Are self-reported exercise adherence measures associated with pain and function outcomes among participants receiving treatment for Achilles tendinopathy? A secondary analysis of a randomised controlled trial.

Musculoskelet Sci Pract

Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.

Published: August 2025


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Article Abstract

Objective: To investigate whether self-reported exercise adherence to a 12-week calf exercise program is associated with pain and function in individuals with Achilles tendinopathy.

Methods: A secondary analysis of a randomised controlled trial, examining self-reported exercise adherence data in 127 participants with Achilles tendinopathy performing a 12-week rehabilitation program. Exercise adherence measures - frequency, volume, and intensity along with patient outcomes - VISA-A and pain, were collected via self-report questionnaires at 6 and 12 weeks.

Results: Completion rates were high (91 %-95 %) for adherence assessments and reported outcome measures. Adherence to frequency (78 %-58 %) reduced from 6 to 12 weeks, but adherence to sets (83 %-79 %) and repetitions was stable over this period (59 %-63 %). Pain and function (VISA-A) scores significantly improved over time. Linear mixed modelling revealed adherence to sets (p = 0.04), repetitions (p = 0.013), and added weight (p = 0.002), were significantly associated with higher VISA-A, and adherence to repetitions (p = 0.014) were significantly associated with lower pain, whilst also controlling for potential confounders. Adherence to frequency was not associated with either outcome.

Conclusion: Although adherence to frequency of exercise is commonly assessed in the literature, it was not associated with clinical outcomes in people with Achilles tendinopathy performing a 12-week rehabilitation program. However, using more weight and doing higher volume may have some relationship with improvement in clinical outcomes. This study highlights the need for researchers to improve their measurement and reporting of exercise adherence in Achilles tendinopathy.

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http://dx.doi.org/10.1016/j.msksp.2025.103362DOI Listing

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