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Ultrasound-Monitored Changes in Achilles Tendinopathy After Extracorporeal Shock Wave Therapy

25 juin 2021 mis à jour par: Stanislav Machač, Ph.D, University Hospital, Motol

The Ultrasound-Monitored Changes in Achilles Tendinopathy After Focused Extracorporeal Shock Wave Therapy - a Randomized Sham-Controlled Trial

This study is designed as a randomized, placebo-controlled clinical trial in which we monitor the effects of low-energy focused extracorporeal shockwave therapy (ESWT) in patients with Achilles tendinopathy (AT). Participants will be randomly divided into two groups. ESWT according to selected parameters will be applied to Group A. Group B will receive sham ESWT.

Patients in both groups will have the same program. The research for one patient lasts a total of 8 weeks (2 months) from the initial to the final examination. In the first week, there will be a clinical examination by a physiotherapist, an ultrasonographic examination, and the patient will complete a VISA-A questionnaire. At the end of the examination, the patient will be randomly assigned to group A or B and receive the first application. For the next 4 weeks, additional applications will be performed once a week. The interval between individual applications should be at least 7 days. Thus, a total of 5 applications of ESWT or sham ESWT will be performed. The final examination will take place 3 weeks after the last application and will include the same procedures as for the initial examination.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

This study is designed as a randomized, placebo-controlled clinical trial in which we monitor the effects of low-energy focused extracorporeal shockwave therapy (ESWT) in patients with Achilles tendinopathy (AT). Participants will be randomly divided into two groups. ESWT according to selected parameters will be applied to Group A. Group B will receive sham ESWT.

Patients in both groups will have the same program. The research for one patient lasts a total of 8 weeks (2 months) from the initial to the final examination. In the initial session, there will be a clinical examination by a physiotherapist, which includes case history questions, measuring range of motion (measured by weight-bearing lunge test), functional loading tests (1-leg heel rise test, 1-leg hop test) and an ultrasonographic examination (tendon cross section area and width at the maximal tendon antero-posterior width place). In addition, the patient will complete a VISA-A questionnaire. At the end of the initial session, the patient will be randomly assigned to group A or B and receive the first application. For the next 4 weeks, additional applications will be performed once a week. The interval between individual applications should be at least 7 days. Thus, a total of 5 applications of ESWT or sham ESWT will be performed. The final examination will take place 3 weeks after the last application and will include the same procedures as for the initial examination.

Type d'étude

Interventionnel

Inscription (Réel)

18

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Tchéquie
      • Prague, Tchéquie
        • University Hospital Motol and 2nd Faculty of Medicine, Charles University

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • the patient complains about Achilles tendon pain, which limits (at least partially) his quality of life during daily activities or sport, and this condition would be referred as a tendinopathy
  • the patient's other leg is asymptomatic
  • the patient is not aware of the symptomatical mechanical tendon damage in past (eg. partial or complete rupture due to injury)
  • the patient has no previous experience with extracorporeal shockwave therapy treatment

Exclusion Criteria:

  • the patient has condition which is contraindication for extracorporeal shock wave therapy treatment
  • the patient had symptomatical mechanical tendon damage in past (eg. partial or complete rupture due to injury)

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Treatment Group (A)
Group of patients with Achilles tendinopathy which are treated by focused extracorporeal shockwave therapy once a week for 5 weeks. ESWT parameters: 0,12 mJ/mm2, 10 Hz, 1300 shocks.
Dispositif: BTL-6000 FSWT
Intensity 0,12 mJ/mm2, frequency 10 Hz, total number of shocks 1300.
Comparateur factice: Sham Group (B)
Group of patients with Achilles tendinopathy in which sham extracorporeal shockwave therapy is applied once a week for 5 weeks. Total applications are 5, applicated weekly. Sham ESWT parameters are same as in Group A (0,12 mJ/mm2, 10 Hz, 1300 shocks) but with modified applicator which does not allow wave transmission.
Dispositif: BTL-6000 FSWT with sham applicator
Intensity 0,12 mJ/mm2, frequency 10 Hz, total number of shocks 1300 - applied with modified applicator which does not allow wave transmission.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Cross-sectional Area at the Place of Maximum Tendon Width
Délai: Change of initial values at 3 weeks follow up after last application (8th week).
Measured by measuring tools in ultrasound machine in cm2. In linear view is selected maximal width place, then the position of ultrasound head is rotated to horizontal view and in this view cross section area is measured.
Change of initial values at 3 weeks follow up after last application (8th week).
Change in Maximum Pain in the Achilles Tendon Area
Délai: Change in maximum pain in the timeframe of the last application (5th week)
Measured by numeric rating scale in points. The values can reach 0-10 points. A higher score means worse pain.
Change in maximum pain in the timeframe of the last application (5th week)
Change in Maximum Pain in the Achilles Tendon Area (Follow up)
Délai: Change in maximum pain at 3 weeks follow up after last application (8th week).
Measured by numeric rating scale in points. The values can reach 0-10 points. A higher score means worse pain.
Change in maximum pain at 3 weeks follow up after last application (8th week).
Change of Ankle Dorsiflexion Range of Motion
Délai: Change of initial values at 3 weeks follow up after last application (8th week).
Measured using weight-bearing lunge test in cm.
Change of initial values at 3 weeks follow up after last application (8th week).

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Number of Participants With Hypoechogenic Areas
Délai: Change of the echostructure at 3 weeks follow up after last application (8th week).
Echostructure is evaluated visually by investigator using musculoskeletal ultrasound machine. Patients who have a hypoechogenic areas in the tendon are counted.
Change of the echostructure at 3 weeks follow up after last application (8th week).
Number of Participants With Increased Thickness of Achilles Tendon
Délai: Change of the tendon continuity at 3 weeks follow up after last application (8th week).
The Achilles tendon continuity in evaluated visually by investigator using musculoskeletal ultrasound machine. Patients who have a visually significant increased thickness of tendon will be counted.
Change of the tendon continuity at 3 weeks follow up after last application (8th week).
Change in VISA-A Questionnaire Score
Délai: Change of initial values at 3 weeks follow up after last application (8th week).
The VISA-A questionnaire is standardized questionnaire for patients with Achilles tendinopathy. The results are recorded in points (0-100 points). The higher score indicates patients better condition.
Change of initial values at 3 weeks follow up after last application (8th week).
Change in Single Leg Heel Rise Test
Délai: Change of initial values at 3 weeks follow up after last application (8th week)
Patient performs as many heel rises using only one leg as possible in 30 seconds or until first sign of pain in Achilles tendon area.
Change of initial values at 3 weeks follow up after last application (8th week)
Change in Single Leg Hop Test
Délai: Change of initial values at 3 weeks follow up after last application (8th week).
Patient performs as many hops on one leg as possible in 30 seconds or until first sign of pain in Achilles tendon area.
Change of initial values at 3 weeks follow up after last application (8th week).

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

University Hospital, Motol

Les enquêteurs

  • Chercheur principal: Stanislav Machač, Mgr., Ph.D., University Hospital Motol and 2nd Faculty of Medicine, Charles University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 février 2021

Achèvement primaire (Réel)

2 avril 2021

Achèvement de l'étude (Réel)

2 avril 2021

Dates d'inscription aux études

Première soumission

24 février 2021

Première soumission répondant aux critères de contrôle qualité

28 février 2021

Première publication (Réel)

4 mars 2021

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

28 juin 2021

Dernière mise à jour soumise répondant aux critères de contrôle qualité

25 juin 2021

Dernière vérification

1 juin 2021

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • EK- 1/21

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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