Disclosures: Alexandre Lavigne, MD: No financial relationships or conflicts of interest

Objective: To assess pain evolution in patients with midportion Achilles tendinopathy on a weekly basis during and after completing an eccentric strengthening protocol.

Design: A prospective observational study with repeated measurements.

Setting: The Achilles tendon eccentric strengthening exercises are performed twice daily on a step at home.

Participants: Patients affected by midportion Achilles tendinopathy diagnosed clinically and confirmed with ultrasound imaging who are symptomatic for more than 6 weeks and less than 2 years.

Interventions: Participants perform Alfredson’s eccentric strengthening protocol for 12 weeks and enter data in a research mobile app on a weekly basis for the 12 weeks of the exercise protocol and the 12 weeks following the end of the exercise protocol. Participants quantify on their mobile app compliance to the exercise protocol, pain according to the Visual Analog Scale (VAS) and minutes of physical activity with and without impact.

Main Outcome Measures: Pain evolution according to VAS during 24 weeks.

Results: In this cohort of 30 participants, the average age is 49.9 years old (SD=8.5) and the average duration of pain since the Achilles tendinopathy onset is 28.8 weeks (SD=24). The regression curve shows a continuous pain improvement from week 0 to week 16, and a pain plateau from week 16 until week 24, but no pain relapse. The average pain improvement is 0.32/10 per week during the first 16 weeks. VAS pain improvement during the 12-week exercise program is 4.68/10 for high-compliant participants (compliance above 75%) compared to 3.57/10 for low-compliant participants (compliance below 75%), p=0.11.

Conclusions: This study, using a mobile app to assess the effectiveness of Achilles tendinopathy rehabilitation, allowed to understand the patients’ pain trend, since pain is a dynamic parameter and cannot be solely assessed with punctual data. This study also kept track of potential rehabilitation determinants such as treatment compliance and mechanical stress quantification.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/weekly-pain-evolution-of-midportion-achilles-tendinopathy-during-and-after-alfredsons-eccentric-strengthening-protocol-monitored-with-mobile-app/