Achilles Tendinopathy, Pain, Chronic, Tendon Injuries, Tendon Thickening
Conditions
Keywords
Achilles tendinopathy, VISA-A, Ultrasound, Stiffness, Competitive athletes, Exercise therapy, Alfredson protocol, Silbernagel protocol
Brief summary
A 6-week randomized clinical trial (RCT) with a 46-week follow-up compared the effect of Alfredson and Silbernagel eccentric programs for the treatment of AT. The primary outcome was a change in the Victorian Institute of Sport Assessment - Achilles (VISA-A) scale from baseline to 12 months. The study was approved by the Ethics Committee of the Faculty of Physical Education and Sport, Charles University (Project number: 254/2021). All participants provided written informed consent before participation.
Interventions
OTHERAlfredson protocol
Alfredson eccentric therapeutical protocol.
OTHERSilbernagel protocol
Silbernagel concentric-eccentric protocol.
Sponsors
Charles University, Czech Republic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Athletes performing track and field, tennis or football at the competitive level * Age 18 to 40 years * Unilateral Achilles tendinopathy * Pain lasting more than 2 months * Diagnosis of Achilles tendinopathy established by pain on function at the Achilles region and ultrasound assessment (tendon thickening, swollen tendon) by one researcher * Participants trained at least 3 times per week before the onset of Achilles tendinopathy * Less than 3 months without training and less than 6 months from the last competition/match * Wish to return to original sport level * Willing to stop with other treatments 2 weeks before the start of the clinical trial
Exclusion criteria
* Achilles tendon rupture in past * Corticosteroid injection in Achilles tendon region in last 6 months * Having other lower limb musculoskeletal injuries or surgery in the last 6 months (e.g., muscle rupture, bone fracture) * Having a neurological, systemic or autoimmune disease (e.g., neuropathy, type 1 diabetes, rheumatoid arthritis)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Victorian Institute of Sport Assessment - Achilles (VISA-A) | 1 year | The VISA-A questionnaire is the most commonly used outcome in clinical trials of Achilles tendinopathy treatment with proven reliability and validity. It consists of eight questions covering pain, function, daily living and sports activities. The score ranges from 0-100 where 0 means disability (impairment of function and pain of Achilles tendon) and 100 represents no disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biomechanical properties - stiffness | 6 weeks | Achilles tendon stiffness (N/m) is a measure of the biomechanical response of the Achilles tendon tissue. Stiffness was assessed by MyotonPro (Myoton AS), which has been shown as a valid and reliable measurement tool of Achilles tendon mechanical properties in the clinical setting. |
| Structure - micromorphology | 6 weeks | Fibre organisation analysis of PSFR (mmˆ-1). |
Countries
Czechia
Outcome results
None listed