Achilles Tendinopathy Clinical Trial
Official title:
Safety and Efficacy of Repetitive Peripheral Magnetic Stimulation in Patients With Achilles Tendinopathy
With this prospective, randomized, controlled trial the investigators want to investigate
effects of a prolonged repetitive Peripheral Magnetic Stimulation (rPMS) intervention on
Achilles tendinopathy and compare it to a well established intervention. This may provide
clinicians with a new, non-pharmacological, non-invasive, near painless approach to treat
tendinopathy.
Although promising results with comparable devices exist, a direct and valid conclusion on
the overall clinical performance of the investigational device cannot be drawn. This is
mainly due to different treatment protocols used in the literature and due to the lack of
insight in the technical documentation of comparable devices. Further, the applied magnetic
fields vary in their amplitude, frequency, waveform and/or stimulation durations.
Therefore, the main goal of this clinical investigation is the collection of clinical data on
the clinical performance of the investigational device. This clinical data will subsequently
serve as a main source for the clinical evaluation of the medical device.
Tendons are collagenous tissues that link muscle to bone, and in best case, a painless
transmission of force allows voluntary movement over a life time. Although tendons show long
time underestimated repair and remodelling capacities, some of them (e.g. the human patellar
or Achilles tendon) remain quite prone to injury. To make things worse, tendinous tissue
reveals incomplete healing capacities and treatments seem to be ineffective to avoid the high
injury recurrence rate and/or the occurrence of chronic tendon pain. Thus, both elite and
recreational athletes, as well as the non-sporting population or workplace employees often
suffer from symptoms like tendon swelling, localized tenderness, activity related pain and
impaired performance, also known as tendinopathy. Such pain-induced restriction of mobility
frequently means the end of a sporting carrier, deteriorates the quality of life and patients
have to live with all harmful consequences of physical inactivity. One tendon most commonly
afflicted by this debilitating musculoskeletal injury is the Achilles tendon. Although it is
the strongest tendon in our body, the prevalence for tendinopathy can be as high as 56% among
certain athletes.
The repetitive peripheral magnetic stimulation (rPMS) works through a deep operating, focused
and painless stimulation mechanism generated by pulsed magnetic fields. This intervention is
already successfully in use to accelerate the healing of bone fractures and to enhance the
healing of operated rotator cuff tears. Additionally, data on in vitro tendon cells indicate
the positive effect of rPMS on tendon tissue by stimulating cell proliferation, up-regulating
tendon-specific gene expression and releasing anti-inflammatory cytokines and growth factors.
More interestingly, intervention studies on the healing of rotator cuff tendon-to-bone
injuries in rat models show increases in tendon stiffness and modulus and enhanced collagen
organization, and type I collagen expression after prolonged rPMS without showing adverse
effects in any mechanical or histological property. These results strongly support the
hypothesis that rPMS might be effective in treating Achilles tendinopathy in humans. This
intervention might reduce pain and functional limitations, reverse tendon degenerative
changes and increase the impaired tendon mechanical and material properties.
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