Electrical Dry Needling as an Adjunct to Eccentric Exercise, Stretching and Manual Therapy for Mid-portion Achilles Tendinopathy: a Multicenter Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 110
- 试验地点
- 2
- 主要终点
- Change in VISA-A Questionnaire
研究概览
简要总结
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.
详细描述
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
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult >18 years old that is able to speak English.
- •Report of at least 3 months of Achilles pain clinically diagnosed as Achilles tendonitis or Achilles tendinopathy
- •Patient has not had physical therapy, massage therapy, chiropractic treatment or injections for Achilles pain in the last 6 months:
- •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
排除标准
- •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.
- •History of previous Achilles tendon surgery, ankle arthrodesis, hind foot fracture, or leg length discrepancy of more than one half inch.
- •History of arthrosis or arthritis of the ankle and/or foot.
- •History of significant ankle and/or foot instability
- •Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:
- •Muscle weakness involving a major lower extremity muscle group
- •Diminished lower extremity patella or Achilles tendon reflexes
- •Diminished / absent sensation in any lower extremity dermatome
- •Involvement in litigation or worker's compensation regarding foot pain
- •Any condition that might contraindicate the use of electro-needling
- •The patient is pregnant.
结局指标
主要结局
Change in VISA-A Questionnaire
时间窗: baseline, 2 weeks, 6 weeks, 3 months
Index of severity of Achilles tendinopathy. Lower score means greater severity of condition.
次要结局
- Change in achilles pain (NPRS) (Rating Score)(baseline, 2 weeks, 6 weeks, 3 months)
- Change in Foot and Ankle Ability Measure - Sports(baseline, 2 weeks, 6 weeks, 3 months)
- Change in Foot and Ankle Ability Measure - ADL(baseline, 2 weeks, 6 weeks, 3 months)
- GROC (ranges from -7 to +7). Global Rating of Change score.(2 weeks, 6 weeks, 3 months)
研究者
James Dunning, DPT, MSc, FAAOMPT
Primary Investigator and President of Spinal Manipulation Institute and Dry Needling Institute of the American Academy of Manipulative Therapy
Alabama Physical Therapy & Acupuncture