Standardized pain mapping for diagnosing Achilles tendinopathy

Visser, Tjerk S O Sleeswijk; Es, Eline M. van; Meuffels, Duncan E.; Verhaar, Jan A N; Vos, Robert‐Jan de

doi:10.1016/j.jsams.2021.10.010

Cited by 4 publications

(7 citation statements)

References 27 publications

(42 reference statements)

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“…However, in this study, we enhanced diagnostic accuracy by implementing a standardised pain map 22. A prior investigation demonstrated a 93% concordance between patient-reported Achilles tendinopathy when using a pain map and diagnoses made by a physician 23. These findings suggest that, in the majority of cases, self-reported Achilles tendinopathy aligns with the clinical diagnosis.…”

Section: Discussionmentioning

confidence: 64%

“…Participants self-identified as having Achilles tendon pain and were provided with a pain map of established locations of Achilles tendon symptoms and asked to select all markings that corresponded to their region of pain (which is superior to both palpation and ultrasound tissue characterisation for pain localisation) 22. Participants who selected the insertion or mid-portion Achilles tendon were included within this validation study and this methodology provides ‘near-perfect’ agreement to sports physician diagnosis of Achilles tendinopathy 23…”

Section: Methodsmentioning

confidence: 99%

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TENDINopathy Severity assessment–Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations

Murphy,

McCleary,

Hince

et al. 2024

Br J Sports Med

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ObjectiveTo evaluate the construct validity (structural validity and hypothesis testing), reliability (test–retest reliability, measurement error and internal consistency) and minimal important change (MIC) of the 13-item TENDINopathy Severity assessment–Achilles (TENDINS-A).MethodsParticipants with Achilles pain completed an online survey including: demographics, TENDINS-A, Foot and Ankle Outcome Score (FAOS) and Victorian Institute of Sport Assessment–Achilles (VISA-A). Exploratory factor analysis (EFA) assessed dimensionality. Confirmatory factor analysis (CFA) assessed structural validity (root mean square error of approximation (RMSEA); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); standardised root measure square (SRMS)). Correlations between TENDINS-A and the FAOS or VISA-A assessed hypothesis testing. Intraclass correlation (ICC) assessed test–retest reliability. Cronbach’s alpha assessed internal consistency. SE of the measurement (SEM) assessed measurement error. A distribution-based approach assessed MIC.Results79 participants (51% female) with a mean (SD) age=42.6 (13.0) years, height=175.0 (11.7) cm and body mass=82.0 (19.1) kg were included. EFA identified three meaningful factors, proposed as pain, symptoms and function. The best model identified using CFA for TENDINS-A had structural validity (RMSEA=0.101, CFI=0.959, TLI=0.947, SRMS=0.068), which included three factors (pain, symptoms and function), but excluded three items from the original TENDINS-A. TENDINS-A exhibited moderate positive correlation with FAOS (r=0.598, p<0.001) and a moderate negative correlation with VISA-A (r=−0.639, p<0.001). Reliability of the TENDINS-A was excellent (ICC=0.930; Cronbach’s α=0.808; SEM=6.54 units), with an MIC of 12 units.ConclusionsOur evaluation of the revised 10-item TENDINS-A determined it has construct validity and excellent reliability, compared with the VISA-A and FAOS which lack content and construct validity. The TENDINS-A is recommended as the preferred patient-reported outcome measure to assess disability in people with Achilles tendinopathy.

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Section: Discussionmentioning

confidence: 64%

Section: Methodsmentioning

confidence: 99%

TENDINopathy Severity assessment–Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations

Murphy,

McCleary,

Hince

et al. 2024

Br J Sports Med

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“…A previous study confirmed a 93% agreement between patient-reported AT with the assistance of the pain map and a physician-established diagnosis. 21 Moreover, 82% of the subcategories of AT (insertional/midportion) reported by patients coincided with their diagnosis by the physician. 21 This increases the likelihood that self-reported AT is consistent with the clinical diagnosis of AT in the vast majority of cases.…”

Section: Discussionmentioning

confidence: 91%

“… 21 Moreover, 82% of the subcategories of AT (insertional/midportion) reported by patients coincided with their diagnosis by the physician. 21 This increases the likelihood that self-reported AT is consistent with the clinical diagnosis of AT in the vast majority of cases. Finally, the training-load data from the baseline questionnaire might be imprecise due to recall bias, and no training-load data was collected during follow-up.…”

Section: Discussionmentioning

confidence: 91%

“…A recent publication showed that the agreement between patient-reported pain on a pain map and clinical diagnosis by a physician is almost perfect. 21 If a participant selected both the insertional and midportion part of Achilles tendon, this was regarded as a combined type of AT. If the participant selected a different location on the Achilles tendon pain map at different follow-up time-points, the first chosen AT subtype was used for further evaluation.…”

Section: Methodsmentioning

confidence: 99%

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