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Association Between Localized Achilles Tendon Movement-Evoked Pain and Core Health-Related Domains in Individuals with Chronic Achilles Tendinopathy
Abstract   Peer reviewed

Association Between Localized Achilles Tendon Movement-Evoked Pain and Core Health-Related Domains in Individuals with Chronic Achilles Tendinopathy

Andrew A. Post, Tim Fleagle, Cesar De Cesar Netto, Katherine E. Hadlandsmyth, Jason M. Wilken, Kathleen A. Sluka and Ruth L. Chimenti
The journal of pain, Vol.25(4 Supplement), pp.50-50
04/2024
DOI: 10.1016/j.jpain.2024.01.232

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Abstract

Current understanding of tendinopathy extends beyond a localized pain diagnosis and includes a multidimensional patient perspective. The purposes of this study were to 1) identify targetable core health-related domains for tendinopathy (disability, psychological variables, pain, factors associated with quality of life) and 2) establish associations between localized Achilles tendon movement-evoked pain (MEP) and core health-related domains in individuals with chronic Achilles tendinopathy (AT). 24 individuals with chronic AT (50% female, Age: 43.9±16.6, BMI: 30.2±6.7kg/m2, Duration of pain: 38.7±39.1months) and 24 controls matched for age, sex, and BMI were enrolled for two one-on-one visits over 24-hours. On Day 1 and 2, participants completed patient reported outcomes (VISA-A, TSK-17, PROMIS-sleep) and functional assessments (maximal standing dorsiflexion stretch, 6-minute walk test, maximum number of heel-raises). An aggregate MEP score was calculated utilizing all functional assessments [(dorsiflexion MEP + 6-minute walk test MEP + maximal heel-raises MEP) – Pre-test resting pain]. Over Days 1 and 2, those with chronic AT reported greater disability (VISA-A, AT: 51.4±17.2, Control: 75.1±17.0, p<0.01), elevated kinesiophobia (TSK-17, AT: 35.0±6.2 Control: 31.1±3.9, p=0.01), and higher aggregate MEP (AT: 6.3±3.4, Control: -0.04±1.1, p<0.01) but no difference in sleep disturbance (PROMIS-sleep, AT: 51.0±10.8, Control: 49.6±5.7, p=0.55). Univariate analysis demonstrated change in aggregate MEP for those with AT from Day 1 to Day 2 was associated with sleep disturbance (r=0.55, p=0.01) but not the VISA-A (r=0.08, p=0.72) or TSK-17 (r=0.11, p=0.60). Clinical evaluation of multiple domains may assist with implementation of a biopsychosocial approach for individuals with chronic AT.

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