None listed
Conditions
Brief summary
Aim: To investigate acute changes in tendon volume and stiffness following different isometric load protocols among people with Achilles tendinopathy and healthy controls. setting: The proposed study will be conducted in the physiology laboratory located in Clayton campus of Monash University. participants: total number of 42 male participants (21 with midportion tendinopathy and 21 healthy matched), recruited from community. intervention: 3 different isometric protocols with different parameters performed on a custom-built dynamometer. the protocols have different load intensity and duration of contraction. each subject in the 2 groups will perform a single protocol per session and the interval between each session is one week. outcome measures: tendon volume, cross-sectional area, and stiffness will be measured at baseline and immediately following intervention using freehand 3-dimensional ultrasoud. secondary outcome: pressure pain threshold measured at baseline and immediately following interventions. discussion: the study will determine if a specific combination of load parameters could maximize volume changes among people with midportion tendinopathy and healthy controls
Interventions
A total of 3 isometric protocols with different load parameters will be performed by each participant in the two trial groups (healthy and midportion) in a random sequence. the participant will perform one isometric protocol per session and interval between each session is one week. intervention is isometric contractions performed on a custom-built dynamometer in the physiology laboratory located at Clayton campus of Monash University.
they will be seated on the dynamometer, hip flexed 120 degre
A total of 3 isometric protocols with different load parameters will be performed by each participant in the two trial groups (healthy and midportion) in a random sequence. the participant will perform one isometric protocol per session and interval between each session is one week. intervention is isometric contractions performed on a custom-built dynamometer in the physiology laboratory located at Clayton campus of Monash University. they will be seated on the dynamometer, hip flexed 120 degrees, knee extended and foot in neutral position supported on the footplate. protocol 1: subjects will perform isometric contractions and ramp-up within 1 sec. and hold the contraction for 1 sec at 75% MVC level. The duration of this intervention will be approximately 10-12 minutes. protocol 2: subjects will ramp-up within 1 sec. and hold the contraction for 7 sec. at 75% MVC level. The approximate duration for this intervention is 20 minutes. protocol 3: subject will ramp-up within 1 sec. and hold the contraction for 7 sec. at 35% MVC level. The approximate duration for this intervention is 20 minutes. for all protocols, subjects will do 4 sets of 10 repetitions. the rest time between sets is 3 minutes and between repetitions is 10 sec. visual feedback (monitor) will be in front of the subject and the exercise parameter will be guided by software guidelines. the researcher (Eman Merza) who is a PhD candidate will supervise and administers the protocols. this is a short-term intervention and adherence or fidelity is not assessed.
Sponsors
Associate Professor Peter Malliaras
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
Male
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
inclusion criteria for MAT group i)Male participants, aged from 18 to 70, ii) diagnosed with Achilles tendinopathy (midportion) based on the following criteria: a)Pain localized to the tendon (2-7cm above the calcaneum), b)Pain during or after Achilles loading (e.g. walking, running), c) Morning stiffness or pain on movement after rest, d) Ultrasound confirmation of midportion Achilles pathology (tendon thickening, hypoechoic regions), iii) history of Achilles pain > 3months, iv) Ankle joint examination, and especially passive plantar-flexion are essentially normal, v) score of <70 on the VISA-A questionnaire, vi) be willing not to receive any physical therapy or other treatment for their Achilles tendon pain during the study period (3 weeks), vii) be willing to attend the laboratory setting 3 times with one week interval between sessions to perform the isometric exercise interventions. viii)Fluent in both written and spoken English, and ix) Able to provide informed written consent. Inclusion criteria for healthy controls: i)healthy male participants, ii) aged from 18 to 70, iii) Fluent in both written and spoken English, and iv) Able to provide informed written consent
Exclusion criteria
exclusion criteria for MAT group i) Exercise treatment for Achilles tendon pain within the last 3 months, ii) Previous Achilles injection in the last 3 months, iii) History of Achilles rupture, iv) Surgery for Achilles tendinopathy, v) Systemic inflammatory disease (e.g. rheumatoid arthritis, ankylosing spondylitis), vi) Inherited connective tissue disorders (e.g Marfan’s syndrome), vii) People diagnosed with hypermobility joint syndrome (e.g. Ehlers-Danlos syndrome), viii) History of musculoskeletal injury of the affected lower limb in the last 6 to 12 months (ankle, knee or hip injury/pathology),ix) Injury or pathology to the spine that may interfere with execution of the exercise interventions in the study, xii) Participants undertaking antibiotic treatment in the last three months from start of recruitment (Fluoroquinolone antibiotics)., and xiii) Participants on cholesterol-lowering medications (Statins) in the last two years. Exclusion criteria for healthy controls: i)Participants with structural abnormalities in AT detected in the diagnostic ultrasound (tendon thickening, areas with hypoechogenicity), ii) history of lower limb injury and pathology of the dominant side in the last 6-12 months.
Outcome results
None listed