Progressive Achilles Loading Via Clinician E-support (PACE)
Ruth Chimenti
Summary
This is a randomized controlled trial with individuals who have Achilles tendon pain. This study is designed to identify an effective rehabilitation program for Achilles tendon pain that expands access to care for military personnel and to predict treatment response. Limited or delayed access to healthcare can exacerbate the severity of pain and duration of disability due to AT. This is particularly relevant for individuals deployed to battlefield settings or are being seen in busy military treatment facilities. Therefore, it is crucial to identify efficient and effective treatment pathways that maximize healthcare access and facilitate a rapid and pain-free return to full duty.
Description
The objectives of this non-inferiority trial are to identify a rehabilitation program focused on education and exercise for AT that expands access to care for military personnel and to identify factors that predict responses to rehabilitation. The following aims will test our central hypothesis that a single-visit, PT-initiated rehabilitation program will be as effective in improving pain and reducing disability as a multi-visit, PT-guided rehabilitation program for AT and that within two weeks of initiating exercise treatment, early changes in patient-reported outcomes can identify responders…
Eligibility
- Age range
- 18–60 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Pain localized to the Achilles tendon (insertion or midportion) * AT pain greater than or equal to 3/10 with tendon-loading exercise Exclusion Criteria: * Younger than 18 years of age or older than 60 years of age * BMI \> 45 kg/m2 * Pain primarily due to a differential diagnosis, including paratendonitis, bursitis (retrocalcaneal or subcutaneous), posterior ankle impingement or os trigonum, irritation or neuropathy of the sural nerve, plantaris tendon involvement) * Presence of a partial Achilles tendon tear or rupture on imaging or a history of Achilles tendon ruptur…
Interventions
- OtherExercise
All participants will be instructed in a progressive Achilles tendon loading exercise program.
- OtherEducation
All participants will receive education on Achilles tendinopathy terminology, common symptoms, diagnosis, expected recovery timeline, importance of physical activity, self-management strategies, multiple factors influencing pain, alternative and adjunct treatment options.
Locations (2)
- University of Iowa Health Care - Gait Analysis LaboratoryIowa City, Iowa
- Carl R. Darnall Army Medical Center (CRDAMC)Fort Cavazos, Texas