Mid-portion Achilles Tendinopathy Musculoskeletal Diseases Mid-portion Achilles Tendinopathy
Conditions
Interventions
Participants will be screened for the eligibility criteria in an online video call. This includes specific questions surrounding the location of pain using a pain map, the nature of the pain, morning
Sponsors
University College Dublin
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Unilateral pain in the mid-portion (2-7 cm proximal to insertion) of the achilles tendon 2. Pain lasting =3 months 3. Experiencing morning pain or stiffness 4. Have access to a smartphone, computer, laptop, or tablet 5. Competent in written and spoken English and be able to provide consent
Exclusion criteria
Exclusion criteria: 1. Clinical suspicion of achilles tendon rupture 2. Previous achilles tendon surgery in symptomatic leg 3. Bilateral or insertional achilles tendinopathy 4. Co-existing foot or ankle pathology such as triognum syndrome, retro-calanceal bursitis, superficial calcaneal bursitis, or Haglund’s syndrome 5. Systemic disease such as ankylosing spondylitis or rheumatoid arthritis 6. Confounding lower limb injury 7. Metabolic or endocrine disorders, such as type I or II diabetes 8. Corticosteroid injection in/near the achilles tendon in the last 3 months 9. Condition that prevents the patients from executing an active exercise programme 10. Previously performed strength exercise rehabilitation for achilles pain 11.Use of fluoroquinoline antibiotics within the previous 2 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Disability measured using the Victorian Institute of Sport Assessment Questionnaire (VISA-A) for Achilles Tendinopathy at baseline, 6, and 12 weeks Feasibility outcomes: 1. Feasibility of daily Action Observation Therapy (AOT) twice a day from the participant's perspective using participant interviews at 6 and 12 weeks 2. Exploration of the relationship between Mid-portion Achilles Tendinopathy (AT), outcome measures, and AOT using participant interviews and specific outcome measures at 6 and 12 weeks 3. Exploration of the relationship between fear of movement, central sensitisation, and AOT using participant interviews at 6 and 12 weeks 4. Reflection on the AOT intervention protocol and amend if indicated using participant interviews at 6 and 12 weeks 5. Piloting the methodological procedures, including remote implementation measured using participant interviews at 6 and 12 weeks 6. Recruitment rate and actual numbers recruited measured using at 6 and 12 weeks 7. Numbers needed for a future large-scale randomised controlled trial determined using a power calculation at 12 weeks 8. Participant experience of participating in a telehealth intervention trial, and assessment of trial procedures, interventions, and outcome measures along with satisfaction through a qualitative exploration at 12 weeks | — |
Secondary
| Measure | Time frame |
|---|---|
| 1.Worst pain in the past week measured used the Numeric Pain Rating Scale (NPRS) at baseline, 6, and 12 weeks 2. Pain on loading measured with the hop test (with an aim to complete 25 hops on each leg) followed by rating pain using the NPRS at baseline, 6, and 12 weeks 3. Physical function capacity measured using the maximum number of single-leg heel raises on each side that individuals are able to perform at baseline, 6, and 12 weeks 4. Participation measured using the Lower Extremity Functional scale at baseline, 6, and 12 weeks 5. Psychological factors measured using the Pain Self-efficacy Questionnaire, a 10-item questionnaire, to assess an individual's level of confidence whilst completing certain activities; the Pain Catastrophising Scale, a multidimensional scale to assess an individuals’ experience of magnification, rumination and helplessness; and the Tampa scale for Kinesiophobia, a 17 item questionnaire, to assess fear of movement, at baseline, 6, and 12 weeks 6. Central processing measured using the Widespread Pain Index and symptoms severity (these measures are part of the fibromyalgia diagnostic criteria, and this tool will be adopted to capture features of central sensitisation) at baseline, 6, and 12 weeks 7. Quality of life measured using the Euroqol-5 dimension questionnaire (which assesses health, mobility, ability to self-care, ability to undertake usual activities, anxiety, and depression) at baseline, 6, and 12 weeks 8. Patients belief about the efficacy of treatment measured using the Patient Global Impression of Change (7-point scale ranging from very much worse to very much improved) at 6 and 12 weeks 9. Patient satisfaction measured using the patient satisfaction questionnaire at 6 and 12 weeks | — |
Countries
Ireland
Outcome results
None listed