Comparative Effect of Accelerated Rehabilitation and Eccentric Strengthening Exercises on Patients With AT

NCT ID: NCT06905756

Last Updated: 2025-04-01

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-20
• Study Completion Date: 2026-02-20

Brief Summary

A common overuse injury to the Achilles tendon, Achilles tendinopathy frequently causes pain, restricted range of motion, and functional impairment.

Detailed Description

The purpose of this randomized clinical research is to evaluate the benefits of eccentric strengthening exercises and rapid rehabilitation on Achilles tendinopathy patients. Using techniques including TENS, isometric exercises, balance training, and endurance exercises, the 12-week accelerated rehabilitation program emphasizes pain management, mobility restoration, and functional recovery through incremental phases. However, in order to improve tendon strength and resilience, eccentric strengthening entails progressively raising resistance and functional loading. Both approaches are backed by earlier research but lack direct comparison in terms of effectiveness. This study will open the door for more research and improve rehabilitation techniques worldwide by adding to the expanding corpus of material on Achilles tendinopathy care.

Conditions

Achilles Tendinopathy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Accelerated rehabilitation

Group Type: EXPERIMENTAL

Accelerated rehabilitation

Intervention Type: DIAGNOSTIC_TEST

15 subjects in group A will be receiving Accelerated Rehabilitation protocol alongwith baseline treatment. Accelerated rehabilitation consisting of three phases, following 12 week exercise regime. Pain reduction, mobility, strengthening, and functional recovery are part of the accelerated rehabilitation protocol for Achilles tendinopathy. Ice, TENS, range-of-motion exercises, isometric calf contractions, and a progressive transition to full weight-bearing based are the mainstays of Phase 1 (Weeks 1-4). Phase 2 (Weeks 5-8) focuses on balance training, resistance band exercises, and seated and standing calf raises as well as light functional workouts like cycling or walking. Phase 3 (Weeks 9-12) progresses to sport-specific and endurance exercises like swimming or running after including plyometric drills, eccentric heel drops, and advanced strengthening. Each exercise will be performed under supervision of skilled physiotherapist for 2 times daily, 2 sets of 5 repetitions.

Eccentric strengthening exercises

Group Type: EXPERIMENTAL

Eccentric strengthening exercises

Intervention Type: COMBINATION_PRODUCT

Group B will be receiving eccentric strengthening exercises alongwith baseline treatment. Techniques of Curwin, Stanish et al will be used for eccentric training. For every exercise, participants do three sets of 15 repetitions, with a 30-second break in between. Weight is added gradually to enhance resistance (5-10 lbs or more, depending on tolerance). The eccentric strengthening regimen for Achilles tendinopathy advances every week. Participants use both feet without dorsiflexion to perform eccentric contractions in Week 1. By Week 3, the focus of the workouts is on the injured foot in maximum dorsiflexion. In Week 4, 10% body weight resistance is introduced, and in Week 5, an extra 5-10 pounds. From Week 6 to Week 8, resistance rises every two weeks. From Weeks 9 to 12, functional motions like hopping, single-leg heel drops, and sport-specific drills are incorporated, all of which are customized to meet individual goals.

Interventions

Accelerated rehabilitation

15 subjects in group A will be receiving Accelerated Rehabilitation protocol alongwith baseline treatment. Accelerated rehabilitation consisting of three phases, following 12 week exercise regime. Pain reduction, mobility, strengthening, and functional recovery are part of the accelerated rehabilitation protocol for Achilles tendinopathy. Ice, TENS, range-of-motion exercises, isometric calf contractions, and a progressive transition to full weight-bearing based are the mainstays of Phase 1 (Weeks 1-4). Phase 2 (Weeks 5-8) focuses on balance training, resistance band exercises, and seated and standing calf raises as well as light functional workouts like cycling or walking. Phase 3 (Weeks 9-12) progresses to sport-specific and endurance exercises like swimming or running after including plyometric drills, eccentric heel drops, and advanced strengthening. Each exercise will be performed under supervision of skilled physiotherapist for 2 times daily, 2 sets of 5 repetitions.

Intervention Type: DIAGNOSTIC_TEST

Eccentric strengthening exercises

Group B will be receiving eccentric strengthening exercises alongwith baseline treatment. Techniques of Curwin, Stanish et al will be used for eccentric training. For every exercise, participants do three sets of 15 repetitions, with a 30-second break in between. Weight is added gradually to enhance resistance (5-10 lbs or more, depending on tolerance). The eccentric strengthening regimen for Achilles tendinopathy advances every week. Participants use both feet without dorsiflexion to perform eccentric contractions in Week 1. By Week 3, the focus of the workouts is on the injured foot in maximum dorsiflexion. In Week 4, 10% body weight resistance is introduced, and in Week 5, an extra 5-10 pounds. From Week 6 to Week 8, resistance rises every two weeks. From Weeks 9 to 12, functional motions like hopping, single-leg heel drops, and sport-specific drills are incorporated, all of which are customized to meet individual goals.

Intervention Type: COMBINATION_PRODUCT

Eligibility Criteria

Inclusion Criteria

• Male and female patients, age greater than 18 years, clinically diagnosed with Achilles tendinopathy.
• Participants that are clinically diagnosed with Achilles tendinopathy.
• Duration of symptoms or pain for more than 1 month.
• Positive clinical tests, such as Thompson test, confirming Achilles tendinopathy.
• Tenderness to palpation along the Achilles tendon or localized pain during activity.
• Patients with a history of overuse injuries related to repetitive activities, such as running or jumping.

Exclusion Criteria

• Following participants will be excluded from this study:
• Presence of systemic conditions such as rheumatoid arthritis, diabetes, or other inflammatory or neuromuscular disorders.
• History of complete Achilles tendon rupture or previous surgical intervention on the affected tendon.
• Patients with other lower limb injuries or conditions (e.g., fractures, ligament tears) that could interfere with Achilles tendinopathy treatment.
• Severe tendon degeneration or calcification confirmed by imaging, unsuitable for rehabilitation.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Superior University

OTHER

Sponsor Role: lead

Responsible Party

Muhammad Naveed Babur

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Punjab Social Security Health Management Hospital Manga Raiwind

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

MSRSW/Batch-Fall23/788

Identifier Type: -

Identifier Source: org_study_id