Astym® Compared Eccentric Exercise for Chronic Mid-substance Achilles Tendinopathy

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to compare the changes in pain and self-perceived function between two different treatments for Achilles tendinopathy: the Astym® protocol (a form of soft tissue mobilization using instruments) and a specific exercise protocol that involves strengthening the calf and Achilles tendon. Astym® (A-stim) is not an acronym, but rather stands for A Stimulation of the body's healing response, describing the physiologic process which occurs with Astym treatment. Astym is the trademark name of a non-invasive treatment where instruments are applied topically to locate unhealthy soft tissue, and to transfer mild to moderate pressure to the underlying soft tissue structures. The aim of Astym treatment is to eliminate scar tissue and stimulate tissue regeneration. Both the principal investigator and co-investigator have been trained and certified in administering the Astym treatment. The specific exercise protocol will involve exercises that strengthen the Achilles and calf through eccentric exercise. Eccentric exercise is a form of exercise where the benefit comes from applying a controlled lengthening stress to the muscle and tendon.

Official Title
-----------------
Astym® Treatment Compared With Eccentric Exercise in the Management of Chronic Mid-substance Achilles Tendinopathy: A Multisite a Randomized Controlled Trial

Conditions
-----------------
Achilles Tendon Pain

Intervention / Treatment
-----------------
* Procedure: Astym


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria Pain for 3 months or longer in the mid portion of only one Achilles tendon. Must read, speak and understand English Exclusion Criteria Previous surgery to the Achilles tendon that is currently painful An injection into the Achilles tendon in the previous 4 weeks Have symptoms in both Achilles tendons concurrently Have taken fluoroquinolone antibiotics in the past 6 months

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Astym<br>A form of soft tissue mobilization using instruments | Procedure: Astym<br> <br> |
| Active Comparator: Eccentric Exercise<br>Eccentric exercise is a form of exercise where the benefit comes from applying a controlled lengthening stress to the muscle and tendon. | Procedure: Astym<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VISA-A |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain Rating Scale |  | 1 year |