Exploring biomarkers of change in movement-evoked pain in Achilles tendinopathy: A secondary analysis of a randomized controlled trial

IF 1.8 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI:10.1016/j.clinbiomech.2025.106706

Adam J. Janowski , Andrew A. Post , Alberto Marcos Heredia-Rizo , Laura A. Frey-Law , Emine O. Bayman , Kathleen A. Sluka , Ruth L. Chimenti

{"title":"Exploring biomarkers of change in movement-evoked pain in Achilles tendinopathy: A secondary analysis of a randomized controlled trial","authors":"Adam J. Janowski , Andrew A. Post , Alberto Marcos Heredia-Rizo , Laura A. Frey-Law , Emine O. Bayman , Kathleen A. Sluka , Ruth L. Chimenti","doi":"10.1016/j.clinbiomech.2025.106706","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Movement-evoked pain contributes to disability, yet factors that predict improvement in pain with rehabilitation remain largely unknown. We aimed to identify predictors and response biomarkers of the reduction in movement-evoked pain intensity with rehabilitation in individuals with Achilles tendinopathy (AT).</div></div><div><h3>Methods</h3><div>Individuals with AT (<em>n</em> = 65) were evaluated at baseline and after 8-weeks of rehabilitation. Pain (Numeric Rating Scale, 0 to 10) was collected during increasingly difficult tendon-loading (resting, walking, heel raises) and stretching (resting, standing, calf stretch) tasks. Psychological, ankle biomechanics, and clinical variables were collected. Linear mixed effects models were built around two paradigms of pain (tendon loading and stretching tasks) to determine variables predictive of change in pain (predictive biomarkers) and variables that changed along with change in pain (response biomarkers) with rehabilitation.</div></div><div><h3>Findings</h3><div>Lower ankle dorsiflexion during walking (β = 0.178, 95 %CI:0.06, 0.29), higher ankle dorsiflexion during stretching (β = −0.111, 95 %CI:-0.174, −0.05), a lower Victorian Institute of Sports Assessment- Achilles (VISA-A) score (β = 0.031, 95 % CI:0.010, 0.054), and younger age (β = 0.047, 95 %CI:0.022, 0.072) at baseline predicted a greater reduction in pain. For response biomarkers, reductions in duration of tendon stiffness (β = 0.018, 95 %CI: 0.001, 0.036), increases in ankle dorsiflexion during walking (β = −0.15, 95 %CI:-0.285, −0.016), reductions in depression (β = 0.109, 95 % CI:0.041, 0.178), and reductions in kinesiophobia (β = 0.151, 95 %CI:0.083, 0.219) were associated with greater reductions in pain. AT type was not associated with pain.</div></div><div><h3>Interpretation</h3><div>Regardless of AT type, kinesiophobia, ankle dorsiflexion, and clinical factors may be important factors to consider as predictors and/or response indicators for reductions in movement-evoked pain with rehabilitation.</div><div><strong>Study Registration:</strong></div><div><span><span>https://clinicaltrials.gov/study/NCT04059146</span><svg><path></path></svg></span></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106706"},"PeriodicalIF":1.8000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003325002797","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Movement-evoked pain contributes to disability, yet factors that predict improvement in pain with rehabilitation remain largely unknown. We aimed to identify predictors and response biomarkers of the reduction in movement-evoked pain intensity with rehabilitation in individuals with Achilles tendinopathy (AT).

Methods

Individuals with AT (n = 65) were evaluated at baseline and after 8-weeks of rehabilitation. Pain (Numeric Rating Scale, 0 to 10) was collected during increasingly difficult tendon-loading (resting, walking, heel raises) and stretching (resting, standing, calf stretch) tasks. Psychological, ankle biomechanics, and clinical variables were collected. Linear mixed effects models were built around two paradigms of pain (tendon loading and stretching tasks) to determine variables predictive of change in pain (predictive biomarkers) and variables that changed along with change in pain (response biomarkers) with rehabilitation.

Findings

Lower ankle dorsiflexion during walking (β = 0.178, 95 %CI:0.06, 0.29), higher ankle dorsiflexion during stretching (β = −0.111, 95 %CI:-0.174, −0.05), a lower Victorian Institute of Sports Assessment- Achilles (VISA-A) score (β = 0.031, 95 % CI:0.010, 0.054), and younger age (β = 0.047, 95 %CI:0.022, 0.072) at baseline predicted a greater reduction in pain. For response biomarkers, reductions in duration of tendon stiffness (β = 0.018, 95 %CI: 0.001, 0.036), increases in ankle dorsiflexion during walking (β = −0.15, 95 %CI:-0.285, −0.016), reductions in depression (β = 0.109, 95 % CI:0.041, 0.178), and reductions in kinesiophobia (β = 0.151, 95 %CI:0.083, 0.219) were associated with greater reductions in pain. AT type was not associated with pain.

Interpretation

Regardless of AT type, kinesiophobia, ankle dorsiflexion, and clinical factors may be important factors to consider as predictors and/or response indicators for reductions in movement-evoked pain with rehabilitation.

Study Registration:

https://clinicaltrials.gov/study/NCT04059146

查看原文本刊更多论文

探索跟腱病变中运动诱发疼痛变化的生物标志物：一项随机对照试验的二次分析。

背景：运动诱发的疼痛会导致残疾，但预测康复后疼痛改善的因素在很大程度上仍然未知。我们旨在确定跟腱病（AT）患者康复后运动诱发疼痛强度降低的预测因素和反应性生物标志物。方法：在基线和8周康复后对65例AT患者进行评估。疼痛（数值评定量表，0到10）是在越来越困难的肌腱负荷（休息、行走、抬起脚跟）和拉伸（休息、站立、小腿拉伸）任务中收集的。收集心理、踝关节生物力学和临床变量。围绕两种疼痛模式（肌腱负荷和拉伸任务）建立线性混合效应模型，以确定预测疼痛变化的变量（预测生物标志物）和随疼痛变化而变化的变量（反应生物标志物）。研究结果：行走时踝关节背屈度较低（β = 0.178, 95% CI:0.06, 0.29），伸展时踝关节背屈度较高（β = -0.111, 95% CI:-0.174, -0.05），维多利亚运动评估研究所-跟腱（VISA-A）评分较低（β = 0.031, 95% CI:0.010, 0.054），基线时较年轻（β = 0.047, 95% CI:0.022, 0.072），预测疼痛减轻程度较大。对于反应生物标志物，肌腱僵硬持续时间的减少（β = 0.018, 95% CI: 0.001, 0.036），步行时踝关节背屈的增加（β = -0.15, 95% CI:-0.285, -0.016），抑郁的减少（β = 0.109, 95% CI:0.041, 0.178）和运动恐惧症的减少（β = 0.151, 95% CI:0.083, 0.219）与疼痛的更大减轻相关。AT型与疼痛无关。解释：无论何种AT类型，运动恐惧症、踝关节背屈和临床因素都可能是重要的因素，可以作为预测和/或康复后运动诱发疼痛减少的反应指标。研究注册：https://clinicaltrials.gov/study/NCT04059146。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.