Journal article
Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial
Clinical biomechanics (Bristol), Vol.109, 106073
10/2023
DOI: 10.1016/j.clinbiomech.2023.106073
PMCID: PMC10543613
PMID: 37657267
Abstract
Background
This study aimed to characterize movement-evoked pain during tendon loading and stretching tasks in individuals with Achilles tendinopathy, and to examine the association between movement-evoked pain with the Achilles tendinopathy type (insertional and midportion), biomechanical, and psychological variables.
Methods
In this laboratory-based, cross-sectional study, 37 individuals with chronic Achilles tendinopathy participated. Movement-evoked pain intensity (Numeric Rating Scale: 0 to 10) and sagittal-plane ankle biomechanics were collected simultaneously during standing, fast walking, single-leg heel raises, and weight-bearing calf stretch. Description of symptoms, including location of Achilles tendon pain and duration of tendon morning stiffness, as well as pain-related psychological measures, including the Tampa Scale of Kinesiophobia were collected. Linear mixed effects models were built around two paradigms of movement-evoked pain (tendon loading and stretching tasks) with each model anchored with pain at rest.
Findings
Movement-evoked pain intensity increased as task demand increased in both models. Lower peak dorsiflexion with walking (β = −0.187, 95% CI: −0.305, −0.069), higher fear of movement (β = 0.082, 95% CI: 0.018, 0.145), and longer duration of tendon morning stiffness (β = 0.183, 95% CI: 0.07, 0.296) were associated with greater pain across tendon loading tasks (R2 = 0.47). Lower peak dorsiflexion with walking (β = −0.27, 95% CI: −0.41, −0.14), higher dorsiflexion with the calf stretch (β = 0.095, 95% CI: 0.02, 0.16), and insertional Achilles tendinopathy (β = −0.93, 95% CI: −1.65, −0.21) were associated with higher pain across tendon stretching tasks (R2 = 0.53).
Interpretation
In addition to exercise, the ideal management of Achilles tendinopathy may require adjunct treatments to address the multifactorial aspects of movement-evoked pain.
Details
- Title: Subtitle
- Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial
- Creators
- Adam J. JanowskiAndrew A. PostAlberto M. Heredia-RizoHadley MosbyMegan DaoLaura Frey LawEmine O. BaymanJason M. WilkenKathleen A. SlukaRuth L. Chimenti
- Resource Type
- Journal article
- Publication Details
- Clinical biomechanics (Bristol), Vol.109, 106073
- DOI
- 10.1016/j.clinbiomech.2023.106073
- PMID
- 37657267
- PMCID
- PMC10543613
- NLM abbreviation
- Clin Biomech (Bristol)
- ISSN
- 0268-0033
- eISSN
- 1879-1271
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100023029, name: Fulbright Program; DOI: 10.13039/100000069, name: National Institute of Arthritis and Musculoskeletal and Skin Diseases, award: R00 AR071517; DOI: 10.13039/501100023561, name: Ministerio de Universidades; DOI: 10.13039/100001943, name: American Physical Therapy Association; DOI: 10.13039/100005924, name: International Association for the Study of Pain; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1TR002537; DOI: 10.13039/100009713, name: Foundation for Physical Therapy Research, award: PRX21/00179
- Language
- English
- Date published
- 10/2023
- Academic Unit
- Iowa Neuroscience Institute; Biostatistics; Nursing; Anesthesia; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
- Record Identifier
- 9984459416902771
Metrics
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