Progressive Achilles Loading via Clinician E-Support (PACE): Protocol for a Dual Site Randomized Controlled Trial (Preprint)

Micah A.K.M. Wong; Mathew Frazier; Ryan Jensen; Timothy Fleagle; Barbara Van Gorp; Nicole Hall; Patrick Ten Eyck; Linder Wendt; Molly Pacha; Jessica Danielson; Mederic Hall; Jason Wilken; Ruth L. Chimenti

doi:10.2196/90955

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Progressive Achilles Loading via Clinician E-Support (PACE): Protocol for a Dual Site Randomized Controlled Trial (Preprint)

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Progressive Achilles Loading via Clinician E-Support (PACE): Protocol for a Dual Site Randomized Controlled Trial (Preprint)

Micah A.K.M. Wong, Mathew Frazier, Ryan Jensen, Timothy Fleagle, Barbara Van Gorp, Nicole Hall, Patrick Ten Eyck, Linder Wendt, Molly Pacha, Jessica Danielson, …

JMIR research protocols

01/14/2026

DOI: 10.2196/90955

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Abstract

Background: Achilles tendinopathy is a widespread condition that limits activity participation in active and sedentary populations. While exercise and education are well established treatments for Achilles tendinopathy, information is lacking on the amount of intervention required and prognostic factors for responders to non-invasive treatments. Objective: This non-inferiority, randomized controlled trial will determine the efficacy of a single-visit, physical therapist initiated rehabilitation program compared to a multi-visit, physical therapist guided rehabilitation program for Achilles tendinopathy, and identify early prognostic factors for individuals who experience the greatest improvement in pain and disability by four weeks. Methods: In this single-blind, two-arm, parallel-group, trial, 160 individuals with Achilles tendinopathy will be randomized to a single visit physical therapist-initiated rehabilitation program or to a multi-visit, physical therapist-guided telehealth rehabilitation program. Primary outcomes will be the numeric rating scale for movement pain and the Victorian Institute of Sport Assessment- Achilles for disability. Secondary outcomes will include measures of tendon health, psychosocial health domain measures, and military participation. Results: This research was funded in July 2024. Participant enrollment began August 2025 and is expected to conclude in 2028. As of January 2025, 15 participants have been enrolled at UIHC, meeting recruitment goals. Conclusions: The PACE trial will identify a rehabilitation program focused on education and exercise for Achilles tendinopathy that expands access to care and will identify factors that predict responses to exercise and education. Clinical Trial: ClinicalTrials.gov NCT06736795; https://clinicaltrials.gov/study/NCT06736795 and OSF Registries osf.io/sgj47; https://osf.io/sgj47

Details

Title: Subtitle: Progressive Achilles Loading via Clinician E-Support (PACE): Protocol for a Dual Site Randomized Controlled Trial (Preprint)
Creators: Micah A.K.M. Wong - University of Iowa
Mathew Frazier - Carl R. Darnall Army Medical Center
Ryan Jensen - Carl R. Darnall Army Medical Center
Timothy Fleagle - University of Iowa
Barbara Van Gorp - University of Iowa
Nicole Hall - University of Iowa
Patrick Ten Eyck - University of Iowa, Biostatistics
Linder Wendt - University of Iowa
Molly Pacha - University of Iowa, Physical Therapy and Rehabilitation Science
Jessica Danielson - University of Iowa
Mederic Hall - University of Iowa
Jason Wilken - University of Iowa
Ruth L. Chimenti - University of Iowa
Resource Type: Journal article
Publication Details: JMIR research protocols
DOI: 10.2196/90955
ISSN: 1929-0748
eISSN: 1929-0748
Language: English
Electronic publication date: 01/14/2026
Academic Unit: Radiology; Biostatistics; Orthopedics and Rehabilitation; Family and Community Medicine; Physical Therapy and Rehabilitation Science; Design Biostat and Ethics
Record Identifier: 9985141990102771

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