- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05456620
Effectiveness of Reducing Tendon Compression in the Treatment of Insertional Achilles Tendinopathy (GhenTendon)
Effectiveness of Reducing Tendon Compression in the Treatment of Insertional Achilles Tendinopathy: a Randomised Clinical Trial
Insertional Achilles tendinopathy is a disabling injury that is common in running athletes. Exercise therapy is considered the best treatment option, but there is still no agreement on the modalities. For example, it is thought that compression overload may be a major cause of tendinopathy and should therefore be restricted during rehabilitation. However, this recommendation is based on expert opinion and not on hard scientific evidence. Therefore, this randomised controlled trial (RCT) will investigate whether a therapy that limits the amount of compression of the tendon during a progressive tendon-loading rehabilitation protocol actually has better outcomes in athletes with insertional Achilles tendinopathy.
28 athletes with insertional Achilles tendinopathy will be randomised into two treatment groups; (1) an experimental 12-week rehabilitation protocol in which the amount of tendon compression is limited and (2) a 12-week control rehabilitation protocol in which the amount of tendon compression is not limited and is rather high. Both treatments consist of supervised progressive tendon-loading exercise therapy and patient education. In addition, the experimental group will also receive heel inserts to limit the amount of dorsiflexion during sports or daily activities. At baseline, at 12 weeks (end of intervention) and at 24 weeks (follow-up), pain, functionality, structure and intratendinous pressure will be determined.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lauren Pringels
- Phone Number: +3293321260
- Email: lauren.pringels@ugent.be
Study Locations
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Ghent, Belgium, 9000
- Department of rehabilitation sciences
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-60 years old
- Diagnosed with insertional Achilles Tendinopathy by a sports medicine physician
- Have experienced symptoms for more than 3 months and less than 3 years
- Playing running-based sports at least twice a week
Exclusion Criteria:
- Have a history of Achilles tendon rupture or surgery
- Have other disorders of the Achilles tendon or ankle (mid-portional Achilles tendinopathy, paratenonitis, osteoarthritis,...)
- Have rheumatological disorder (e.g. Spondylitis Ankylosis)
- Have metabolic or endocrine disorders, such as type I or type II diabetes
- Have had an Achilles injection in the past 3 months
- Have other conditions that prevent following an active exercise programme
- Have already been treated with physiotherapy, shockwave therapy or orthotics in the past 3 months
- Medication use with (fluoro)quinolones antibiotic in the past 2 years
- Currently pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Low Tendon Compression Rehabilitation (LTCR)
A progressive, criteria-based, 4-stage exercise protocol in which the amount of tendon compression is limited (12 weeks).
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The intervention treatment consists of a progressive 4-stage, criteria-based exercise protocol, in which the amount of tendon compression is limited. This includes:
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Active Comparator: High Tendon Compression Rehabilitation (HTCR)
A progressive, criteria-based, 4-stage exercise protocol in which the amount of tendon compression is not limited (12 weeks).
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The control treatment consists of a progressive 4-phase, criteria-based exercise protocol, in which the amount of tendon compression is not limited. This includes:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change of the Victorian Institute of Sports Assessment-Achilles Questionnaire (VISA-A) score over 12 weeks
Time Frame: 12 weeks (at the end of intervention)
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The VISA-A score is a measure of pain and lower limb function (disability) associated with Achilles tendinopathy.
A higher score indicates a better outcome and a 10 point increase is accepted as being clinically meaningful.
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12 weeks (at the end of intervention)
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The change of the Victorian Institute of Sports Assessment-Achilles Questionnaire (VISA-A) score over 24 weeks
Time Frame: 24 weeks (at follow-up)
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The VISA-A score is a measure of pain and lower limb function (disability) associated with Achilles tendinopathy.
A higher score indicates a better outcome and a 10 point increase is accepted as being clinically meaningful.
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24 weeks (at follow-up)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Subjective patient satisfaction
Time Frame: This will be assessed at the end of the intervention (week 12) and at follow-up (week 24).
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Patient overall rating: excellent / good / fair / poor
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This will be assessed at the end of the intervention (week 12) and at follow-up (week 24).
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Return to sports rate
Time Frame: This will be assessed at the end of the intervention (week 12) and at follow-up (week 24).
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Participation: return to desired sport on pre-injury level / return to desired sport but on a lower level / return to sports but not desired sport / no return to sports
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This will be assessed at the end of the intervention (week 12) and at follow-up (week 24).
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Hop test
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Self-reported pain rating on a Visual Analogue Scale (VAS) during a single leg hop test
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Lower Extremity Functional Scale
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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The lower extremity functional scale (LEFS) is a valid patient-rated outcome measure for the measurement of lower extremity function.
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Tampa scale for kinesiophobia (TSK)
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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The TSK is a 17-item self report checklist using a 4-point Likert scale that was developed as a measure of fear of movement or (re)injury.
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Heel-raise test
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Participants will have to perform heel raises in standing position until thay are fatigued.
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Health status using the EuroQol 5 Dimension 5 Level (EQ-5D-5L) questionnaire
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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The EQ-5D-5L is a self-assessed, health related, quality of life questionnaire.
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Compliance
Time Frame: This will be assessed weekly until the end of the intervention.
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Compliance to the exercise programme and orthotics (total percentage of prescription) will be assessed using a short online questionnaire.
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This will be assessed weekly until the end of the intervention.
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Adverse effects
Time Frame: This will be assessed weekly until the end of the intervention.
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Adverse effects resulting from the intervention
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This will be assessed weekly until the end of the intervention.
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Credibility/Expectations Questionnaire
Time Frame: This wel be assessed at the start of the intervention (week 0)
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As participants are not blinded about their assigned intervention, it is important to determine their beliefs about the treatment.
With this in mind, participants will complete the Credibility/Expectations Questionnaire (CEQ) after being assigned to an intervention group.
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This wel be assessed at the start of the intervention (week 0)
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Ultrasound examination to assess the tendon structure
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Anteroposterior thickness - Neovascularisation (modified-Öhberg scale)
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Pain rating (VAS) during activities of daily living
Time Frame: This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Self-reported pain (VAS, 0-100 mm) during activities of daily living over the last seven days.
A higher score indicates more pain.
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This will be assessed at the start (week 0), at the end of the intervention (week 12) and at follow-up (week 24).
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Pain monitoring
Time Frame: This will be assessed weekly until the end of the intervention.
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Numeric Pain Rating Scale (NRS, 0-10) during exercises, after exercises and in the morning will be assessed.
A higher score indicates more pain.
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This will be assessed weekly until the end of the intervention.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Luc Vanden Bossche, Department of Rehabilitation Sciences, Ghent University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BC-11818
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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