Responsiveness of Quantitative Musculoskeletal Ultrasound Measures on the Healing of Achilles Tendon
NCT ID: NCT04651985
Last Updated: 2022-11-03
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
30 participants
OBSERVATIONAL
2021-08-31
2022-07-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Injured Achilles tendon participants who have an Achilles tendinopathy
They will do the eccentric exercise protocol and go through a series of ultrasound examination.
Eccentric strengthening exercises of the Achilles tendon
This exercise will require the completion of slow active eccentric plantar flexion exercises with the forefoot positioned over the edge of a step. These exercises will be repeated twice daily (three sets of 15 repetitions with the knee in extension and three sets of 15 repetitions with the knee in flexion) during a three-month period. The amount of loading will be calibrated and progressed on a weekly basis by the physiotherapist according the participant's perceived effort and pain intensity.
Healthy Achilles tendon (contralateral) of participants who have an Achilles tendinopathy
They will do the eccentric exercise protocol and go through a series of ultrasound examination.
Eccentric strengthening exercises of the Achilles tendon
This exercise will require the completion of slow active eccentric plantar flexion exercises with the forefoot positioned over the edge of a step. These exercises will be repeated twice daily (three sets of 15 repetitions with the knee in extension and three sets of 15 repetitions with the knee in flexion) during a three-month period. The amount of loading will be calibrated and progressed on a weekly basis by the physiotherapist according the participant's perceived effort and pain intensity.
Interventions
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Eccentric strengthening exercises of the Achilles tendon
This exercise will require the completion of slow active eccentric plantar flexion exercises with the forefoot positioned over the edge of a step. These exercises will be repeated twice daily (three sets of 15 repetitions with the knee in extension and three sets of 15 repetitions with the knee in flexion) during a three-month period. The amount of loading will be calibrated and progressed on a weekly basis by the physiotherapist according the participant's perceived effort and pain intensity.
Eligibility Criteria
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Inclusion Criteria
* AT signs objectified by the physical exam and the ultrasound imaging at the initial evaluation
* At least 18 years old
* Victorian Institute of Sport Assessment-Achilles Questionnaire (VISA-A) score below 90
* have pain of at least 3 out of 10 according to the analog visual scale during athletic activities
Exclusion Criteria
* A complete rupture of the Achilles tendon History of Achilles tendon rupture Inflammatory arthropathy
* Sign of neurological lesion on physical examination of the lower limb
* Neurological disease (e.g. multiple sclerosis, stroke)
* History of intervention of the Achilles tendon or ankle (e.g. surgery, cortisone infiltration, extracorporeal shock waves therapy, platelet-rich plasma injection).
18 Years
99 Years
ALL
No
Sponsors
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Centre hospitalier de l'Université de Montréal (CHUM)
OTHER
Responsible Party
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Principal Investigators
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Martin Lamontagne, MD
Role: PRINCIPAL_INVESTIGATOR
Centre Hospitalier Universitaire de Montreal (CHUM)
Locations
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Hôpital Hôtel-Dieu de Montreal
Montreal, Quebec, Canada
Countries
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References
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Alfredson H, Pietila T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med. 1998 May-Jun;26(3):360-6. doi: 10.1177/03635465980260030301.
Beyer R, Kongsgaard M, Hougs Kjaer B, Ohlenschlaeger T, Kjaer M, Magnusson SP. Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial. Am J Sports Med. 2015 Jul;43(7):1704-11. doi: 10.1177/0363546515584760. Epub 2015 May 27.
Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83.
Cardoso TB, Pizzari T, Kinsella R, Hope D, Cook JL. Current trends in tendinopathy management. Best Pract Res Clin Rheumatol. 2019 Feb;33(1):122-140. doi: 10.1016/j.berh.2019.02.001. Epub 2019 Mar 8.
Collinger JL, Fullerton B, Impink BG, Koontz AM, Boninger ML. Validation of grayscale-based quantitative ultrasound in manual wheelchair users: relationship to established clinical measures of shoulder pathology. Am J Phys Med Rehabil. 2010 May;89(5):390-400. doi: 10.1097/PHM.0b013e3181d8a238.
de Jonge S, van den Berg C, de Vos RJ, van der Heide HJ, Weir A, Verhaar JA, Bierma-Zeinstra SM, Tol JL. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med. 2011 Oct;45(13):1026-8. doi: 10.1136/bjsports-2011-090342.
Farnqvist K, Pearson S, Malliaras P. Adaptation of Tendon Structure and Function in Tendinopathy With Exercise and Its Relationship to Clinical Outcome. J Sport Rehabil. 2020 Jan 1;29(1):107-115. doi: 10.1123/jsr.2018-0353.
Kudron C, Carlson MJ, Meron A, Sridhar B, Brakke Holman R. Using Ultrasound Measurement of the Achilles Tendon in Asymptomatic Runners to Assist in Predicting Tendinopathy. J Ultrasound Med. 2020 Mar;39(3):491-496. doi: 10.1002/jum.15125. Epub 2019 Sep 6.
Lalumiere M, Lariviere C, Nadeau MJ, Paquette P, Lamontagne M, Desmeules F, Gagnon DH. Proposing a Minimal Data Set of Musculoskeletal Ultrasound Imaging Biomarkers to Inform Clinical Practice: An Analysis Founded on the Achilles Tendon. Ultrasound Med Biol. 2020 Sep;46(9):2222-2235. doi: 10.1016/j.ultrasmedbio.2020.04.024. Epub 2020 Jun 8.
McAuliffe S, Tabuena A, McCreesh K, O'Keeffe M, Hurley J, Comyns T, Purtill H, O'Neill S, O'Sullivan K. Altered Strength Profile in Achilles Tendinopathy: A Systematic Review and Meta-Analysis. J Athl Train. 2019 Aug;54(8):889-900. doi: 10.4085/1062-6050-43-18. Epub 2019 Aug 6.
Nadeau MJ, Desrochers A, Lamontagne M, Lariviere C, Gagnon DH. Quantitative ultrasound imaging of Achilles tendon integrity in symptomatic and asymptomatic individuals: reliability and minimal detectable change. J Foot Ankle Res. 2016 Aug 17;9:30. doi: 10.1186/s13047-016-0164-3. eCollection 2016.
Ortega-Avila AB, Reina-Martin I, Cervera-Garvi P, Lopezosa-Reca E, Cabello-Manrique D, Gijon-Nogueron G. Systematic review of the psychometric properties of the Victorian Institute of Sports Assessment - Achilles tendinopathy questionnaire. Disabil Rehabil. 2021 Apr;43(8):1056-1064. doi: 10.1080/09638288.2019.1652701. Epub 2019 Aug 20.
Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983 Sep;17(1):45-56. doi: 10.1016/0304-3959(83)90126-4.
Wearing SC, Grigg NL, Hooper SL, Smeathers JE. Conditioning of the Achilles tendon via ankle exercise improves correlations between sonographic measures of tendon thickness and body anthropometry. J Appl Physiol (1985). 2011 May;110(5):1384-9. doi: 10.1152/japplphysiol.00075.2011. Epub 2011 Mar 10.
Rompe JD, Nafe B, Furia JP, Maffulli N. Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis: a randomized controlled trial. Am J Sports Med. 2007 Mar;35(3):374-83. doi: 10.1177/0363546506295940. Epub 2007 Jan 23.
Sunding K, Fahlstrom M, Werner S, Forssblad M, Willberg L. Evaluation of Achilles and patellar tendinopathy with greyscale ultrasound and colour Doppler: using a four-grade scale. Knee Surg Sports Traumatol Arthrosc. 2016 Jun;24(6):1988-96. doi: 10.1007/s00167-014-3270-4. Epub 2014 Sep 6.
Other Identifiers
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2021-9100
Identifier Type: -
Identifier Source: org_study_id
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