Comparative Effect of Accelerated Rehabilitation and Eccentric Strengthening Exercises on Patients With AT

Compartive Effect of Accelerated Rehabilitation and Eccentric Strengthing Exercises on Patient With Achilles Tendinopathy

A common overuse injury to the Achilles tendon, Achilles tendinopathy frequently causes pain, restricted range of motion, and functional impairment.

Study Overview

• Status: Active, not recruiting
• Conditions: Achilles Tendinopathy
• Intervention / Treatment: Diagnostic test: Accelerated rehabilitation; Combination product: Eccentric strengthening exercises

Detailed Description

The purpose of this randomized clinical research is to evaluate the benefits of eccentric strengthening exercises and rapid rehabilitation on Achilles tendinopathy patients. Using techniques including TENS, isometric exercises, balance training, and endurance exercises, the 12-week accelerated rehabilitation program emphasizes pain management, mobility restoration, and functional recovery through incremental phases. However, in order to improve tendon strength and resilience, eccentric strengthening entails progressively raising resistance and functional loading. Both approaches are backed by earlier research but lack direct comparison in terms of effectiveness. This study will open the door for more research and improve rehabilitation techniques worldwide by adding to the expanding corpus of material on Achilles tendinopathy care.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male and female patients, age greater than 18 years, clinically diagnosed with Achilles tendinopathy.
• Participants that are clinically diagnosed with Achilles tendinopathy.
• Duration of symptoms or pain for more than 1 month.
• Positive clinical tests, such as Thompson test, confirming Achilles tendinopathy.
• Tenderness to palpation along the Achilles tendon or localized pain during activity.
• Patients with a history of overuse injuries related to repetitive activities, such as running or jumping.

Exclusion Criteria:

• Following participants will be excluded from this study:
• Presence of systemic conditions such as rheumatoid arthritis, diabetes, or other inflammatory or neuromuscular disorders.
• History of complete Achilles tendon rupture or previous surgical intervention on the affected tendon.
• Patients with other lower limb injuries or conditions (e.g., fractures, ligament tears) that could interfere with Achilles tendinopathy treatment.
• Severe tendon degeneration or calcification confirmed by imaging, unsuitable for rehabilitation.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Accelerated rehabilitation	Diagnostic test: Accelerated rehabilitation; 15 subjects in group A will be receiving Accelerated Rehabilitation protocol alongwith baseline treatment. Accelerated rehabilitation consisting of three phases, following 12 week exercise regime. Pain reduction, mobility, strengthening, and functional recovery are part of the accelerated rehabilitation protocol for Achilles tendinopathy. Ice, TENS, range-of-motion exercises, isometric calf contractions, and a progressive transition to full weight-bearing based are the mainstays of Phase 1 (Weeks 1-4). Phase 2 (Weeks 5-8) focuses on balance training, resistance band exercises, and seated and standing calf raises as well as light functional workouts like cycling or walking. Phase 3 (Weeks 9-12) progresses to sport-specific and endurance exercises like swimming or running after including plyometric drills, eccentric heel drops, and advanced strengthening. Each exercise will be performed under supervision of skilled physiotherapist for 2 times daily, 2 sets of 5 repetitions.
Experimental: Eccentric strengthening exercises	Combination product: Eccentric strengthening exercises; Group B will be receiving eccentric strengthening exercises alongwith baseline treatment. Techniques of Curwin, Stanish et al will be used for eccentric training. For every exercise, participants do three sets of 15 repetitions, with a 30-second break in between. Weight is added gradually to enhance resistance (5-10 lbs or more, depending on tolerance). The eccentric strengthening regimen for Achilles tendinopathy advances every week. Participants use both feet without dorsiflexion to perform eccentric contractions in Week 1. By Week 3, the focus of the workouts is on the injured foot in maximum dorsiflexion. In Week 4, 10% body weight resistance is introduced, and in Week 5, an extra 5-10 pounds. From Week 6 to Week 8, resistance rises every two weeks. From Weeks 9 to 12, functional motions like hopping, single-leg heel drops, and sport-specific drills are incorporated, all of which are customized to meet individual goals.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numerical pain rating scale	The Pain Scale has a numerical rating system (NRS) with 11 points, with 0 denoting no pain and 10 denoting the most excruciating pain. The following categories apply to scores: 0= denotes no pain 1-3= mild pain 4-6=moderate pain 7-10= severe pain.(12)	12 Months
WHOQOL (world health organization and quality of life)	The WHOQOL uses 26 questions to calculate quality of life across the four domains. Each item is scored on a 5-point Likert scale (1 to 5), where higher scores indicate a better quality of life, lower score indicate, poor quality of life. Average total score for healthy populations is about 90. 0-20 = Poor Quality of Life 21-40 = Moderate Quality of Life 41-60 = Good Quality of Life 61-80 or greater than 80 = Very Good Quality of life.	12 Months

Collaborators and Investigators

• Sponsor: Superior University

Study record dates

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: Musculoskeletal Diseases; Muscular Diseases; Wounds and Injuries; Tendon Injuries; Tendinopathy
• Other Study ID Numbers: MSRSW/Batch-Fall23/788

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