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| Name | Class |
|---|---|
| Universidade do Vale do ParaÃba | OTHER |
| Norwegian Fund for Postgraduate Training in Physiotherapy | OTHER |
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Laser treatment with the proper dosage has been found effective in the treatment of chronic Achilles tendinopathy, and animal research indicate that a combination of cryotherapy followed by LLLT could yield an even better result.
Thus, the main purpose of this project is to test if the addition of low level laser therapy can enhance the treatment result of exercise and cryotherapy in patients with chronic Achilles tendinopathy, yielding less pain and higher function.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise + Cryotherapy + LLLT | Active Comparator |
| |
| Exercise + Cryotherapy + Sham LLLT | Sham Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low-level Laser Therapy | Other | LLLT, 904 nm wavelength, 3 Joules per treatment point in accordance with World Association for Laser Therapy (WALT) guidelines. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The VISA-A questionnaire: An index of the severity of Achilles tendinopathy | Range 0-100 | Change from baseline to week 4 and 12 |
| Pain (Numerical Rating Scale) | Range 0-10 | Change from baseline to week 4 and 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Pain pressure threshold algometry | Algometer placed upon the Achilles tendon at the most sensitive spot identified by palpation. If it is unclear what the most sensitive spot is, the algometer is placed 2 cm proximal from the calcaneus. | Change from baseline to week 4 and 12 |
| Palpation tenderness |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ingvill F Naterstad, MSc | University of Bergen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Bergen | Bergen | Hordaland | 5008 | Norway |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| D005081 | Exercise Therapy |
| D017679 | Cryotherapy |
| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D013812 | Therapeutics |
| D010789 | Phototherapy |
| D012046 | Rehabilitation |
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Two identical laser devices are used, where one is active and the other is sham. One laser device has a 3x60 mW output power and the other one has 0 mW output power (sham).
These are labelled with yellow or blue tape by a secretary who is otherwise not participating in the study.
Since the laser device has an invisible beam (904 nm wavelength) and is of such low power that heat is not detected, both the participant and the clinician will be blinded.
|
| Sham Low-level Laser Therapy | Other | Same procedure as in the LLLT group with the exception of laser irradiation (0 mW mean output power). |
|
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| Exercise therapy | Other | Concentric and eccentric exercises with a total duration of approximately 20 minutes. |
|
| Cryotherapy | Other | Twenty minutes of cryotherapy applied to the Achilles tendon. |
|
The Achilles tendon is palpated by the assessor while the participant is lying prone. The participant indicates whether the pressure produces pain by answering yes/no. |
| Change from baseline to week 4 and 12 |
| Single legged heel raise | The participant stands solely on one leg and lifts the heel of the floor. The distance from the heel to the floor is measured. | Change from baseline to week 4 and 12 |
| Jump for distance | One leg take-off and landing | Change from baseline to week 4 and 12 |
| Thickness of the Achilles tendon | Measured with real time ultrasonography in a longitudinal and sagittal view. | Change from baseline to week 4 and 12 |
| Neovascularization in the Achilles tendon | Doppler activity measured with real time ultrasonography in a longitudinal and sagittal view. | Change from baseline to week 4 and 12 |
| Qualitative assessment of structural changes of the Achilles tendon | Structural changes are assessed by real time ultrasonography. The structural changes of the Achilles tendon is scored as absent, mild, moderate, or severe. | Change from baseline to week 4 and 12 |
| Qualitative assessment of effusion within of the Achilles tendon | Amount of effusion is assessed by real time ultrasonography. The amount of effusion within and around the Achilles tendon is scored as absent, mild, moderate, or severe. | Change from baseline to week 4 and 12 |
| D000359 |
| Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D026741 | Physical Therapy Modalities |