Electrical DN as an Adjunct to Eccentric Exercise, Stretching + MT for Achilles Tendinopathy

Not Applicable

Recruiting

• Conditions: Achilles Tendinopathy
• Interventions: Other: Electric dry needling and conventional PT; Other: Conventional PT

• Registration Number: NCT03968614
• Lead Sponsor: Alabama Physical Therapy & Acupuncture

Brief Summary

The purpose of this research is to compare two different approaches for treating patients with achilles tendinopathy: eccentric exercise, stretching and manual therapy VS Electric dry needling, eccentric exercise, stretching and manual therapy. Physical therapists commonly use all of these techniques to treat achilles tendinopathy. This study is attempting to find out if one treatment strategy is more effective than the other.

Detailed Description

Patients with achilles tendinopathy will be randomized to receive 8-10 treatments (1-2 treatments per week) over 6 weeks (10 treatments max) of either: (1)Eccentric exercise, stretching, manual therapy and electrical dry needling or 2. eccentric exercise, stretching and manual therapy

Study Timeline

• Study First Submitted: 2019-05-28
• Study First Submitted QC: 2019-05-28
• Study First Posted: 2019-05-30
• Study Start: 2019-06-10
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-14
• Last Update Posted: 2025-05-18
• Primary Completion: 2026-05-01
• Study Completion: 2026-05-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 110

Inclusion Criteria

1. Adult >18 years old that is able to speak English.

2. Report of at least 3 months of Achilles pain clinically diagnosed as Achilles tendonitis or Achilles tendinopathy

3. Patient has not had physical therapy, massage therapy, chiropractic treatment or injections for Achilles pain in the last 6 months:

4. Diagnosis of noninsertional tendinopathy, defined as the following

   • Subjective report of pain located 2-6 cm proximal to the insertion of Achilles tendon to the calcaneus, particularly with running or jumping
   • Tenderness to palpation of the Achilles tendon while the clinician gently squeezes the tendon between the thumb and index finger in a proximal to distal direction
   • Positive Arc Sign - Intratendinous swelling moves relative to the malleoli with the tendon during active dorsi/plantar Flexion
   • Royal London Test - Tenderness to palpation decreases significantly or disappears with max dorsiflexion

Exclusion Criteria

1. Report of red flags to manual physical therapy to include: hypertension infection, diabetes, peripheral neuropathy, heart disease, stroke, chronic ischemia, edema, severe vascular disease, malignancy, etc.

2. History of previous Achilles tendon surgery, ankle arthrodesis, hind foot fracture, or leg length discrepancy of more than one half inch.

3. History of arthrosis or arthritis of the ankle and/or foot.

4. History of significant ankle and/or foot instability

5. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

   1. Muscle weakness involving a major lower extremity muscle group
   2. Diminished lower extremity patella or Achilles tendon reflexes
   3. Diminished / absent sensation in any lower extremity dermatome

6. Involvement in litigation or worker's compensation regarding foot pain

7. Any condition that might contraindicate the use of electro-needling

8. The patient is pregnant.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Electrical Dry Needling and conventional PT	Electric dry needling and conventional PT	Electrical Dry Needling, Eccentric Exercise, Stretching and Manual Therapy
Conventional PT	Conventional PT	Eccentric Exercise, Stretching and Manual Therapy

Primary Outcome Measures

Name	Time	Method
Change in VISA-A Questionnaire	baseline, 2 weeks, 6 weeks, 3 months	Index of severity of Achilles tendinopathy. Lower score means greater severity of condition.

Secondary Outcome Measures

Name	Time	Method
Change in achilles pain (NPRS) (Rating Score)	baseline, 2 weeks, 6 weeks, 3 months	Higher scores mean greater pain
Change in Foot and Ankle Ability Measure - Sports	baseline, 2 weeks, 6 weeks, 3 months	Sports (0-32 points) 8 Item 32-point sports subscale
Change in Foot and Ankle Ability Measure - ADL	baseline, 2 weeks, 6 weeks, 3 months	activities of daily living (0-84 points) 21 Item 84-point ADL Subscale
GROC (ranges from -7 to +7). Global Rating of Change score.	2 weeks, 6 weeks, 3 months

Trial Locations

Locations (1)

Prisma Health - Research PT Specialists; 🇺🇸 Columbia, South Carolina, United States