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Trial registered on ANZCTR
Registration number
ACTRN12606000179538
Ethics application status
Approved
Date submitted
8/05/2006
Date registered
16/05/2006
Date last updated
16/05/2006
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pilot Randomised Clinical Trial of Prolotherapy Injections and Eccentric Loading Exercises Singly and in Combination for the Treatment of Painful Achilles Tendinosis
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Scientific title
Pilot Randomised Clinical Trial of Prolotherapy Injections and Eccentric Loading Exercises Singly and in Combination for the Treatment of Painful Achilles Tendinosis to Minimise Pain, Stiffness and Disability.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Achilles Tendinosis
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Condition category
Condition code
Musculoskeletal
1233
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prolotherapy Injections (20% dextrose/ 0.1% lignocaine/ 0.1% ropivacaine) - Administered weekly for no longer than 12 weeks.
Eccentric Loading Exercises - The current 'gold standard' in the treatment for Achilles tendinosis. These exercises are performed twice daily by the participant at home. The exercises are performed twice daily for 12 weeks.
Combined Prolotherapy Injections and Eccentric Loading Exercises
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Intervention code [1]
1026
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Treatment: Other
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Comparator / control treatment
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Control group
Active
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Outcomes
Primary outcome [1]
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Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire: Consists of eight questions measuring the domains of pain, stiffness, function in daily living, and sporting activity. On a scale of 0-100, the minimum clinically important difference is 20 and a trivial difference is 10.
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Assessment method [1]
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Timepoint [1]
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Measured at baseline, six weeks, three months and six months.
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Secondary outcome [1]
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Treatment Satisfaction
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Assessment method [1]
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Timepoint [1]
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Meausred at baseline, six weeks, three months and six months.
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Secondary outcome [2]
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Patient Global Impression of Change
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Assessment method [2]
2992
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Timepoint [2]
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Meausred at baseline, six weeks, three months and six months.
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Secondary outcome [3]
2993
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Sonographic Assessment
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Assessment method [3]
2993
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Timepoint [3]
2993
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Meausred at baseline, six weeks, three months and six months.
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Secondary outcome [4]
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Assessment of Cost-Effectiveness
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Assessment method [4]
2994
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Timepoint [4]
2994
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Meausred at baseline, six weeks, three months and six months.
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Eligibility
Key inclusion criteria
Clinical diagnosis of painful Achilles tendinosisPain and tenderness centred 2-7 cm from the calcaneal attachmentPain longer than 3 months. Activity related pain VISA-A score less than 80 for participants involved in sport and less than 70 for people not involved in sport.
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Previous treatment with over one month of eccentric loading exercises, any prolotherapy injections, any Achilles surgery or any foot surgery on the affected side in the last year.Bilateral symptomsAllergy to any of the components of the injection solutionSignificant medical conditions likely to be fatal or severely disabling in the next 3 monthsInflammatory arthritis or other causes of calf or ankle painDiabetes mellitusCurrent or planned pregnancyA steroid injection in or near the affected Achilles tendon in the last 3 monthsAny musculoskeletal condition that that prevents them from performing eccentric loading exercises.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation involves contacting the holder of the allocation schedule (NHMRC Clinical Trials Centre) who is off-site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated by the NHMRC Clinical Trials Centre
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/05/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Griffith University
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Address [1]
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Musculoskeletal Research Foundation of Australia
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Address [2]
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Country [2]
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Australia
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Primary sponsor type
University
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Name
Griffith University
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
1192
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Country [1]
1192
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Logan Hospital
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Ethics committee address [1]
2700
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Ethics committee country [1]
2700
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Australia
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Date submitted for ethics approval [1]
2700
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Approval date [1]
2700
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17/02/2006
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Ethics approval number [1]
2700
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MED/04/06/HREC
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Ethics committee name [2]
2701
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Active Health, QEII Stadium, Christchurch
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Ethics committee address [2]
2701
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Ethics committee country [2]
2701
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New Zealand
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Date submitted for ethics approval [2]
2701
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Approval date [2]
2701
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17/02/2006
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Ethics approval number [2]
2701
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MED/04/06/HREC
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Summary
Brief summary
The reported incidence of painful Achilles tendinosis is 6-17% amongst adult athletes. This condition results in considerable impairment of training and performance in athletes. To date, evidence suggests that of the treatment strategies investigated, exercise programs that involve mildly painful eccentric contractions of the muscles of the calf are the most effective at reducing pain and improving function for people suffering from this condition. Although the underlying mechanism conferring improvement is unknown, there is now some evidence suggesting a link between the presence of newly formed blood vessels (neovascularisation) and painful tendinosis. With a program of mildly painful eccentric loading exercises, there is a sustained reduction in pain with disappearance of these new vessels. Similar sustained reductions in pain have been shown with prolotherapy injections of hypertonic glucose and local anaesthetic. Prolotherapy involves the repeated injections of an irritant solution with the intention of sclerosing neovessels and stimulating inflammation and subsequently new collagen formation. With respect to Achilles tendinosis, the relative efficacy of these two approaches, individually and in combination, has not been tested. This project aims to conduct a pilot randomised clinical trial comparing prolotherapy injections eccentric loading exercises singly and in combination. It will be conducted in research clinics to be set up at Logan and in Christchurch, New Zealand. It will be a single blinded trial with the assessor being the blinded person. Experience and information from this pilot trial will be used to inform an adequately powered randomised clinical trial of prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Associate Professor Michael Yelland
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Address
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School of Medicine
Griffith University
Logan Campus
University Drive
Meadowbrook QLD 4131
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Country
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Australia
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Phone
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+61 7 33821358
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Fax
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+61 7 33821338
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Email
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[email protected]
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Contact person for scientific queries
Name
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Kent Sweeting
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Address
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School of Medicine
Griffith University
Logan Campus
University Drive
Meadowbrook QLD 4131
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Country
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Australia
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Phone
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+61 7 33821363
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Fax
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+61 7 33821338
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial.
2011
N.B. These documents automatically identified may not have been verified by the study sponsor.
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