Topical Glyceryl Trinitrate (GTN) and Eccentric Exercises in the Treatment of Midportion Achilles Tendinopathy

Launched by ROYAL COLLEGE OF SURGEONS, IRELAND · Jul 13, 2015

Keywords

ClinConnect Summary

Study Design

The study will be designed to meet CONSORT guidelines. A randomized placebo controlled trial will be carried out at the Physiotherapy Department of Connolly Hospital, Blanchardstown, Dublin 15. The study will be conducted on patients who present to the department with a diagnosis of Achilles tendinopathy. The diagnosis will be confirmed based on a history of an insidious onset of Achilles tendon pain, a tender nodule/thickening of the tendon to the region 2 to 6cm from the calcaneal insertion, and an ultrasound examination that excludes a frank tear.

Participants will be rand...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Current diagnosis of Achilles tendinopathy
• • 2. Subjects must be able and willing to give written informed consent and to comply with the requirements of this study protocol
• • 3. Subjects must be male or female, aged 18 years or above at Baseline
• • 4. Achilles pain of \>3 months or more
• • 5. Mid-portion Achilles tenderness and thickening on palpation
• • 6. Confirmation of the diagnosis upon Ultra-sound assessment, and ruling out of other pathologies (eg: ruptures)
• Exclusion Criteria:
• • 1. Previous corticosteroid injection to the affected tendon in the past 3 months
• • 2. Symptoms of less than 3 months duration
• • 3. Previous use of topical GTN
• • 4. Current use of nitrates, eg: GTN spray, tablet, transdermal patch.
• • 5. Contra-indication to GTN therapy (see section 12.2.3)
• • 6. Current pregnancy, breastfeeding or planning pregnancy
• • 7. VISA-A score \> 80
• • 8. Previous surgery to the affected Achilles tendon
• • 9. Seronegative spondyloarthropathy with Achilles enthesitis
• • 10. Previous performance of a heavy load eccentric exercise program of the Achilles in the last 2 years
• • 11. Severe migraines which fail to respond to over the counter medication and require specific migraine management
• • 12. Inability to perform the exercise program due to serious illness, such as unstable angina/blood pressure, myocardial infarction in past three months, cardiomyopathy, uncontrolled metabolic disease, recent ECG changes, advanced respiratory disease or third degree heart block.
• • 13. Any medical or psychiatric condition that the investigator deems appropriate for exclusion
• • 14. Staff or students of Connolly Hospital, Blanchardstown