The Experts below are selected from a list of 762 Experts worldwide ranked by ideXlab platform

Michael S Richards - One of the best experts on this subject based on the ideXlab platform.

  • ultrasound strain mapping of achilles tendon compressive strain patterns during dorsiflexion
    Journal of Biomechanics, 2016
    Co-Authors: Ruth L Chimenti, Samuel A Flemister, John Ketz, Mary Bucklin, Mark R Buckley, Michael S Richards
    Abstract:

    Abstract Heel Lifts are commonly prescribed to patients with Achilles tendinopathy, yet little is known about the effect on tendon compressive strain. The purposes of the current study were to (1) develop a valid and reliable ultrasound elastography technique and algorithm to measure compressive strain of human Achilles tendon in vivo , (2) examine the effects of ankle dorsiflexion (lowering via controlled removal of a Heel lift and partial squat) on compressive strain of the Achilles tendon insertion and (3) examine the relative compressive strain between the deep and superficial regions of the Achilles tendon insertion. All tasks started in a position equivalent to standing with a 30 mm Heel lift. An ultrasound transducer positioned over the Achilles tendon insertion was used to capture radiofrequency images. A non-rigid image registration-based algorithm was used to estimate compressive strain of the tendon, which was divided into 2 regions (superficial, deep). The bland-Altman test and intraclass correlation coefficient were used to test validity and reliability. One-way repeated measures ANOVA was used to compare compressive strain between regions and across tasks. Compressive strain was accurately and reliably (ICC>0.75) quantified. There was greater compressive strain during the combined task of lowering and partial squat compared to the lowering ( P =.001) and partial squat ( P P =.001). While these findings need to be examined in a pathological population, Heel Lifts may reduce tendon compressive strain during daily activities.

  • Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion.
    Journal of biomechanics, 2015
    Co-Authors: Ruth L Chimenti, John Ketz, Mary Bucklin, Mark R Buckley, A. Samuel Flemister, Michael S Richards
    Abstract:

    Heel Lifts are commonly prescribed to patients with Achilles tendinopathy, yet little is known about the effect on tendon compressive strain. The purposes of the current study were to (1) develop a valid and reliable ultrasound elastography technique and algorithm to measure compressive strain of human Achilles tendon in vivo, (2) examine the effects of ankle dorsiflexion (lowering via controlled removal of a Heel lift and partial squat) on compressive strain of the Achilles tendon insertion and (3) examine the relative compressive strain between the deep and superficial regions of the Achilles tendon insertion. All tasks started in a position equivalent to standing with a 30mm Heel lift. An ultrasound transducer positioned over the Achilles tendon insertion was used to capture radiofrequency images. A non-rigid image registration-based algorithm was used to estimate compressive strain of the tendon, which was divided into 2 regions (superficial, deep). The bland-Altman test and intraclass correlation coefficient were used to test validity and reliability. One-way repeated measures ANOVA was used to compare compressive strain between regions and across tasks. Compressive strain was accurately and reliably (ICC>0.75) quantified. There was greater compressive strain during the combined task of lowering and partial squat compared to the lowering (P=.001) and partial squat (P

Shannon E. Munteanu - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial.
    British journal of sports medicine, 2020
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Angela Evans, Peter Malliaras, Sean Docking, Karl B. Landorf, James M. Gerrard, Shannon E. Munteanu
    Abstract:

    Objective(s) To compare the efficacy of in-shoe Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy. Methods This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) Heel Lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance. Results There was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the Heel Lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the Heel Lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points. Conclusion In adults with mid-portion Achilles tendinopathy, Heel Lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions. Trial registration number ACTRN12617001225303.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial
    Journal of foot and ankle research, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Angela Evans, Peter Malliaras, Sean Docking, Karl B. Landorf, Shannon E. Munteanu
    Abstract:

    Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe Heel Lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel Lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel-group randomised trial comparing the efficacy of Heel Lifts to calf muscle eccentric exercise for Achilles tendinopathy. Ninety-two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a Heel lift group that will receive pre-fabricated 12 mm in-shoe Heel Lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment – Achilles (VISA–A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7-point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol-5D-5L™ questionnaire), physical activity levels (using the 7-day Recall Physical Activity Questionnaire) and calf muscle function (using the standing Heel rise test). Data will be analysed using the intention to treat principle. The HEALTHY trial (Heel Lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice. Australian New Zealand Clinical Trials Registry: ACTRN12617001225303 . Registered on August 22nd, 2017.

  • Effects of Heel Lifts on lower limb biomechanics and muscle function: A systematic review.
    Gait & posture, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Jade M. Tan, Glen A. Whittaker, Angela Evans, Shannon E. Munteanu
    Abstract:

    Abstract Background Heel Lifts, placed inside footwear are recommended for the management of numerous musculoskeletal conditions. Despite the potential therapeutic benefit of Heel Lifts, the mechanism(s) by which they exert their effects is unclear. The aim of this systematic review was to synthesise reported findings and summarise the effects of Heel Lifts on lower limb biomechanics and muscle function. Research question Do Heel Lifts affect lower limb biomechanics and muscle function during walking and running? Methods Electronic databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED) were searched from inception to April 2018. Studies were included if they (i) included participants without a limb length discrepancy or neurological condition, (ii) evaluated the effect of bilateral Heel Lifts that were removable (attached to the participants’ foot (barefoot) or inserted inside footwear) or an existing feature of a shoe, and (iii) assessed lower limb biomechanics or muscle function during walking or running in asymptomatic or symptomatic participants. Results A total of 23 studies (377 participants) were included. Study quality, assessed using a Modified Quality Index, ranged from 5 to 13 out of 15. A large number of biomechanical parameters were assessed, but few effects were statistically significant. The differences that were significant and had a large effect size are described below. In asymptomatic participants, Heel Lifts of 10 mm decreased duration of swing phase (standardised mean difference [SMD] = -1.3) and Heel Lifts of at least 5 cm decreased velocity (SMD = -0.93) during walking. In asymptomatic participants, Heel Lifts of 15 mm decreased maximum ankle dorsiflexion angle (SMD = -1.5) and Heel Lifts of 12 and 18 mm decreased gastrocnemius muscle tendon unit length (SMD = -0.96) during running. In participants with restricted ankle joint dorsiflexion, Heel Lifts of 6 and 9 mm increased medial gastrocnemius electromyography amplitude (SMD between 0.68 and 0.98) during walking. In participants with haemophilia, Heel Lifts of 9 mm increased ankle joint maximum range of motion (SMD = 1.6) during walking. Significance Heel Lifts affect specific lower limb biomechanical and muscle function parameters during walking and running. The clinical relevance and potential therapeutic benefits of these effects needs further investigation.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial
    BMC, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Peter Malliaras, Sean Docking, Karl B. Landorf, Angela M. Evans, Shannon E. Munteanu
    Abstract:

    Abstract Background Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe Heel Lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel Lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel-group randomised trial comparing the efficacy of Heel Lifts to calf muscle eccentric exercise for Achilles tendinopathy. Methods Ninety-two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a Heel lift group that will receive pre-fabricated 12 mm in-shoe Heel Lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment – Achilles (VISA–A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7-point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol-5D-5L™ questionnaire), physical activity levels (using the 7-day Recall Physical Activity Questionnaire) and calf muscle function (using the standing Heel rise test). Data will be analysed using the intention to treat principle. Discussion The HEALTHY trial (Heel Lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12617001225303. Registered on August 22nd, 2017

Ruth L Chimenti - One of the best experts on this subject based on the ideXlab platform.

  • Nonsurgical Treatment Options for Insertional Achilles Tendinopathy.
    Foot and Ankle Clinics of North America, 2019
    Co-Authors: Connor P. Dilger, Ruth L Chimenti
    Abstract:

    : Most nonoperative treatments for insertional Achilles tendinopathy (IAT) have insufficient evidence to support treatment recommendations. Exercise has the highest level of evidence supporting the ability of this treatment option to reduce IAT pain. The effects of exercise may be enhanced by a wide variety of other treatments, including soft tissue treatment, nutritional supplements, iontophoresis, education, stretching, and Heel Lifts. When exercise is unsuccessful, extracorporeal shock wave therapy seems to be the next best nonoperative treatment option to reduce IAT pain. After other nonoperative treatment options have been exhausted, injections may be considered, particularly to facilitate participation in an exercise program.

  • ultrasound strain mapping of achilles tendon compressive strain patterns during dorsiflexion
    Journal of Biomechanics, 2016
    Co-Authors: Ruth L Chimenti, Samuel A Flemister, John Ketz, Mary Bucklin, Mark R Buckley, Michael S Richards
    Abstract:

    Abstract Heel Lifts are commonly prescribed to patients with Achilles tendinopathy, yet little is known about the effect on tendon compressive strain. The purposes of the current study were to (1) develop a valid and reliable ultrasound elastography technique and algorithm to measure compressive strain of human Achilles tendon in vivo , (2) examine the effects of ankle dorsiflexion (lowering via controlled removal of a Heel lift and partial squat) on compressive strain of the Achilles tendon insertion and (3) examine the relative compressive strain between the deep and superficial regions of the Achilles tendon insertion. All tasks started in a position equivalent to standing with a 30 mm Heel lift. An ultrasound transducer positioned over the Achilles tendon insertion was used to capture radiofrequency images. A non-rigid image registration-based algorithm was used to estimate compressive strain of the tendon, which was divided into 2 regions (superficial, deep). The bland-Altman test and intraclass correlation coefficient were used to test validity and reliability. One-way repeated measures ANOVA was used to compare compressive strain between regions and across tasks. Compressive strain was accurately and reliably (ICC>0.75) quantified. There was greater compressive strain during the combined task of lowering and partial squat compared to the lowering ( P =.001) and partial squat ( P P =.001). While these findings need to be examined in a pathological population, Heel Lifts may reduce tendon compressive strain during daily activities.

  • Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion.
    Journal of biomechanics, 2015
    Co-Authors: Ruth L Chimenti, John Ketz, Mary Bucklin, Mark R Buckley, A. Samuel Flemister, Michael S Richards
    Abstract:

    Heel Lifts are commonly prescribed to patients with Achilles tendinopathy, yet little is known about the effect on tendon compressive strain. The purposes of the current study were to (1) develop a valid and reliable ultrasound elastography technique and algorithm to measure compressive strain of human Achilles tendon in vivo, (2) examine the effects of ankle dorsiflexion (lowering via controlled removal of a Heel lift and partial squat) on compressive strain of the Achilles tendon insertion and (3) examine the relative compressive strain between the deep and superficial regions of the Achilles tendon insertion. All tasks started in a position equivalent to standing with a 30mm Heel lift. An ultrasound transducer positioned over the Achilles tendon insertion was used to capture radiofrequency images. A non-rigid image registration-based algorithm was used to estimate compressive strain of the tendon, which was divided into 2 regions (superficial, deep). The bland-Altman test and intraclass correlation coefficient were used to test validity and reliability. One-way repeated measures ANOVA was used to compare compressive strain between regions and across tasks. Compressive strain was accurately and reliably (ICC>0.75) quantified. There was greater compressive strain during the combined task of lowering and partial squat compared to the lowering (P=.001) and partial squat (P

Chantel L. Rabusin - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial.
    British journal of sports medicine, 2020
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Angela Evans, Peter Malliaras, Sean Docking, Karl B. Landorf, James M. Gerrard, Shannon E. Munteanu
    Abstract:

    Objective(s) To compare the efficacy of in-shoe Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy. Methods This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) Heel Lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance. Results There was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the Heel Lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the Heel Lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points. Conclusion In adults with mid-portion Achilles tendinopathy, Heel Lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions. Trial registration number ACTRN12617001225303.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial
    Journal of foot and ankle research, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Angela Evans, Peter Malliaras, Sean Docking, Karl B. Landorf, Shannon E. Munteanu
    Abstract:

    Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe Heel Lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel Lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel-group randomised trial comparing the efficacy of Heel Lifts to calf muscle eccentric exercise for Achilles tendinopathy. Ninety-two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a Heel lift group that will receive pre-fabricated 12 mm in-shoe Heel Lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment – Achilles (VISA–A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7-point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol-5D-5L™ questionnaire), physical activity levels (using the 7-day Recall Physical Activity Questionnaire) and calf muscle function (using the standing Heel rise test). Data will be analysed using the intention to treat principle. The HEALTHY trial (Heel Lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice. Australian New Zealand Clinical Trials Registry: ACTRN12617001225303 . Registered on August 22nd, 2017.

  • Effects of Heel Lifts on lower limb biomechanics and muscle function: A systematic review.
    Gait & posture, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Jade M. Tan, Glen A. Whittaker, Angela Evans, Shannon E. Munteanu
    Abstract:

    Abstract Background Heel Lifts, placed inside footwear are recommended for the management of numerous musculoskeletal conditions. Despite the potential therapeutic benefit of Heel Lifts, the mechanism(s) by which they exert their effects is unclear. The aim of this systematic review was to synthesise reported findings and summarise the effects of Heel Lifts on lower limb biomechanics and muscle function. Research question Do Heel Lifts affect lower limb biomechanics and muscle function during walking and running? Methods Electronic databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED) were searched from inception to April 2018. Studies were included if they (i) included participants without a limb length discrepancy or neurological condition, (ii) evaluated the effect of bilateral Heel Lifts that were removable (attached to the participants’ foot (barefoot) or inserted inside footwear) or an existing feature of a shoe, and (iii) assessed lower limb biomechanics or muscle function during walking or running in asymptomatic or symptomatic participants. Results A total of 23 studies (377 participants) were included. Study quality, assessed using a Modified Quality Index, ranged from 5 to 13 out of 15. A large number of biomechanical parameters were assessed, but few effects were statistically significant. The differences that were significant and had a large effect size are described below. In asymptomatic participants, Heel Lifts of 10 mm decreased duration of swing phase (standardised mean difference [SMD] = -1.3) and Heel Lifts of at least 5 cm decreased velocity (SMD = -0.93) during walking. In asymptomatic participants, Heel Lifts of 15 mm decreased maximum ankle dorsiflexion angle (SMD = -1.5) and Heel Lifts of 12 and 18 mm decreased gastrocnemius muscle tendon unit length (SMD = -0.96) during running. In participants with restricted ankle joint dorsiflexion, Heel Lifts of 6 and 9 mm increased medial gastrocnemius electromyography amplitude (SMD between 0.68 and 0.98) during walking. In participants with haemophilia, Heel Lifts of 9 mm increased ankle joint maximum range of motion (SMD = 1.6) during walking. Significance Heel Lifts affect specific lower limb biomechanical and muscle function parameters during walking and running. The clinical relevance and potential therapeutic benefits of these effects needs further investigation.

  • Efficacy of Heel Lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial
    BMC, 2019
    Co-Authors: Chantel L. Rabusin, Hylton B. Menz, Jodie A. Mcclelland, Peter Malliaras, Sean Docking, Karl B. Landorf, Angela M. Evans, Shannon E. Munteanu
    Abstract:

    Abstract Background Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe Heel Lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel Lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel-group randomised trial comparing the efficacy of Heel Lifts to calf muscle eccentric exercise for Achilles tendinopathy. Methods Ninety-two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a Heel lift group that will receive pre-fabricated 12 mm in-shoe Heel Lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment – Achilles (VISA–A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7-point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol-5D-5L™ questionnaire), physical activity levels (using the 7-day Recall Physical Activity Questionnaire) and calf muscle function (using the standing Heel rise test). Data will be analysed using the intention to treat principle. Discussion The HEALTHY trial (Heel Lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of Heel Lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12617001225303. Registered on August 22nd, 2017

Jason Stacy - One of the best experts on this subject based on the ideXlab platform.

  • Shock wave therapy for Achilles tendinopathy
    Current Reviews in Musculoskeletal Medicine, 2011
    Co-Authors: Michelle Wilson, Jason Stacy
    Abstract:

    Achilles tendinopathy has been reported as the most common overuse injury in sports medicine clinics (Clement et al. Am J Sports Med 12: 179–184, 1984). Standard treatment regimens include activity modification, Heel Lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading. There is a lack of consensus regarding treatment. Even so, most athletes will respond to this regimen. However, conservative management will prove to be inadequate for a subset of patients. When conservative therapy fails, other noninvasive treatment measures may be considered. Extracorporeal shock wave therapy (ESWT) has been used in soft-tissue disorders including lateral epicondylitis, plantar fasciitis, and calcific tendonitis of the shoulder. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is lacking. This article explores the role of shock wave therapy in the management of recalcitrant Achilles tendinopathy in patients attempting to avoid an invasive intervention.