Do physical tests have a prognostic value in chronic midportion Achilles tendinopathy?

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Achilles tendinopathy is a common condition affecting athletes and active individuals.
• Patient-reported outcomes (PROs) are crucial for evaluating treatment effectiveness.
• Predictive markers for PROs in Achilles tendinopathy are valuable for personalized treatment strategies.

Purpose of the Study:

• To investigate the prognostic value of baseline physical tests on patient-reported outcomes in chronic midportion Achilles tendinopathy.
• To identify specific physical examination findings that predict treatment response.

Main Methods:

• Prospective cohort study analyzing data from a randomized trial.
• 80 patients with chronic midportion Achilles tendinopathy performed a progressive calf muscle exercise program.
• Baseline and follow-up assessments included the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire and physical tests (range of motion, strength, jump height, pain provocation tests).
• Mixed Linear Models were used to assess associations between baseline tests and VISA-A improvement.

Main Results:

• Significant improvement in VISA-A scores was observed after 24 weeks (mean change: 20 points).
• Baseline ankle dorsiflexion with a bent knee was associated with improved VISA-A scores (β=0.2, P=0.049).
• Baseline pain provocation tests (Visual Analogue Scale for palpation and 10 hops) showed significant negative associations with VISA-A improvement (β=-0.2 to -0.3, P<0.001).

Conclusions:

• Simple pain provocation tests at baseline have clinically relevant prognostic value for patient-reported outcomes in Achilles tendinopathy.
• Patients with lower baseline pain during these tests experience better improvements in pain, function, and activity levels.
• These findings support the use of pain provocation tests to guide treatment expectations and personalize care for Achilles tendinopathy.