Evaluation of the Course and Effectiveness of Conservative Therapy in Patients With Achilles Tendinopathy
Achilles Tendinopathy
About this trial
This is an interventional treatment trial for Achilles Tendinopathy focused on measuring Achilles Tendinopathy, Extracorporeal Shockwave Therapy, Ultrasonography
Eligibility Criteria
Inclusion Criteria: the patient shows symptoms of Achilles tendinopathy (pain, swelling and dysfunction in the area of Achilles tendon), which at least partially limit his quality of life during normal or sporting activities, the patient is in the age group of 18-60 years, the patient has difficulties in only one lower limb; the second, asymptomatic limb will be considered the reference, the patient is not aware of any mechanical damage to the tendon in symptomatic limb in the past (e.g. partial or complete rupture as a result of an injury), the patient has not undergone any treatment aimed at AS in the last 3 months (surgery, corticoid application, plasma therapy, shock waves, physiotherapy, etc.), objective US examination of AS shows structural changes (expansion, neovascularization, focal hypoechoic areas, etc.). Exclusion Criteria: patient has been diagnosed with a rheumatic disease or a disease of the central nervous system patient has any condition which is contraindication for ESWT application patient is aware of mechanical damage to the Achilles tendon as a result of an injury in the past.
Sites / Locations
- University Hospital Motol and 2nd Faculty of Medicine, Charles University
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Group A - ESWT + exercise
Group B - exercise
Participants in group A will complete a 12-week ankle dorsiflexion resistance training protocol according to Silbernagel. It is a series of heel rise exercises with a gradual progression of load according to defined criteria, which the patient practices every day. In addition, participants will receive a low-energy focused ESWT. In total, it will be applied 4 times with an interval of 7 days from the BTL-6000 FSWT device with piezoelectric generator. The energy will be set to 0.14 mJ/mm2, frequency 6 Hz, total number of shocks 1800. The application will be semi-static at the location of the largest USG finding. 600 shocks are applied from all three sides (medial, lateral, dorsal). The set values will not change throughout the research. These parameters were selected in accordance to ISMST guidelines.
Participants in group B will complete a 12-week ankle dorsiflexion resistance training protocol according to Silbernagel. It is a series of heel rise exercises with a gradual progression of load according to defined criteria, which the patient practices every day.