Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial.

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 v...

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Publicado en:Clinical Biomechanics Vol. 109
Autores principales: Janowski, Adam J., Post, Andrew A., Heredia-Rizo, Alberto M., Mosby, Hadley, Dao, Megan, Law, Laura Frey, Bayman, Emine O., Wilken, Jason M., Sluka, Kathleen A., Chimenti, Ruth L.
Formato: research Journal Article
Publicado: Elsevier B.V. Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
      vid: 109
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      pub: Elsevier B.V.
      place: New York, New York
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        172366331
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        10.1016/j.clinbiomech.2023.106073
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        atl: Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial.
      aug:
        au:
          Janowski, Adam J.
          Post, Andrew A.
          Heredia-Rizo, Alberto M.
          Mosby, Hadley
          Dao, Megan
          Law, Laura Frey
          Bayman, Emine O.
          Wilken, Jason M.
          Sluka, Kathleen A.
          Chimenti, Ruth L.
        affil: Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
      sug:
        subj:
          Achilles Tendinopathy Complications
          Pain Risk Factors
          Stretching Physiology
          Movement Physiology
          Partial Weight-Bearing Physiology
          Risk Assessment
          Human
          Secondary Analysis
          Randomized Controlled Trials
          Biomechanics
          Cross Sectional Studies
          Achilles Tendinopathy Symptoms
          Pain Psychosocial Factors
          Scales
          Confidence Intervals
          Descriptive Statistics
          Pain Measurement
      ab: 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. 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. 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). In addition to exercise, the ideal management of Achilles tendinopathy may require adjunct treatments to address the multifactorial aspects of movement-evoked pain. • Limited use of ankle dorsiflexion is associated with more severe pain in Achilles tendinopathy. • No association was found between movement-evoked pain and ankle power during fast walking. • Achilles tendinopathy type seems to influence movement-evoked pain and ankle biomechanics.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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