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Trial registered on ANZCTR
Registration number
ACTRN12607000276459
Ethics application status
Approved
Date submitted
4/09/2006
Date registered
22/05/2007
Date last updated
22/05/2007
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised Clinical Trial of Prolotherapy Injections and Eccentric Loading Exercises for Painful Achilles Tendinosis
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Scientific title
Randomised Clinical Trial of Prolotherapy Injections and Eccentric Loading Exercises 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
1906
1906
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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
Eccentric Loading Exercises - The current 'gold standard' in the treatment of Achilles tendinosis. These exercises are performed twice daily for 12 weeks.
Prolotherapy Injections (30% dextrose/ 0.1% lignocaine/ 0.1% ropivacaine) - Administered weekly beside the tendon for no longer than 12 weeks.
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Intervention code [1]
1319
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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 8 questions measuring the domains of pain, stiffness, function, 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, 6 weeks, 3 months, 6 months and 12 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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Measured at baseline, 6 weeks, 3 months, 6 months and 12 months.
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Secondary outcome [2]
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Patient Global Impression of Change
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Assessment method [2]
4578
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Timepoint [2]
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Measured at baseline, 6 weeks, 3 months, 6 months and 12 months.
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Secondary outcome [3]
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Sonographic Assessment
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Assessment method [3]
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Timepoint [3]
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Measured at baseline, 6 weeks, 3 months, 6 months and 12 months.
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Secondary outcome [4]
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Assessment of Cost-Effectiveness
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Assessment method [4]
4580
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Timepoint [4]
4580
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Measured at baseline, 6 weeks, 3 months, 6 months and 12 months.
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Secondary outcome [5]
4581
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Foot Posture Index
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Assessment method [5]
4581
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Timepoint [5]
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he Foot Posture Index will only be measured at baseline.
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Eligibility
Key inclusion criteria
Clinical diagnosis of painful Achilles tendinosis. Pain and tenderness centred 2-7cm from the calcaneal attachment. Pain longer than 6 weeks. Activity related painVISA-A score less than 80 for participants involved in sport and less than 70 for participants 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 1 month of eccentric loading exercises, any prolotherapy, steroid, polidocinol, aprotinin or autologous blood injectionsAny Achilles surgery or any foot surgery on the affected side in the last yearAllergy to any of the components of the injection solutionAny significant medical condition likely to be fatal or severely disabling in the next 12 monthsInflammatory arthritis or other causes of calf or ankle painCurrent or planned pregnancyAny musculoskeletal condition 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 invloves 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
The assessor is blinded
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Phase
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
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/06/2007
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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
144
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Accrual to date
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Final
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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]
2052
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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]
1860
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None
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Name [1]
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Nil
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Address [1]
1860
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Country [1]
1860
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Griffith Univeristy HREC-Logan Hospital
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
3808
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Approval date [1]
3808
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Ethics approval number [1]
3808
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Ethics committee name [2]
3809
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Griffith Univeristy HREC-Daisy Hill Surgery
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Ethics committee address [2]
3809
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Ethics committee country [2]
3809
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Australia
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Date submitted for ethics approval [2]
3809
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Approval date [2]
3809
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Ethics approval number [2]
3809
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Ethics committee name [3]
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Griffith Univeristy HREC-Allsports Physiotherapy (Indooroopilly)
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Ethics committee address [3]
3810
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Ethics committee country [3]
3810
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Australia
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Date submitted for ethics approval [3]
3810
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Approval date [3]
3810
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Ethics approval number [3]
3810
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Ethics committee name [4]
3811
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Griffith Univeristy HREC- Auchenflower Musculoskeletal Medicine
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Ethics committee address [4]
3811
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Ethics committee country [4]
3811
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Australia
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Date submitted for ethics approval [4]
3811
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Approval date [4]
3811
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Ethics approval number [4]
3811
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Ethics committee name [5]
3812
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Griffith Univeristy HREC-Buderim Physiotherapy
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Ethics committee address [5]
3812
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Ethics committee country [5]
3812
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Australia
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Date submitted for ethics approval [5]
3812
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Approval date [5]
3812
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Ethics approval number [5]
3812
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Ethics committee name [6]
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Griffith Univeristy HREC-Caloundra Spinal and Sports Medicine Centre
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Ethics committee address [6]
3813
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Ethics committee country [6]
3813
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Australia
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Date submitted for ethics approval [6]
3813
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Approval date [6]
3813
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Ethics approval number [6]
3813
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Ethics committee name [7]
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Griffith Univeristy HREC- Musculoskeletal and Golf Injury Clinic (Mosman)
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Ethics committee address [7]
3814
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Ethics committee country [7]
3814
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Australia
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Date submitted for ethics approval [7]
3814
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Approval date [7]
3814
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Ethics approval number [7]
3814
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Ethics committee name [8]
3815
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Griffith Univeristy HREC-Brighton Spinal Group (Brighton)
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Ethics committee address [8]
3815
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Ethics committee country [8]
3815
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Australia
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Date submitted for ethics approval [8]
3815
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Approval date [8]
3815
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Ethics approval number [8]
3815
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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 has not been tested. This project aims to conduct a randomised clinical trial comparing prolotherapy injections eccentric loading exercises. It will be conducted in research clinics at Logan, Sydney, Melbourne and Caloundra. Experience and information from the previous pilot trial has been used to inform this 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
27926
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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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Kent Sweeting
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Address
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School of Medicine
Griffith University
Logan Campus
University Drive
Meadowbrook QLD 4131
Australia
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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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Contact person for scientific 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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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
No additional documents have been identified.
Download to PDF