographics, and problems list.
* Record: Date of birth, age, gender, race, ethnicity, DoD ID number, name of standard of care medications (over-the-counter and prescription), current email address (to be used for scheduling), height (in inches), weight (in pounds),history of prior injury to the injured leg, and note any prior acupuncture received for Achilles tendinopathy.
* If the subject is an active duty member, the investigators will ask: Have you or are you currently on a fitness restriction for Achilles tendinopathy.

If so, what are/were the dates of the restriction?

• There are several standard of care treatments for Achilles tendinopathy which include physical therapy as well as a prescribed home exercise program. The investigators will standardize what patients in this study are receiving by having all subjects follow a standard home exercise program defined as the Insertional Achilles Tendinopathy Eccentric Training Protocol and have them discontinue any formal physical therapy or other therapies when entering this study. Regular physical activity such as exercise is allowed.

Randomization: Subjects will be randomized into 1 of 2 research treatment groups using block randomization with repeated measures:

* Group 1: Acupuncture (needles will be placed at BL 60, BL 61, KI 3, KI 4 with needles directed into the Achilles tendon. Needles inserted until a firm catch of the needle entering the tendon was appreciated. Energy (a small electrical current) is placed from KI 3(-) KI 4(+) and BL 61 (-) BL 60(+) at 30 Hz for 15min) plus the prescribed home exercise program
* Group 2: The prescribed home exercise program alone.

Visit 1-Day 1 (may be same day as screening visit) (research-related)::

* Subjects will be given a study diary to document the number of times they performed the Insertional Achilles Tendinopathy Eccentric Training Protocol.
* Subjects will be advised to complete exercises twice a day for three sets of 15 repetitions for 12 weeks.4
* Administer the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A)
* Document Morphine Equivalent Units (MEU) and over-the-counter and prescription medications used in the last 2 weeks.
* Self-reported pain severity pre-intervention (0 for no pain to 10 being the worst pain)
* Research treatment intervention according to their randomization group:

Group 1:

Subjects will be asked what their expectations are regarding acupuncture's effectiveness for Achilles tendinopathy.

The prescribed home exercise program will be reviewed. Acupuncture will be performed. Research coordinator will record the name of the investigator performing the acupuncture

Group 2:

The prescribed home exercise program will be reviewed. Self-reported pain severity post-intervention (0 for no pain to 10 being the worst pain)

Visit 2-Week 2 (research-related)::

* Subjects' study diaries will be reviewed and the number of times the Insertional Achilles Tendinopathy Eccentric Training Protocol was performed will be documented.
* Subjects will be reminded to complete the exercises twice a day for three sets of 15 repetitions for 12 weeks.
* Administer the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A)
* Document Morphine Equivalent Units (MEU) and over-the-counter and prescription medications used since the last visit.
* Self-reported pain severity pre-intervention (0 for no pain to 10 being the worst pain)
* Research treatment intervention according to their randomization group:

Group 1:

The prescribed home exercise program will be reviewed. Acupuncture will be performed. Research coordinator will record the name of the investigator performing the acupuncture

Group 2:

The prescribed home exercise program will be reviewed. Self-reported pain severity post-intervention (0 for no pain to 10 being the worst pain)

Visit 3-Week 4 (research-related):

* Subjects' study diaries will be reviewed and the number of times the Insertional Achilles Tendinopathy Eccentric Training Protocol was performed will be documented.
* Subjects will be reminded to complete the exercises twice a day for three sets of 15 repetitions for 12 weeks.
* Administer the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A)
* Document Morphine Equivalent Units (MEU) and over-the-counter and prescription medications used since the last visit.
* Self-reported pain severity pre-intervention (0 for no pain to 10 being the worst pain)
* Research treatment intervention according to their randomization group:

Group 1:

The prescribed home exercise program will be reviewed. Acupuncture will be performed. Research coordinator will record the name of the investigator performing the acupuncture

Group 2:

The prescribed home exercise program will be reviewed. Self-reported pain severity post-intervention (0 for no pain to 10 being the worst pain)

Visit 4-Week 6 (research-related)::

Subjects' study diary will be reviewed and the number of times the Insertional Achilles Tendinopathy Eccentric Training Protocol was performed will be documented.

* Subjects will be reminded to complete the exercises twice a day for three sets of 15 repetitions for 12 weeks.4
* Administer the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A)
* Document Morphine Equivalent Units (MEU) and over-the-counter and prescription medications used since the last visit.
* Self-reported pain severity pre-intervention (0 for no pain to 10 being the worst pain)
* Research treatment intervention according to their randomization group:

Group 1:

The prescribed home exercise program will be reviewed. Acupuncture will be performed. Research coordinator will record the name of the investigator performing the acupuncture

Group 2:

The prescribed home exercise program will be reviewed. Self-reported pain severity post-intervention (0 for no pain to 10 being the worst pain)

Visit 5-Week 12 (research-related)::

* Collect subjects' study diaries.
* Administer the Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A)
* Document Morphine Equivalent Units (MEU) and over-the-counter and prescription medications used since the last visit.
* Self-reported pain severity (0 for no pain to 10 being the worst pain)
* Ask if subjects' expectations were met or changed regarding acupuncture's effectiveness for Achilles Tendinopathy. (Group 1 ONLY)

CROSSOVER: At Visit 5 (final visit), patients in the non-acupuncture group with continuing pain will be given the option to crossover into the acupuncture arm of the study where they will complete visit 1 through 5. Visit 1 will be on the same day with corresponding measures as described above for a total study enrollment time of 24 weeks.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Insertional Achilles Tendinopathy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Acupuncture and Home Exercise

Acupuncture and home exercise.

Group Type EXPERIMENTAL

Acupuncture and Home Exercise

Intervention Type OTHER

Acupuncture (needles will be placed at BL 60, BL 61, KI 3, KI 4 with needles directed into the Achilles tendon. Needles inserted until a firm catch of the needle entering the tendon was appreciated. Energy (a small electrical current) is placed from KI 3(-) KI 4(+) and BL 61 (-) BL 60(+) at 30 Hz for 15min) plus the prescribed home exercise program

Home Exercise Alone

The prescribed home exercise program alone.

Group Type ACTIVE_COMPARATOR

Home Exercise Alone

Intervention Type OTHER

The prescribed home exercise program alone.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Acupuncture and Home Exercise

Acupuncture (needles will be placed at BL 60, BL 61, KI 3, KI 4 with needles directed into the Achilles tendon. Needles inserted until a firm catch of the needle entering the tendon was appreciated. Energy (a small electrical current) is placed from KI 3(-) KI 4(+) and BL 61 (-) BL 60(+) at 30 Hz for 15min) plus the prescribed home exercise program

Intervention Type OTHER

Home Exercise Alone

The prescribed home exercise program alone.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Male and female DoD beneficiaries, age 18 years or older
* diagnosed with Achilles tendinopathy OR patients meeting criteria of pain 2cm or less from the insertion to the Achilles tendon on the calcaneus.
* Patients must have had pain for greater than 8 weeks and a VISA-A score less than 60.

Exclusion Criteria

* Pregnant
* Active cellulitis over the area of needle insertion.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Mike O'Callaghan Military Hospital

FED

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Matthew Hawks, MD

Role: PRINCIPAL_INVESTIGATOR

Mike O'Callaghan Military Medical Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

96th Medical Group

Eglin Air Force Base, Florida, United States

Site Status

Mike O'Callaghan Military Medical Center

Nellis Air Force Base, Nevada, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Li HY, Hua YH. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments. Biomed Res Int. 2016;2016:6492597. doi: 10.1155/2016/6492597. Epub 2016 Nov 3.

Reference Type BACKGROUND
PMID: 27885357 (View on PubMed)

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. Br J Sports Med. 2001 Oct;35(5):335-41. doi: 10.1136/bjsm.35.5.335.

Reference Type BACKGROUND
PMID: 11579069 (View on PubMed)

Iversen JV, Bartels EM, Langberg H. The victorian institute of sports assessment - achilles questionnaire (visa-a) - a reliable tool for measuring achilles tendinopathy. Int J Sports Phys Ther. 2012 Feb;7(1):76-84.

Reference Type BACKGROUND
PMID: 22319681 (View on PubMed)

Childress MA, Beutler A. Management of chronic tendon injuries. Am Fam Physician. 2013 Apr 1;87(7):486-90.

Reference Type BACKGROUND
PMID: 23547590 (View on PubMed)

Rowe V, Hemmings S, Barton C, Malliaras P, Maffulli N, Morrissey D. Conservative management of midportion Achilles tendinopathy: a mixed methods study, integrating systematic review and clinical reasoning. Sports Med. 2012 Nov 1;42(11):941-67. doi: 10.1007/BF03262305.

Reference Type BACKGROUND
PMID: 23006143 (View on PubMed)

Arnold MJ, Moody AL. Common Running Injuries: Evaluation and Management. Am Fam Physician. 2018 Apr 15;97(8):510-516.

Reference Type BACKGROUND
PMID: 29671490 (View on PubMed)

Hawks MK. Successful Treatment of Achilles Tendinopathy with Electroacupuncture: Two Cases. Med Acupunct. 2017 Jun 1;29(3):163-165. doi: 10.1089/acu.2017.1232.

Reference Type BACKGROUND
PMID: 28736593 (View on PubMed)

Breivik EK, Bjornsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin J Pain. 2000 Mar;16(1):22-8. doi: 10.1097/00002508-200003000-00005.

Reference Type BACKGROUND
PMID: 10741815 (View on PubMed)

Ludington E, Dexter F. Statistical analysis of total labor pain using the visual analog scale and application to studies of analgesic effectiveness during childbirth. Anesth Analg. 1998 Sep;87(3):723-7. doi: 10.1097/00000539-199809000-00045. No abstract available.

Reference Type BACKGROUND
PMID: 9728862 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

FWH20180170H

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Hamstring Tightness
NCT02516137 COMPLETED NA
Adverse Events in Dry Needling
NCT03612843 COMPLETED