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Progressive Achilles Loading via Clinician e-Support (PACE): Protocol for a Dual-Site Randomized Controlled Trial
Micah A K M Wong1, Mathew Frazier2, Ryan Jensen2
1Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 500 Newton Rd., Iowa City, IA, United States, 1 3193359802.
JMIR Research Protocols
|April 7, 2026
Summary
This study compares single-visit versus telehealth physical therapist (PT) rehabilitation for Achilles tendinopathy (AT). It aims to find effective treatments and predict patient responses to exercise and education for this common condition.
Area of Science:
- Sports Medicine
- Rehabilitation Science
- Orthopedics
Background:
- Achilles tendinopathy (AT) is a prevalent condition affecting both athletic and sedentary individuals.
- Current exercise and education treatments for AT lack defined intervention durations and identified prognostic factors for noninvasive treatment response.
- Further research is needed to optimize rehabilitation strategies and predict outcomes for Achilles tendinopathy.
Purpose of the Study:
- To determine the efficacy of a single-visit, physical therapist (PT)-initiated rehabilitation program compared to a multivisit, PT-guided telehealth program for Achilles tendinopathy (AT).
- To identify early prognostic factors associated with the greatest improvement in pain and disability within four weeks for individuals with AT.
- To expand access to effective AT rehabilitation through innovative delivery models.
Main Methods:
- A noninferiority randomized controlled trial involving 160 individuals diagnosed with Achilles tendinopathy.
- Participants will be randomly assigned to either a single-visit PT-initiated program or a multivisit, PT-guided telehealth program.
- Primary outcomes include pain (numeric rating scale) and disability (Victorian Institute of Sport Assessment-Achilles), with secondary measures of tendon health, psychosocial factors, and military readiness.
Main Results:
- Participant enrollment for the PACE trial began in August 2025 and is ongoing, with 15 participants enrolled as of January 2026.
- The study is projected to conclude in 2028, with recruitment meeting initial goals.
- Preliminary data on treatment efficacy and prognostic factors are not yet available.
Conclusions:
- The PACE trial aims to identify an optimal rehabilitation program for Achilles tendinopathy (AT) utilizing education and exercise.
- The study will provide insights into factors that predict patient response to these noninvasive interventions.
- Findings are expected to enhance the accessibility and effectiveness of AT treatment.
