Lower-Extremity Kinetic Chain Exercise Program for Achilles Tendinopathy

NCT07730866 | Active Not Recruiting

• 1 other identifier: AT-RCT
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Achilles tendinopathy is a common condition that causes pain, stiffness, and reduced function of the Achilles tendon. It can affect both physically active individuals and the general adult population, often making everyday activities and exercise more difficult. Exercise therapy is widely used as the primary conservative treatment; however, rehabilitation programs that focus only on the Achilles tendon may not address movement impairments involving the entire lower extremity. This randomized controlled trial will evaluate a rehabilitation program based on the lower-extremity kinetic chain in adults with chronic mid-portion Achilles tendinopathy. Fifty participants will be randomly assigned to receive either a kinetic chain-based exercise program or a conventional rehabilitation program. Assessments will be completed before the intervention begins and again after it is finished. The study will measure postural stability using the Biodex Balance System, foot and ankle function using the Foot and Ankle Outcome Score (FAOS), pain intensity using the Visual Analog Scale (VAS), and ankle range of motion using a goniometer. The results will provide information on the effects of a rehabilitation approach that addresses the coordinated function of the lower extremity in people with chronic Achilles tendinopathy.

Conditions

Achilles Tendinopathy (AT)

Keywords

Achilles Tendinopathy; Kinetic Chain Exercise; Lower-Extremity Rehabilitation Exercise Therapy; Postural Stability

Outcome Measures

Primary Outcomes (1)

• overall stability index

  The Overall Stability Index (OSI) will be measured using the Biodex Balance System to assess dynamic postural stability. The OSI quantifies the variance of platform displacement from level in all directions during dynamic balance testing. Lower OSI values indicate better postural stability, whereas higher values indicate greater postural instability.

  Baseline and immediately after completion of the 8-week intervention

Secondary Outcomes (3)

• Pain Intensity Level

  Baseline and immediately after completion of the 8-week intervention

• Foot and Ankle Function

  Baseline and immediately after completion of the 8-week intervention

• Ankle Joint Range of Motion

  Baseline and immediately after completion of the 8-week intervention

Study Arms (2)

Lower-Extremity Kinetic Chain Exercise Group

EXPERIMENTAL

Participants assigned to the experimental group will receive a supervised lower-extremity kinetic chain-based exercise program designed to improve lower-limb neuromuscular control, movement coordination, strength, flexibility, and postural stability. The program includes progressive exercises targeting the foot, ankle, knee, hip, and trunk while addressing movement patterns throughout the lower-extremity kinetic chain, adding to the conventional exercise rehabilitation program. The intervention will be delivered for 8 weeks.

Behavioral: Lower-Extremity Kinetic Chain Exercise Program; Behavioral: Conventional Exercise Program

Conventional Exercise Group

ACTIVE COMPARATOR

Participants assigned to the comparison group will receive a conventional exercise rehabilitation program for chronic Achilles tendinopathy consisting of standard therapeutic exercises focused primarily on the Achilles tendon and calf musculature according to current rehabilitation practice. The intervention will be delivered for the same treatment period as the experimental group.

Behavioral: Conventional Exercise Program

Interventions

Lower-Extremity Kinetic Chain Exercise Program BEHAVIORAL

The program includes progressive exercises targeting the foot, ankle, knee, hip, and trunk while addressing movement patterns throughout the lower-extremity kinetic chain

Lower-Extremity Kinetic Chain Exercise Group

Conventional Exercise Program BEHAVIORAL

A standard rehabilitation program consisting of conventional therapeutic exercises commonly prescribed for chronic Achilles tendinopathy, including tendon-loading and lowe

Conventional Exercise Group; Lower-Extremity Kinetic Chain Exercise Group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• \- Adults aged 18-45 years.
• Male and female participants.
• Clinical diagnosis of Achilles tendinopathy, confirmed by an orthopedic physician or physiotherapist and history of Achilles tendon surgery or lower-limb surgery within the previous 12 months.
• Symptoms (pain, stiffness, and impaired function) persisting for at least 3 months (chronic Achilles tendinopathy).
• Pain reproduced during tendon-loading activities (e.g., walking, running, hopping, or single-leg heel raises).
• Ability to walk independently without an assistive device.
• Body Mass Index (BMI) between 18.5 and \<30 kg/m².
• Willingness to participate and provide written informed consent.

You may not qualify if:

• \- Patients with insertional Achilles tendinopathy or a partial/complete Achilles tendon rupture.
• History of lower-limb fracture within the previous 12 months.
• Presence of systemic inflammatory, rheumatologic, or connective tissue disorders (e.g., rheumatoid arthritis, ankylosing spondylitis).
• Neurological disorders affecting balance, gait, or lower-limb function (e.g., stroke, Parkinson's disease, peripheral neuropathy, multiple sclerosis).
• Vestibular disorders or other conditions known to impair postural stability.

Sponsors & Collaborators

• May University in Cairo: lead

Study Sites (1)

Faculty of Physical Therapy, May University in Cairo

Cairo, Cairo Governorate, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of physical Therapy, Department of Basic Science

Study Record Dates

• First Submitted: July 23, 2026
• First Posted: July 28, 2026
• Study Start: June 6, 2026
• Primary Completion (Estimated): August 2, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: July 28, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)