Responsiveness of Quantitative Musculoskeletal Ultrasound Measures on the Healing of Achilles Tendon

Centre hospitalier de l'Université de Montréal (CHUM)

Status

Completed

Conditions

Achilles Tendinopathy

Treatments

Other: Eccentric strengthening exercises of the Achilles tendon

Study type

Observational

Funder types

Other

Identifiers

NCT04651985

2021-9100

Details and patient eligibility

About

To this day, the most accepted treatment for the Achilles tendinopathy (AT) remains the exercise program to strengthen the plantar flexor muscles. The eccentric exercises protocol proposed by Alfredson is the most popular and recommended one by the rehabilitation professionals. Currently, the response to interventions is measured almost exclusively by clinical data, especially using questionnaires, since the Quantitative Ultrasound (QUS) is rarely used. In fact, the thickness of the Achilles tendon, which is generally the only measure noted when using musculoskeletal ultrasound on AT, does not allow the clinician to confirm an improvement following an eccentric exercise program if the tendon is thinner, especially in adults with chronic AT. No scientific evidence indicates whether there is an improvement in the biological integrity of the Achilles tendon following the completion of Alfredson's eccentric strengthening protocol. This is why it seems relevant to use the pre-established minimal biomarker data set obtained with the QUS in order to study the variation of these data in response to a rehabilitation intervention and to verify how these variations influence clinical data.

Full description

A comprehensive clinical evaluation (questionnaires, clinical examination and ultrasound imaging) will be completed immediately before the intervention (pre), immediately after the intervention (post), and three months after the intervention (follow-up).

Enrollment

30 patients

Sex

All

Ages

18 to 99 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Symptoms consistent with AT in the middle third of the Achilles tendon for at least six weeks
AT signs objectified by the physical exam and the ultrasound imaging at the initial evaluation
At least 18 years old
Victorian Institute of Sport Assessment-Achilles Questionnaire (VISA-A) score below 90
have pain of at least 3 out of 10 according to the analog visual scale during athletic activities

Exclusion criteria

Pain at the Achilles tendon enthesis
A complete rupture of the Achilles tendon History of Achilles tendon rupture Inflammatory arthropathy
Sign of neurological lesion on physical examination of the lower limb
Neurological disease (e.g. multiple sclerosis, stroke)
History of intervention of the Achilles tendon or ankle (e.g. surgery, cortisone infiltration, extracorporeal shock waves therapy, platelet-rich plasma injection).