Achilles Tendon Rupture Patient Outcomes at 12 Months

NCT07391553 | Not Yet Recruiting

• 2 other identifiers: JRO-0663IRAS ID: 357432
• Study Type: observational
• Target: 115
• Locations: 1 country
• Sites: 2

Brief Summary

Achilles tendon rupture is a common injury that can significantly impact strength, function, and quality of life. While non-surgical management using structured rehabilitation protocols such as the Swansea Morriston Achilles Rupture Treatment (SMART) protocol is increasingly adopted, there is limited evidence on long-term recovery outcomes, particularly beyond six months. This study aims to evaluate recovery at 12-15 months following non-surgical management of Achilles tendon rupture in an NHS population. Participants will attend a single study visit during which plantarflexor muscle strength will be assessed using isokinetic dynamometry, and patient-reported outcomes will be collected using the Achilles Tendon Total Rupture Score (ATRS) and EQ-5D-5L questionnaire. Achilles Tendon Resting Angle (ATRA) will also be measured to provide an estimate of tendon elongation. The primary objectives are to quantify plantarflexor strength recovery and self-reported functional outcomes. Secondary analyses will explore associations between strength, tendon elongation, quality of life, return to sport, and pre-injury symptoms. This cross-sectional observational study will recruit adult patients managed non-surgically with the SMART protocol from Liverpool University Hospitals NHS Foundation Trust. Findings will provide clinically relevant data on long-term recovery following conservative treatment and may inform rehabilitation strategies and return-to-activity decision-making.

Conditions

Achilles Tendon Rupture

Keywords

Achilles tendon rupture; Physiotherapy; orthopaedics; trauma; rehabilitation

Outcome Measures

Primary Outcomes (2)

• Isokinetic plantarflexor strength

  Peak torque (Nm): the maximum force produced by the calf muscles during a contraction * Peak torque normalised to bodyweight (Nm/kg): to allow comparison between individuals of different body sizes * Limb Symmetry Index (LSI): the strength of the injured limb expressed as a percentage of the uninjured limb

  12-15 months post-injury (single study visit)

• Achilles Tendon Total Rupture Score

  A validated patient-reported outcome measure assessing symptoms and functional limitations following Achilles tendon rupture. Scores range from 0 to 100, with higher scores indicating better perceived recovery.

  12-15 months post-injury (single study visit)

Secondary Outcomes (5)

• Correlation between isokinetic strength and ATRS

  12-15 months post injury

• Health-related quality of life

  12-15 months post injury

• Achilles Tendon Resting Angle

  12-15 months post injury

• Return to sport/activity status

  12-15 months post injury

• Pre-injury Achilles symptoms

  12-15 months post injury

Study Arms (1)

Non-Surgically Managed Achilles Tendon Rupture Cohort

Adults who sustained an Achilles tendon rupture and were managed non-surgically using the SMART rehabilitation protocol within Liverpool University Hospitals NHS Foundation Trust. All participants are 12-15 months post-injury at the time of assessment.

Other: Non-Surgical Management Using the SMART Protocol

Interventions

Non-Surgical Management Using the SMART Protocol OTHER

Participants previously received standard non-surgical treatment for Achilles tendon rupture following the SMART (Swansea Morriston Achilles Rupture Treatment) functional rehabilitation protocol as part of routine NHS care. No interventions are assigned as part of this study; all data are collected at a single follow-up visit.

Non-Surgically Managed Achilles Tendon Rupture Cohort

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults who previously sustained an Achilles tendon rupture and were treated non-surgically using the SMART rehabilitation protocol within Liverpool University Hospitals NHS Foundation Trust. Eligible participants are identified from an existing clinical database and represent patients 12-15 months post-injury who completed standard physiotherapy rehabilitation. All participants are drawn from routine NHS orthopaedic and physiotherapy services at Aintree and Broadgreen Hospitals.

You may qualify if:

• Aged 18 years or older at the time of recruitment
• Have a confirmed diagnosis of Achilles tendon rupture, diagnosed clinically and recorded within the NHS clinical database
• Have been managed non-surgically using the SMART (Swansea Morriston Achilles Rupture Treatment) rehabilitation protocol
• Be between 12 and 15 months post-injury at the time of study assessment
• Be able and willing to provide written informed consent to participate in the study

You may not qualify if:

• Unable to provide informed consent
• Have previously undergone surgical repair of the Achilles tendon or experienced a re-rupture
• Have a neuromuscular or neurological condition that could affect lower limb strength or function
• Did not follow the SMART rehabilitation protocol for non-surgical management
• Have a history of Achilles tendinopathy or rupture in the contralateral (uninjured) limb
• Are unable to tolerate isokinetic strength testing due to pain, discomfort, or other medical reasons

Sponsors & Collaborators

• Liverpool University Hospitals NHS Foundation Trust: lead

Study Sites (2)

Broadgreen Hospital Physiotherapy department

Liverpool, Merseyside, L14 3LB, United Kingdom

Location

Aintree University Hospital Therapies department

Liverpool, Merseyside, L9 7 AL, United Kingdom

Location

MeSH Terms

Conditions

Wounds and Injuries

Study Officials

• Jeff Morton, BSc. (Hons) Physiotherapy

  Liverpool University Hospitals NHS Foundation Trust

  STUDY CHAIR

Central Study Contacts

Raymond Healy, BSc. (Hons) Physiotherapy

CONTACT

0151 529 3335; raymond.healy@liverpoolft.nhs.uk

Jeff Morton, BSc. (Hons) Physiotherapy

CONTACT

0151 706 2760; jeff.morton@liverpoolft.nhs.uk

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Physiotherapist

Study Record Dates

• First Submitted: January 25, 2026
• First Posted: February 6, 2026
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): June 1, 2028
• Study Completion (Estimated): January 1, 2029
• Last Updated: July 6, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

GB (2)