[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100606658":3},{"organization":4,"armGroups":7,"interventions":20,"overallOfficials":25,"centralContacts":30,"locations":40,"responsibleParty":65,"collaborators":69,"id":72,"slug":73,"hasResults":74,"nctId":75,"briefTitle":76,"officialTitle":77,"acronym":25,"eligibilityCriteria":78,"healthyVolunteers":74,"sex":79,"minAge":80,"maxAge":81,"enrollmentInfo":82,"targetDuration":25,"studyType":85,"phases":86,"briefSummary":88,"conditions":89,"keywords":97,"overallStatus":102,"whyStopped":25,"lastUpdateSubmitDate":103,"lastUpdatePostDateStruct":104,"startDateStruct":107,"completionDateStruct":109,"leadSponsor":111,"locationsCount":112},{"fullName":5,"class":6},"Halic University","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Alfredson protocol","ACTIVE_COMPARATOR","Participants in this group will follow the classical Alfredson eccentric heel-drop protocol, widely used in the management of Achilles tendinopathy.",[13],"Other: Alfredson Protocol",{"label":15,"type":16,"description":17,"interventionNames":18},"muscle architecture-based exercise program","EXPERIMENTAL","Participants in this group will perform an exercise program tailored to the architectural properties of the triceps surae muscles. Positioning and loading strategies will be individualized to optimize activation of the soleus and gastrocnemii.",[19],"Other: Muscle Architecture-Based Exercise Program",[21,26],{"type":6,"name":22,"description":23,"armGroupLabels":24,"otherNames":25},"Muscle Architecture-Based Exercise Program","Participants in this arm will perform exercises specifically designed according to the architectural and functional properties of the triceps surae muscles. For example, knee-flexed positions will be used to target the soleus, while knee-extended positions will be emphasized for the gastrocnemii. Loading intensity and exercise progression will be tailored to optimize tendon and muscle remodeling.",[15],null,{"type":6,"name":27,"description":28,"armGroupLabels":29,"otherNames":25},"Alfredson Protocol","This intervention involves the traditional eccentric heel-drop program, originally developed for mid-portion Achilles tendinopathy. Participants perform three sets of 15 repetitions, twice daily, throughout the intervention period. Exercises are carried out both with the knee extended and flexed to load different portions of the triceps surae. The protocol applies repetitive eccentric loading to the Achilles tendon with the aim of stimulating collagen synthesis, reducing symptoms, and promoting tendon adaptation.",[9],[31,36],{"name":32,"role":33,"phone":34,"phoneExt":25,"email":35},"Ömer Bayrak, Research Assistant","CONTACT","+905558826116","omer.bayrak16@icloud.com",{"name":37,"role":33,"phone":38,"phoneExt":25,"email":39},"Defne KAYA UTLU, Professor","+90 (530) 696 03 56","defne.kayautlu@sbu.edu.tr",[41,61],{"facility":42,"status":25,"city":43,"state":44,"zip":45,"country":46,"countryCode":25,"cosmosGeoPoint":47,"geoPoint":52,"contacts":53},"İstanbul University","Istanbul","Fatih","34060","Turkey (Türkiye)",{"type":48,"coordinates":49},"Point",[50,51],28.94966,41.01384,{"lat":51,"lon":50},[54,57],{"name":55,"role":33,"phone":56,"phoneExt":25,"email":35},"Ömer Bayrak, Resarch Assistant","05558826116",{"name":58,"role":33,"phone":59,"phoneExt":25,"email":60},"Mehmet Demirel, Medical Doctor, Assistant Prof","+90 (531) 633 39 75","mehmet.demirel@istanbul.edu.tr",{"facility":42,"status":25,"city":43,"state":44,"zip":45,"country":46,"countryCode":25,"cosmosGeoPoint":62,"geoPoint":64,"contacts":25},{"type":48,"coordinates":63},[50,51],{"lat":51,"lon":50},{"type":66,"investigatorFullName":67,"investigatorTitle":68,"investigatorAffiliation":5,"oldNameTitle":25,"oldOrganization":25},"PRINCIPAL_INVESTIGATOR","Ömer Bayrak","Research Assistant",[70],{"name":71,"class":6},"Istanbul University","100606658","muscle-architecture-vs-alfredson-protocol-in-achilles-tendinopathy-100606658",false,"NCT07178418","Muscle Architecture vs Alfredson Protocol in Achilles Tendinopathy","The Effects of a Muscle Architecture-Based Exercise Program and the Alfredson Protocol on Muscle-Tendon Architecture and Physical Performance in Subjects With Achilles Tendinopathy","Inclusion Criteria:\n\n* Presence of pain and tenderness in the mid-portion of the Achilles tendon (2-6 cm proximal to the insertion) persisting for at least 3 months\n* Clinical diagnosis of non-insertional Achilles tendinopathy\n* Pain aggravated by physical activity\n* Palpable tenderness localized to the mid-portion of the tendon\n* Voluntary participation in the study with signed informed consent\n\nExclusion Criteria:\n\n* Diagnosis of insertional Achilles tendinopathy\n* History of surgery or fracture in the affected lower limb within the past 12 months\n* Corticosteroid injection to the Achilles tendon within the past month\n* Presence of systemic diseases (e.g., diabetes mellitus, rheumatoid arthritis)\n* Presence of neurological disorders (e.g., peripheral neuropathy, central nervous system disorders)\n* Prior experience with eccentric exercise protocols targeting the Achilles tendon\n* Acute onset of symptoms suggestive of a tendon rupture","ALL","18 Years","60 Years",{"count":83,"type":84},20,"ESTIMATED","INTERVENTIONAL",[87],"NA","Achilles tendinopathy is a frequent overuse disorder caused by repetitive loading of the tendon, particularly observed in athletes and middle-aged men. It is typically characterized by mid-portion pain, stiffness in the morning, and functional limitations, with structural alterations such as thickening and disrupted collagen alignment. Chronic progression often compromises performance and quality of life.\n\nEccentric training protocols, such as the Alfredson regimen, are commonly prescribed but their standardized nature does not fully address individual variability. Alternative approaches including Heavy Slow Resistance training and progressive loading models (e.g., Silbernagel protocol) have demonstrated clinical effectiveness and higher patient adherence, yet they still apply uniform loading across the triceps surae without accounting for architectural differences.\n\nGiven the heterogeneous structure of the soleus and gastrocnemii, targeted loading strategies may be required to optimize tendon adaptation. To address this, the present study employs a muscle architecture-based exercise program tailored to the functional and structural properties of each muscle. Ultrasound imaging will be used to evaluate muscle-tendon morphology, while isokinetic dynamometry and functional performance tests will quantify outcomes. Pain (VAS) and functional capacity (VISA-A) will also be assessed.\n\nThis randomized controlled trial aims to compare the effectiveness of an architecture-specific program with the Alfredson protocol on tendon remodeling, strength, endurance, functional performance, and symptom reduction in individuals with non-insertional Achilles tendinopathy.",[90,91,92,93,94,95,96],"Achilles Tendinopathy (AT)","Eccentric Exercise Training","Muscle Architecture","Isokinetic Test","Ultrasound","Balance","Anaerobic Power",[98,99,100,9,101],"Achilles tendinopathy","muscle architecture","isokinetic strength","tendon architecture","NOT_YET_RECRUITING","2025-09-10",{"date":105,"type":106},"2025-09-17","ACTUAL",{"date":108,"type":84},"2025-10-15",{"date":110,"type":84},"2026-12-31",{"name":5,"class":6},2]