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Recovery of symptoms, function, tendon structure and mechanical properties in patients with Achilles Tendinopathy: A comparison between men and women

Award Number: R01AR072034
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2018
PERIOD OF PERFORMANCE END DATE: 03/31/2024

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Recovery of symptoms, function, tendon structure and mechanical properties in patients with Achilles Tendinopathy: A comparison between men and women - Project Summary/Abstract Achilles tendinopathy has an incidence rate of 2.35 per 1000 in the general population and is most prevalent in middle-aged individuals (35-55 y/o), but occurs in men and women of all ages. The primary symptom is pain during daily activities such as walking and exercising such as running. Aside from the pain, Achilles tendinopathy has been shown to significantly decrease physical activity level, resulting in further negative effects on overall health and well-being. The treatment for Achilles tendinopathy with the highest level of evidence is eccentric exercise, providing mechanical loading of the muscle-tendon unit. In a recent systematic review, all studies reported significant improvements in patient-reported symptoms but at 12 weeks the means ranged from 69-80 (100 being fully recovered) indicating that even with the most effective treatment individuals continued to have symptoms. At this time, other more invasive interventions such as injection therapies (ex. platelet-rich plasma) and surgery are recommended for patients who fail exercise treatment despite a lack of understanding of what factors are related to continued problems. Just achieving a reduction in pain and symptoms with treatment also does not ensure resolution of the tendon's structural abnormalities. In fact, studies evaluating the recovery of tendon structure with exercise suggest that at least 24 weeks may be needed to observe a significant change. Other individual factors such as sex, degree of tendon structural damage and functional deficits are also proposed to influence both the time course and success rate of recovery. The long-term goal of our research is to advance understanding of tendon injuries and repair, enabling tailored treatments to be developed. This study begins to address this long-term goal by evaluating the time-course of recovery in terms of tendon structure (ultrasound imaging) and viscoelastic properties (elastography) along with symptoms (patient-reported outcomes) and muscle-tendon function (functional test-battery) in men and women with Achilles tendinopathy treated with an exercise program. Aim 1 is to evaluate if there are differences in change over time in symptoms, muscle-tendon function, tendon structure, and mechanical properties between males and females with Achilles tendinopathy receiving exercise treatment. Aim 2 is to investigate whether the presence and magnitude of tendon structural abnormality at baseline will affect the ability and time-course of recovery with exercise treatment for Achilles tendinopathy. Aim 3 is to explore if patients who continue to have symptoms at the 16-week evaluation will further improve in symptoms, muscle-tendon function, tendon structure and mechanical properties over the course of one year. This study will be the first to evaluate if there is a difference in recovery of tendon structure and mechanical properties between males and females with Achilles tendinopathy receiving exercise treatment. It will also be the first study to evaluate recovery of tendinopathy with exercise intervention using outcome measures for tendon structure and mechanical properties along with validated measures of muscle-tendon function and symptoms.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = -$1,211 )
2024	2022	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	8/5/2024	SUPPLEMENT FOR EXPANSION	-$1,211
														Subtotal = -$1,211

Issue Date FY: 2022 ( Subtotal = $397,101 )
2022	2022	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	5/10/2022	NON-COMPETING CONTINUATION	$332,598
2022	2022	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	5	5/11/2022	SUPPLEMENT FOR EXPANSION	$64,503
														Subtotal = $397,101

Issue Date FY: 2021 ( Subtotal = $534,463 )
2021	2021	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	4/30/2021	NON-COMPETING CONTINUATION	$469,960
2021	2021	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	4	5/3/2021	SUPPLEMENT FOR EXPANSION	$64,503
														Subtotal = $534,463

Issue Date FY: 2020 ( Subtotal = $547,717 )
2020	2020	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	3	4/30/2020	SUPPLEMENT FOR EXPANSION	$59,101
2020	2020	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	3/31/2020	NON-COMPETING CONTINUATION	$488,616
														Subtotal = $547,717

Issue Date FY: 2019 ( Subtotal = $488,616 )
2019	2019	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	3/29/2019	NON-COMPETING CONTINUATION	$488,616
														Subtotal = $488,616

Issue Date FY: 2018 ( Subtotal = $487,243 )
2018	2018	UNIVERSITY OF DELAWARE	220 HULLIHEN HALL	NEWARK	DE	19716	NEW CASTLE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	3/30/2018	NEW	$487,243
														Subtotal = $487,243

Grand Total All Awards = $2,453,929

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Recovery of symptoms, function, tendon structure and mechanical properties in patients with Achilles Tendinopathy: A comparison between men and women

Award Number: R01AR072034

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/01/2018

PERIOD OF PERFORMANCE END DATE: 03/31/2024

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