QUANTIFY: Quantitative Understanding of Advanced Novel Techniques for Imaging Fasciitis and Yielding Biomarkers

NCT ID: NCT06803056

Last Updated: 2025-10-07

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

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-22

Study Completion Date

2026-08-31

Brief Summary

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This study is to create a test that can accurately find and measure the problem areas in muscle and fascia tissue, also known as myofascial pain. The hypothesis is that a combination of imaging findings will be able to detect when myofascial pain is present. The goal is to improve management of myofascial pain by making better tools to find changes in the muscle and fascia tissues for a more personalized treatment. This project was funded by the HEAL initiative (https://heal.nih.gov/).

Detailed Description

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The objective of the R61 phase is to use novel imaging techniques to develop a diagnostic biosignature to objectively and accurately determine the location and severity of abnormal myofascial tissue. A cross-sectional study design approach with 3 groups: plantar fasciitis (n=50), Achilles tendinopathy (n=25), and pain-free controls (n=25) to test Specific Aim: Develop a diagnostic imaging biosignature of myofascial tissue to differentiate individuals with plantar fasciitis from other foot pain without a myofascial component (Achilles tendinopathy) and from matched pain-free controls.

The goal is to develop a diagnostic imaging biosignature that will be able to distinguish between A-MTrP in individuals with plantar fasciitis compared to healthy tissue control (pain-free controls). The biosignature developed in this R61 phase will be screened for clinical utility and considered of interest for further study if it meets the following milestone criteria: area under the receiver operating characteristic curve (ROC AUC) \>0.7, sensitivity \>60%, and specificity \>60%. The ROC analysis will estimate diagnostic performance by comparing differences in biosignatures between tissue where myofascial pain is present vs. tissue where pain is absent.

The proposed sample size of 50 individuals with plantar fasciitis, 25 individuals with Achilles tendinopathy, and 25 matched controls was chosen to provide a confidence interval halfwidth of 0.10 for an AUC of 0.70, assuming 5 muscle measurements for each participant and an overall A-MTrPs prevalence of 0.36 in individuals with plantar fasciitis. Further assuming the 20 biomarkers to be considered in the R61 phase have AUCs uniformly distributed from 0.5 to 0.8, will have at least 85% power to obtain a biosignature meeting the milestone criteria.

Conditions

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Plantar Fasciopathy Achilles Tendinopathy Controls

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

All participants will complete a clinical exam of the foot and ankle to identify painful myofascial tissue. All participants will subsequently have magnetic resonance imaging and ultrasound imaging of their foot and ankle.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic imaging

All participants will have a clinical exam, magnetic resonance imaging, and ultrasound imaging of their foot and ankle.

Group Type OTHER

Clinical exam

Intervention Type DIAGNOSTIC_TEST

An experienced physical therapist with expertise in dry needling will confirm study eligibility and complete a standard clinical exam for myofascial pain. Gold standard for diagnosing myofascial pain as defined by Travell and Simons will be used. The criteria for muscle trigger point (TrP) include: 1) a taut band of skeletal muscle that is tender to palpation, 2) sustained compression of the taut band reproduces or exacerbates the participant's symptoms. Healthy tissue is defined as no palpable taut band.

Ultrasound imaging

Intervention Type DIAGNOSTIC_TEST

Shear wave elastography and b-mode ultrasound imaging techniques will capture the biomechanical and structural profile of foot and ankle muscle on the involved side.

Magnetic Resonance Imaging

Intervention Type DIAGNOSTIC_TEST

T1rho and IDEAL sequences will be used to capture the biochemical and structural profile of foot and ankle muscles on the involved side

Interventions

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Clinical exam

An experienced physical therapist with expertise in dry needling will confirm study eligibility and complete a standard clinical exam for myofascial pain. Gold standard for diagnosing myofascial pain as defined by Travell and Simons will be used. The criteria for muscle trigger point (TrP) include: 1) a taut band of skeletal muscle that is tender to palpation, 2) sustained compression of the taut band reproduces or exacerbates the participant's symptoms. Healthy tissue is defined as no palpable taut band.

Intervention Type DIAGNOSTIC_TEST

Ultrasound imaging

Shear wave elastography and b-mode ultrasound imaging techniques will capture the biomechanical and structural profile of foot and ankle muscle on the involved side.

Intervention Type DIAGNOSTIC_TEST

Magnetic Resonance Imaging

T1rho and IDEAL sequences will be used to capture the biochemical and structural profile of foot and ankle muscles on the involved side

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of plantar fasciitis
* Duration of plantar fasciitis pain greater than or equal to 3 months
* Severity of plantar fasciitis pain greater than or equal to 3/10


* Clinical diagnosis of insertional Achilles tendinopathy:
* Duration of Achilles tendinopathy pain greater than or equal to 3 months
* Severity of Achilles tendon pain greater than or equal to 3/10

Control group:

• Similar age, sex, and BMI as plantar fasciitis and Achilles tendinopathy groups

Exclusion Criteria

* Younger than 18 years of age
* History of an invasive procedures to the foot and ankle on the side of interest
* History of lower extremity injections, dry needling, or EPAT/ESWT within past 3 months on the side of interest
* Contraindications for MRI (e.g. non-MR compatible implanted devices, claustrophobia, inability to remain still comfortably for 1 hour in a supine position, body size too large for MR scanner)
* Clinically unstable medical or psychiatric issues
* Pregnant or possibly pregnant
* Co-morbidities associated with changes in musculoskeletal imaging, including: Diagnosed systemic conditions affecting the foot and ankle (e.g., rheumatoid arthritis, spondyloarthropathy, gout) endocrine disorder with complications (e.g., uncontrolled Type I or II diabetes, diabetic peripheral neuropathy) Neuromuscular diseases (e.g., Charcot-Marie-Tooth (CMT) disease) Connective tissue disorder (e.g. Marfan's syndrome, Ehlers-Danlos) Osteoarthritis of the foot or ankle History of foot or ankle fracture Infection of the foot or ankle (e.g., infectious fasciitis, calcaneal osteomyelitis) within the past year Familial hypercholesterolemia Neoplasms involving the foot, Plantar fibromatosis
* Control group only: Persistent or recurrent leg pain in the past 6 months
* Plantar fasciitis and Achilles tendinopathy groups only: Other source of heel or foot pain (e.g., tarsal tunnel syndrome, peripheral neuropathy, lumbar radiculopathy, calcaneal stress fracture, Morton's neuroma, fibromyalgia) or co-occurring plantar fasciitis and Achilles tendinopathy (for the Achilles tendinopathy group).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Center for Complementary and Integrative Health (NCCIH)

NIH

Sponsor Role collaborator

Rochester Institute of Technology

OTHER

Sponsor Role collaborator

Ruth Chimenti

OTHER

Sponsor Role lead

Responsible Party

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Ruth Chimenti

Assistant Professor, Physical Therapy and Rehabilitation Science

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Kathleen Sluka, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

James Holmes, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Ruth L Chimenti, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Locations

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University of Iowa Health Care

Iowa City, Iowa, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jing Danielson, DDS

Role: CONTACT

319-356-1722

Jessica Danielson, DDS

Role: CONTACT

319-356-9791

Facility Contacts

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Jessica Danielson, DDS

Role: primary

319-335-9791

Jessica Danielson, DDS

Role: backup

319-356-1722

Other Identifiers

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R61AT012275

Identifier Type: NIH

Identifier Source: secondary_id

View Link

202409110

Identifier Type: -

Identifier Source: org_study_id

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