Table 2.
For specific aim 1, study outcomes will be assessed pretreatment (week 0 at evaluation session 1), after completion of education combined with exercise (week 8 at evaluation session 2), and after 4 weeks of continuing the home exercise program at home (week 12 at evaluation session 3).
| Outcome | Description | Time (weeks) | ||||
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0 | 8 | 12 | ||
| Specific aim 1 | ||||||
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Pain | |||||
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Movement-evoked pain during heel raisesa | Participants will rate the intensity and location of their Achilles tendon pain using the 11-point NPRSb during maximum number of single limb heel raises and 3 single limb hops [33,34]. Pain will be assessed during movement activities using the NPRS which consists of a 0-10 scale where 0 represent “no pain” and 10 represents “worst pain imaginable.” Test-retest reliability: r=0.67-0.96. Convergent validity: r=0.79-0.95 [34] | Xc | X | —d |
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Anticipated movement-evoked pain | Participants will rate the anticipated intensity of their Achilles tendon pain using a 101-point NPRS before heel raises and before hopping [33] | X | X | X |
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Tendon stiffness | Participants will rate the average duration of stiffness in the Achilles tendon in the morning from 0 to ≥100 min over the past week | X | X | X |
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Global rating of change | Anticipated and final change in the overall condition of the Achilles tendon on a 15-point scale. Test-retest reliability: ICCe 0.90. Face validity: r=0.72-0.90 [35] | X | X | X |
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Anticipated change in symptoms | Anticipated and final change in symptoms on a 15-point scale following physical therapy [35] | X | X | X |
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Function | |||||
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Global physical functiona | Self-reported physical function will be assessed with the patient-reported outcomes measurement information system 2.0 and computer adaptive test physical function, which has been used in orthopedic and Achilles tendon populations [18,19]. Internal consistency reliability: r=0.96. Convergent validity: r=0.68-0.79 [36] | X | X | X |
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Achilles tendon function | Function will be assessed with the Victorian Institute of Sport Assessment-Achilles questionnaire as a symptom severity measure with activity that is specific to patients with ATf. Test-retest reliability: r=0.93. Construct validity: r=0.58 [37] | X | X | X |
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Activity log | Self-reported activity, including type (aerobic and strengthening) and duration per week on the home exercise log for first week compared with last week of exercise-education program | — | X | — |
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Activity level | International Physical Activity Questionnaire Short-Form and self-reported activity levels including number of days and time spend completing vigorous or moderate activity, walking or sitting over past 7 days. Test-retest reliability: r=0.32-0.88. Criterion validity: r=0.12-0.57 [38] | X | X | X |
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Patient-specific functional scale | Patient-reported ability to complete self-selected activities on an 11-point scale: 0=unable to perform activity and 10=able to perform activity at previous level. Test-retest: r=0.84 [39]. Concurrent validity: r=0.55-0.83 [40] | X | — | X |
aPrimary outcomes.
bNPRS: numeric pain rating scale.
cOutcome collected at timepoint.
dOutcome not collected at timepoint.
eICC: intraclass correlation coefficient.
fAT: Achilles tendinopathy.