Isometric Contraction-Based Pain Modulation Versus Eccentric Strengthening in Treating Achilles Tendinopathy

March 25, 2025 updated by: Muhammad Naveed Babur, Superior University
Achilles tendinopathy is a common overuse injury that leads to pain and functional limitations. Traditional rehabilitation focuses on eccentric strengthening, which has been widely studied for its benefits in promoting tendon remodeling and improving strength. However, recent research suggests that isometric contractions may offer superior pain modulation effects, especially in the early stages of rehabilitation.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

This study aims to compare the effectiveness of isometric contraction-based pain modulation versus eccentric strengthening in treating Achilles tendinopathy. Isometric exercises involve maintaining a static muscle contraction, which has been shown to reduce pain through neuromuscular mechanisms, potentially making it a valuable alternative or complement to eccentric loading.

Study Type

Interventional

Enrollment (Actual)

38

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan
        • Punjab Social Security Health Management Hospital Manga Raiwind

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Clinically Diagnosed with Achilles Tendinopathy using MRI
  • At least 3 months incidence period of Achilles Tendinopathy
  • Must be able to attend all treatment sessions and follow-up assessments.
  • Ability to walk independently without any assistive devices.

Exclusion Criteria:

  • Severely restricted ROM of ankle
  • Patients who underwent surgery for Achilles tendinopathy
  • Patients who had undergone previous surgery of lower limb extremity
  • Those using ankle orthosis
  • Patients with systemic diseases affecting ankle (osteoarthritis, rheumatoid arthritis, and osteoporosis)
  • Individuals with neurological disorders affecting the lower limbs.
  • Systemic Conditions like diabetes, cardiovascular diseases.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Isometric Contraction-Based Pain Modulation Protocol for Achilles Tendinopathy
Diagnostic test: Isometric Contraction-Based Pain Modulation Protocol for Achilles Tendinopathy
The standard recommendation for tendinopathy rehab became 30 to 45 second heavy isometric contractions repeated for 3 to 5 repetitions
Experimental: Eccentric Strengthening (Alfredson's Protocol for Achilles Tendinopathy )
Combination product: Eccentric Strengthening (Alfredson's Protocol for Achilles Tendinopathy )
The eccentric loading protocol, popularized by the research of Alfredson, consisted of 3 sets of 15 for both bent knee and straight knee heel raises with each heel lowering lasting 3-seconds

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
NUMERIC PAIN RATING SCALE (NPRS):
Time Frame: 12 Months
The Numeric Pain Rating Scale is a widely used, reliable, and user-friendly tool for assessing an individual's level of pain (NPRS). The patient is required to rate their level of discomfort using a self-reported scale with a range of 0 to 10, where ""0"" indicates no pain and ""10"" indicates the most excruciating pain.
12 Months
PRESSURE ALGOMETRY:
Time Frame: 12 Months
The pressure pain threshold (PPT), or the lowest force that causes pain in a particular body part, can be objectively measured using pressure algometry. To test sensitivity and identify shifts in pain perception, a portable instrument called a pressure algometer gently and gradually applies pressure to tissue, such as muscles or tendons. Pressure Algometry offers a methodical, objective way to measure pain sensitivity, which is commonly utilized in clinical and research contexts. It is frequently used to evaluate tenderness and pain in musculoskeletal issues, myofascial pain, and tendinopathy. Pressure algometry is a widely used tool to assess mechanical pain sensitivity by applying controlled pressure to a specific area and measuring the pain threshold. Its reliability is well-established, with intra-rater reliability coefficients ranging from 0.70 to 0.94, depending on the site of application and methodological consistency .
12 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Superior University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 20, 2025

Primary Completion (Estimated)

June 20, 2025

Study Completion (Estimated)

February 20, 2026

Study Registration Dates

First Submitted

March 25, 2025

First Submitted That Met QC Criteria

March 25, 2025

First Posted (Actual)

April 1, 2025

Study Record Updates

Last Update Posted (Actual)

April 1, 2025

Last Update Submitted That Met QC Criteria

March 25, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MSRSW/Batch-Fall23/789

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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